Knowing the process as a pathway to trusting the outcome: System awareness and resistance to vaccine conspiracy theories

Medical conspiracy beliefs are a major barrier to vaccine uptake. These beliefs often reflect a deep mistrust of institutions and are resistant to correction via traditional information-based approaches. We propose that one underexplored factor—system awareness, or objective knowledge about the procedures and safeguards involved in the development and regulation of pharmaceuticals—may help counteract conspiracy beliefs. We developed and validated a novel 9-item measure of system awareness, the Development and Regulation of Pharmaceuticals Scale (DRoPs), and administered it to a U.S. sample ( N = 411) via a two-wave online survey. Participants also completed measures of conspiracy beliefs, health literacy, science knowledge, cognitive reflection, political ideology, and vaccination intentions. The DRoPs scale demonstrated a unidimensional structure with acceptable reliability and construct validity. Hierarchical regression models showed that DRoPs scores were negatively associated with medical and vaccine-specific conspiracy beliefs, above and beyond known predictors such as political orientation, generic conspiracy beliefs, health literacy, and science knowledge. While causality cannot be inferred from this design, these results lay a conceptual and empirical foundation from which future interventions might be developed. Equipping individuals with knowledge of regulatory safeguards may prove to be a promising complement to existing health communication strategies, particularly for audiences wary of institutional trust appeals.