Studies confirm influence of country of origin on trust in COVID-19 vaccines

During Brazil’s COVID-19 vaccination campaign, when several brands of vaccines were available and the Chinese vaccine was the most common, an unprecedented phenomenon occurred. People crossed neighborhoods or even cities in search of vaccination centers that administered a specific brand of vaccine. Photos of people getting vaccinated were posted on social media alongside proud hashtags praising the national health system, such as “Long live the SUS” (in reference to the system’s popular acronym) and labels such as “It was Pfizer,” “I got AstraZeneca,” and “I was lucky, I got Janssen.”

In Mexico, a country with a history of low vaccine hesitancy, the Russian formulation was the preferred vaccine. In both India and Iran, there was a preference for locally produced vaccines. Americans also showed a clear preference for domestic vaccines in the United States, even compared to those from countries with similar quality standards, such as the United Kingdom and Germany.

“It was a global phenomenon. For the first time, concern about the origin of immunizers was demonstrated. Before the pandemic, no one even knew where they were manufactured. There are no reports or studies on the effect of country of origin on immunizers, a concept already well documented in marketing that refers to the impact that a product’s origin has on consumer decisions and evaluations,” says João Lucas Hana Frade, Ph.D. in Organizational Administration from the Ribeirão Preto School of Economics, Business, and Accounting at the University of São Paulo (FEA-RP-USP).

Frade conducted a review study supported by FAPESP that analyzed 52 published works on the topic of vaccines in 48 countries. “The curious thing is that after the pandemic, the phenomenon was no longer reported. Nevertheless, it’s important to understand these preferences in order to formulate effective public policies, investigating the role of politicians, the media, and influential figures in endorsing vaccines,” he says. 

A country or a product?

The country of origin effect is often observed in expensive or status-related products, such as wine and cars. Vaccines, on the other hand, are generally free and are produced to protect society as a whole, not just those who receive them.

“When consumers don’t have sufficient technical knowledge to choose a product, they choose to use characteristics of the country of origin to infer the quality of the product. This makes a German car appealing, not exactly because of its engine power or safety, but because it corresponds to the quality standards and status of the country’s products. Apparently, the way vaccines were publicized generated similar insecurities, which led to the country of origin effect in vaccination campaigns,” explains Janaina de Moura Engracia Giraldi, a professor at FEA-RP-USP and advisor for the study published in Management Review Quarterly.  

As a result, vaccines from countries such as the United States, the United Kingdom, Russia, and China began to be judged based on their origin, raising concerns about quality. “The phenomenon transcended public health, also involving aspects of marketing and psychology, driven by anti-vaccine activism,” says the professor.

In the study, the researchers identified similar patterns in different countries, such as people’s preference for domestic vaccines (developed in their own countries). “National bias even appeared in countries that didn’t develop vaccines in the early stages of the pandemic, such as Brazil, Japan, and Ghana,” says Frade. There was also a clear preference for Western vaccines, especially those developed in Germany, the US, and the UK, over Russian or Chinese options. This was observed in several regions, including Europe, Latin America, the Middle East, and Asia.

“With the COVID-19 pandemic, the origin of immunizers became a crucial factor in vaccine acceptance. Although there have been previous studies on the effect of country of origin on medicines, they didn’t predict the complex relationship between country of origin and vaccine hesitancy observed in the pandemic context,” says the researcher.

Based on the results, the researchers argue that the country of origin effect should be considered in future pandemic vaccination campaigns. “Understanding the country of origin effect is essential for effective health communications. In addition, vaccine manufacturers can strategically emphasize or downplay their country of origin, depending on the perceived benefits or risks associated with it,” says Frade.

About São Paulo Research Foundation (FAPESP)
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