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From Vaccine Skepticism to Institutional Distrust: The Post-Pandemic Shift
Francesco De Maria1, Francesco Branda2, Giancarlo Ceccarelli3
1Infectious and Tropical Diseases Unit, "Renato Dulbecco" Teaching Hospital of Catanzaro, 88100 Catanzaro, Italy.
Vaccines
|July 27, 2026
Summary
Vaccine hesitancy has shifted from individual beliefs to institutional distrust post-COVID-19. Rebuilding vaccine confidence requires focusing on institutional credibility and transparency, not just information campaigns.
Area of Science:
- Public Health
- Sociology of Science
- Health Communication
Background:
- Vaccine hesitancy traditionally linked to individual factors.
- COVID-19 pandemic highlighted evolving citizen-institution relationships.
- Investigating if vaccine hesitancy reflects broader institutional distrust.
Purpose of the Study:
- Synthesize evidence on vaccine confidence and trust dynamics.
- Propose a new framework: institutional hesitancy.
- Reframe vaccine acceptance within institutional credibility and legitimacy.
Main Methods:
- Narrative synthesis of literature (2015-2026).
- Included peer-reviewed articles, surveillance reports, and surveys.
- Focused on trust in science, government, and health agencies as vaccination determinants.
Main Results:
- Institutional trust strongly predicts vaccine acceptance, exceeding demographics and knowledge.
- Pandemic amplified institutional skepticism beyond COVID-19 vaccines.
- Information-based approaches are insufficient when trust is low.
Conclusions:
- Post-pandemic era demands reconceptualizing vaccine hesitancy.
- Institutional hesitancy framework shifts focus to citizen-institution dynamics.
- Restoring trust requires long-term strategies beyond communication campaigns.
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