Polarized Trust and Vaccine Confidence in Korea during the COVID-19 Pandemic

• In Event: Trust Us? How Public Perceptions and Trust Impact Support for Health Policies

Abstract

How and why does trust in government erode and what are the consequences for compliance with public health measures? High degrees of trust and social solidarity among the population are frequently evoked as an explanation for success at bringing the pandemic under control. Especially, during the COVID-19 pandemic, US health policymakers faced declining public trust in health authorities, followed by the public’s polarized reactions to evidence-based health recommendations amid the high level of uncertainty and controversies over the risk of COVID-19 and the safety of vaccines. Recent study findings suggest that people’s attitudes toward vaccines and health behaviors tend to be polarized when their trust in health authorities declines. Moreover, while there is an extensive literature in the US on partisan reactions to public health recommendations, little is known how the public’s attitudes and behaviors are also divided along with partisan lines in other countries.
The Republic of Korea (ROK) emerged as among the most successful country in ensuring compliance with public health measures during the pandemic, even while using less coercive measures, and has achieved high vaccine uptake. However, the country went through a change in the political leadership in the administration through the presidential election in the middle of the COVID-19 pandemic in March 2022. In this election, Candidate Yoon Seok-Yeol from the Conservative Party was elected, succeeding former President Moon Jae-In of the Democratic Party. Although the new President received a relatively high approval rate (about 50% of the population supporting him) at the beginning of his inauguration, the rate soon plummeted to below 30% within five months as a result of several major political controversies and the President’s mistakes. Furthermore, the Korea Disease Control and Prevention Agency (KCDA) also faced political controversy, e.g., the new director held potentially conflicting stocks which was related to the first Korean vaccine. Would the public’s trust in the President and the KDCA decrease Would trust the President and the KDCA decline and become polarized during this period of political ferment in the ROK? Would the decline or the polarization of trust be associated with the public’s confidence in vaccines against COVID-19 and health-protective behaviors as the literature suggests?
This study explores these issues in greater depth and in the context of recent political developments in the ROK that have contributed to heightened political polarization. Using data from four rounds of a repeat cross-section survey that collected 6,000 responses from the Korean public collected between May and November 2022, we find that trust in the KDCA has substantially reduced and polarized since a contentious election that brought Conservative Party candidate Yoon Seok-Yeol to power. This decline in trust in the KDCA is mirrored by declining vaccine confidence. More specifically, the majority of Liberals (70%) answered that they trusted the President, while only 30% of Conservatives answered so before the inauguration. But, the percentages were flipped after the inauguration: 29% of Liberals and 62% of conservatives trusted the President. During this period, we find a significant decline in trust in the KDCA, by nearly 20 percentage points, and the willingness to vaccinate and vaccine confidence only among political Liberals. Compared to Wave 2, which was fielded within two months of the inauguration, the likelihood dropped by 8 percentage points in the willingness to get an additional dose, by 11 percentage points in the perceived effectiveness, and by 14 percentage points in the perceived social benefits. Trust in the KDCA continuously remained the strongest predictor of vaccine acceptance and confidence in the study period. In sum, while the ROK had a different circumstance where public support for the President was sharply declining in both partisan groups than the US, there were very similar declining patterns observed in trust in the major health authority and people’s vaccine confidence.
We discuss the implications of the analysis for understanding the polarization of health beliefs and behaviors and how trust is built and can be eroded in even a short period of time. This analysis challenges the notion that a nation’s ‘political culture’ is relatively fixed and that we can neatly divide societies into high- and low-trust as proponentsof strong culturalist arguments tend to suggest. Ultimately, this study suggests that government health authorities, which are presumed to be inoculated from politics, are not free from political controversies. Therefore, they should consider the political and health consequences of their actions and the public’s view of them and need to develop strategies to effectively respond to political controversies around them to maintain their capabilities and minimize policy failure.

Authors

• Yongjin Choi, London School of Hygiene and Tropical Medicine

• Ashley M Fox, SUNY at Albany