Institutional Trust and Public Health Communication

Transparent communication about development timelines, testing standards, and risk-benefit profiles is essential to counter hesitancy stemming from emergency authorisations. In low- and middle-income settings, the effect of trust and communication on vaccine acceptance is heightened compared to higher-income settings. Institutional trust in health authorities and government directly influenced vaccine attitudes. Participants viewed data transparency as important for vaccine trust and uptake. Poor institutional communication was identified as a driver of declining COVID-19 booster uptake. Distrust in authorities was one of the key demotivators for COVID-19 vaccination. Lack of proactive sharing of vaccine data increased scepticism toward booster recommendations. Communication about vaccination did not reliably reach non-desk workers such as porters and HCAs. One participant described the vaccination drive as potentially 'scripted,' reflecting deep institutional distrust. Questions about vaccine efficacy or further doses were sometimes treated as anti-vaccine, which reduced open dialogue. Doctors were among the most frequently cited motivators for vaccination, making them key interm…