Modeling the role of institutional trust to improve vaccine confidence: The New Zealand case

Abstract

This study explores how institutional trust influences vaccine confidence during public health crises, using New Zealand’s COVID-19 response as a high-trust case study. Applying the Stakeholder Relationship Management (SRM) framework, the research investigates how demographic, value-based, health, institutional, and informational factors shape vaccine attitudes across varying levels of institutional trust. Results demonstrate that institutional trust is a critical predictor of both vaccine confidence and skepticism, with trust in science and reliance on official sources driving confidence, and social media reliance correlating with skepticism. Segmenting participants by trust levels revealed distinct patterns, highlighting the importance of tailoring communication strategies to trust-based subgroups. The findings reposition vaccine hesitancy as a crisis and risk communication challenge—rooted not solely in individual traits but in institutional relationships and the complex information environment. The study advocates for integrating strategic communication principles into public health risk communication, emphasizing long-term trust-building, credibility, and message alignment across platforms. This research offers a model for cross-contextual testing and underscores the need for governments and health authorities to engage low-trust communities more effectively, particularly through strategic use of social media during health emergencies.