Vaccine hesitancy and trust in sub-Saharan Africa.

Lack of trust is a primary reason behind the global rise in vaccine hesitancy. Existing research on the trust-vaccine hesitancy nexus has almost exclusively focused on COVID-19 with the vast majority of studies examining industrialized countries. In this study, we investigated the influence of trust in different policy-relevant actors (government, science, media, pharmaceutical companies, society) on vaccine hesitancy for recently available vaccines related to polio and HPV which we benchmark against a COVID-19 vaccine. Leveraging unique primary data on 5203 individuals from six countries (Ghana, Kenya, Nigeria, South Africa, Tanzania, and Uganda), we showed that individuals' trust in the government and society are key predictors of vaccine hesitancy. Furthermore, we demonstrated that these relationships are remarkably stable across vaccine, disease, and country contexts.

Who shares fake news on social media? Evidence from vaccines and infertility claims in sub-Saharan Africa.

The widespread dissemination of misinformation on social media is a serious threat to global health. To a large extent, it is still unclear who actually shares health-related misinformation deliberately and accidentally. We conducted a large-scale online survey among 5,307 Facebook users in six sub-Saharan African countries, in which we collected information on sharing of fake news and truth discernment. We estimate the magnitude and determinants of deliberate and accidental sharing of misinformation related to three vaccines (HPV, polio, and COVID-19). In an OLS framework we relate the actual sharing of fake news to several socioeconomic characteristics (age, gender, employment status, education), social media consumption, personality factors and vaccine-related characteristics while controlling for country and vaccine-specific effects. We first show that actual sharing rates of fake news articles are substantially higher than those reported from developed countries and that most of the sharing occurs accidentally. Second, we reveal that the determinants of deliberate vs. accidental sharing differ. While deliberate sharing is related to being older and risk-loving, accidental sharing is associated with being older, male, and high levels of trust in institutions. Lastly, we demonstrate that the determinants of sharing differ by the adopted measure (intentions vs. actual sharing) which underscores the limitations of commonly used intention-based measures to derive insights about actual fake news sharing behaviour.