Trust, Information and Vaccine Aonfidence in Crisis Settings: A Scoping Review.

Background: In humanitarian crises, reliable and accurate information about health, security and humanitarian aid can be a tool for survival. At the same time, existing social structures and information systems are often disrupted, leading to uncertainty and challenges in interpreting information, including information that may guide individual public health decisions, particularly as part of vaccination programmes. This study aims to systematically explore the existing literature on these dynamics. Methods: A scoping review was conducted using the key themes: misinformation, infodemic, vaccine confidence and trust with relevant synonyms and subheadings included to build the search strategy. Initial searching was conducted through MEDLINE (Ovid), Embase (Ovid), Global Health (Ovid), PsycINFO (Ovid), Web of Science and SCOPUS, and through hand searching reference lists. Articles were screened and data extracted using Covidence software. A content analysis was used to elucidate common and overlapping themes. Findings: Forty-one studies from 14 country contexts as well as 4 from regional and global analyses met the inclusion criteria. The themes identified were (1) the drivers of mistrust, (2) the complexity of misinformation and vaccine confidence and (3) equity and programming with communities. Conclusion: The scoping review concluded that trust is essential for vaccine confidence in crisis contexts, and intentionally cultivating trust means engaging with historical injustices, politics, power dynamics and information. Vaccine equity, culturally sensitive communication strategies and ensuring interventions are community-driven should also be central to vaccine programming. Critical knowledge gaps remain about the interplay of trust, information and vaccine confidence in crisis settings and the best strategies that should be adopted to support humanitarian response.