Mistrust in government and COVID-19 vaccination acceptance in Nigeria: investigating the indirect roles of attitudes towards vaccination.

Background: Research shows that trust in government is associated with the acceptance of COVID-19 vaccination. However, there is no empirical evidence suggesting the pathway by which this association is formed. This study examines how dimensional attitudes towards vaccination explain the relationship between mistrust in government and COVID-19 vaccination acceptance. Methods: The study was an online cross-sectional survey involving 1026 adults (of which 58.9% are female) resident in Nigeria with a mean age of 26.09 (±8.46) years. Data were collected using structured questionnaires assessing the level of mistrust in government, dimensional attitudes towards vaccination, and acceptance to be vaccinated for COVID-19. Structural equation modeling was used to analyze data. Results: Results show that 56.8% of participants mistrust the government, while COVID-19 vaccination acceptance rate was 28.2%. Mistrust in government was significantly associated with low acceptance of COVID-19 vaccination. Furthermore, mistrust in the government was predictive of negative attitudes towards COVID-19 vaccination which include worries about unforeseen future effects of vaccines, mistrust of vaccine benefits (MVB), concerns about commercial profiteering (CCP), and preference for natural immunity. The outcomes of indirect effect analyses indicated that mistrust in government was associated with high mistrust in vaccine benefits (MVB) and increased concerns about commercial profiteering (CCP), which in turn lead to low acceptance of COVID-19 vaccination. Conclusions: Mistrust in the government was high and was coupled with low vaccination acceptance. It is important to initiate culturally relevant awareness programs aiming at combating false notions about COVID-19 vaccination such as MVB and CCP arising from mistrust in government. [ABSTRACT FROM AUTHOR]