Communication Actions, Vaccine Conspiracy, and Situational Differences in Vaccine Recommendation

The importance of examining human papillomavirus (HPV) vaccine-related conspiratorial thinking and its effects has become more prominent amid the global increase in anti-vaccine activism. However, little is known about how conspiratorial thinking shapes vaccine-related outcomes and how these processes vary across sociocultural contexts. Using survey data from China (N = 619) and the United States (N = 600), this study distinguishes between conspiracy orientation and conspiracy attribution in the context of the HPV vaccine. We propose a serial mediation model involving active communication behaviors (ACBs) that explain how conspiratorial thinking leads to vaccine-related outcomes. Results showed that conspiracy attribution and ACBs sequentially mediated the negative relationship between vaccine conspiracy orientation and HPV vaccination recommendation among Chinese active-vulnerable publics, whereas the opposite pattern emerged among their U.S. counterparts. These cross-national differences emphasize the contextual nature of communication behaviors when publics are engaged in a quasi-problem-solving process. The findings offer both theoretical insights into conspiratorial information processing and practical implications for developing more tailored counter-conspiracy communication strategies.