Conspiracy theories are central to the complex system of predictors of Italian vaccine hesitancy

Abstract

Although COVID-19 vaccines have long been widely available, their uptake has remained constrained by vaccine hesitancy. Research on this phenomenon has identified more than 50 determinants, but it has largely relied on reductionist approaches that examine the pairwise association between hesitancy and individual predictors. As a result, we know much more about which variables correlate with hesitancy than about how these factors are organized within a broader belief system. This article addresses this gap by adopting a network approach that reconstructs vaccine hesitancy as embedded in a wider configuration of attitudes, dispositions, and sociodemographic characteristics. Using Italian survey data, I estimate the network of these determinants in a country where hesitancy has been comparatively widespread. This approach highlights that vaccine hesitancy emerges from a highly connected system rather than from isolated factors alone. Within this system, conspiracy endorsement stands out as a central structuring element, being directly linked to most of the variables included in the analysis. The network approach also isolates a more limited set of factors that remain directly associated with hesitancy net of all other variables in the system, thereby moving beyond long inventories of correlates and pointing to a narrower set of targets for public intervention.