The Vaccine Trust Framework

The Vaccine Trust Framework

Read more: www.thevaccinetrustproject.com

THE

VACCINE

TRUST

FRAMEWORK

Our analysis highlights that trust broadly operates at two levels in the healthcare space: trust in the promises inherent in the social contract surrounding health and the delivery of that contract

T RU S T I N T H E

Promise

of the social contract

T RU S T I N T H E

Delivery

Of the social contract

Belief that the health system will uphold the social contract. This implied contract includes an emotional certainty in the goodwill and shared values of the systems surrounding health.

Belief that the health system is accessible, safe, and effective.

This trust relies on a cognitive understanding of the system’s competence, generally linked with past experiences.

Considerations which determine trust level:

Does the health system have my best interests at heart?

Do I believe that the vaccine has value for me?

Considerations which determine trust level:

Does the health system generally work for me?

Do I believe the vaccine is available & accessible to me?

2

THE

VACCINE

TRUST

FRAMEWORK

Each type of trust is linked with different types of health decisions – with the promise more closely linked with the social aspects of health decisions, while trust in the process is linked the the practicalities of health

Trust in the promise drives desire to act

Tied to individual and collective life objectives

Trust in the delivery drives ability to succeed

Tied to the practical reality of accessing healthcare

All health decisions impact people’s lives, and most have profound social implications. These implications are especially relevant when a vaccine touches deeply-held cultural priorities (e.g. fertility), or has the potential to impact others (e.g. the decision to vaccinate).

Healthcare decisions are also of course guided by people’s understanding of the basic mechanisms of health, e.g. how diseases are caused, managed or cured. This includes people’s understanding of how the health systems they interact with manage treatment and prevention efforts, and prioritize different populations.

Harryson (50, Nairobi), got vaccinated as a way to attract customers to his safari tour business…

… But he still felt the need to do extensive research to feel certain that the side-effects were not too harmful

3

THE

VACCINE

TRUST

FRAMEWORK

The four types of trust can be understood in isolation and through their relationships with each other— we call these quadrants and the relationships between them The Vaccine Trust Framework T RU S T I N T H E …

Health system promise Does the health system have my and my community’s best interests at heart?

Vaccine promise Do I believe that this vaccine has value for me and my community?

A U T O N O M Y F A I R N E S S P R I O R I T Y

B E N E F I T A L I G N M E N T

A C C E S S

R E L E VA N C E S A F E T Y

Healthcare delivery

Vaccine delivery

Does the health system generally work for me and my community?

Each trust quadrant compounds multiple trust dimensions that in combination make up the quadrant. To read more about the trust dimensions, see the Insights Report on HPV from Kenya and Pakistan.

Do I feel this vaccine is available and accessible to me and my community?

C A P A B I L I T Y A F F O R D A B I L I T Y C O M P E T E N C E

A D E Q U A C Y

O F

C O M P A S S I O N

D E L I V E RY

S E T T I N G

I N F O

C O N F I D E N T I A L I T Y

A G E N C Y

4

THE

VACCINE

TRUST

FRAMEWORK

The four types of trust can be understood in isolation and through their relationships with each other— we call these quadrants and the relationships between them The Vaccine Trust Framework

In isolation, each quadrant can help explain vaccine uptake, and identify where to target trust-building efforts to ensure vaccine uptake…

… and combined, the four trust types form a holistic understanding of trust that can more robustly help predict and understand vaccine behavior

Zooming in one type of trust in isolation can provide a deep understanding of the barriers to vaccine uptake and where to target trust efforts.

Looking at the four trust quadrants combined provides a robust understanding of trust that can help predict vaccine uptake – and shed light on the quadrants' interaction 5

THE

VACCINE

TRUST

FRAMEWORK

The Vaccine Trust Framework offers a picture of the trust landscape at a specific time—over time, it gives insights into the dynamic interactions among the four trust quadrants EXAMPLE:

MANDATED

YEAR 1 Health system promise

Healthcare delivery

VACCINES

YEAR 3

Vaccine promise

Vaccine delivery

A vaccine is pushed through despite low vaccine trust e.g., by mandate…

Health system promise

Healthcare delivery

YEAR 5

Vaccine promise

Vaccine delivery

… which decreases the trust in the health system over time…

Health system promise

Healthcare delivery

Vaccine promise

Vaccine delivery

… creating even lower trust levels for future vaccines

This is a key component of the Vaccine Trust Framework within low-trust contexts:

Every vaccine has a trust impact – positive or negative – which eventually impacts trust in the overall health system 6