How does uncertainty matter to risk communication in the age of COVID- 19? : social amplification on uncertainty-characterised health-related risk

Abstract

Uncertainty in health-related risk communication is often downplayed for fear of inciting panic, discouraging protective behaviour, and undermining public trust in authorities. However, novel diseases like COVID-19 have challenged experts and governments to provide accurate and consistent protective recommendations. Consequently, these uncertainties and the authority's efforts to minimise uncertainty have been exposed and amplified by the over-saturated media environment, excessively politicalised context, and distrustful public, resulting in counterproductive effects and culminating in public scepticism. Previous research indicated that not only the effects of communicating uncertainty remain inconsistent, but it is also inadequate theorisation in response to the complex interplays between individuals and environmental factors in examining the impact of conveying uncertainty in risk communication. Therefore, the present thesis aims to use three studies through the examples of COVID-19 and COVID-19 vaccine hesitancy to investigate how contextual socio- political factors and the media environment socially amplified uncertainty-characterised health-related risk. It also explores improved methods of communicating uncertainty associated with vaccines. The first study utilised a comparative approach to evaluating how Hong Kong, Macau, and Taiwan governments responded to COVID-19 at the onset of the outbreak when its characteristics were highly uncertain. The three governments’ news releases were analysed to examine the administration’s public communication of the uncertain situation and recommendations on preventive measures. The results demonstrated that their responses varied and were associated with governance style, public trust, and connection with the Chinese government, exacerbating pre-existing socio-political issues. Diverse uncertainties surrounding COVID-19 vaccines have interplayed with socio- political factors, causing a worldwide prevalence of socio-politicised vaccine hesitancy. The second study, guided by grounded theory and purposive sampling, used in-depth qualitative interviews with 21 respondents from varying backgrounds to investigate how uncertainty-featured COVID-19 vaccines and socio-political context shaped people’s vaccine-related beliefs and behaviours. A theoretical framework derived from three emerged themes revealed how individuals’ health-related and societal concerns, political reasons, and information-gathering efforts interacted to contextualise vaccine hesitancy, demonstrated how political polarisation steered vaccination norms (e.g., vaccination decisions, collective vaccination) away from prioritising health concerns, and serves as a robust tool in addressing vaccine hesitancy. The third study demonstrated an explorational online experiment (n=189) on MTurk to investigate the effects of communicating different types of uncertainty associated with

vaccine protection and side effects on people’s attitudes toward vaccines. The findings indicated that regarding the vaccine’s side effects, individuals were more willing to accept unknowability than uncertainty caused by science. Despite a lack of statistically significant results, this is one of the first exploratory experiments to investigate how to communicate uncertainties in vaccines and provide valuable insights into uncertainty typology and developing promotional messages. This study advances both uncertainty research and vaccine communication. The results of this thesis can contribute to risk communication and uncertainty research. The three studies conceptualised how the interaction between uncertainty in health-related risk and surrounding social-political factors affects the effectiveness of risk communication in the context of COVID-19 and COVID-19 vaccines. The findings also provide valuable insights for assessing context-specific vaccine hesitancy and communicating uncertainties in future vaccine communication. (Word count: 499)