Document Type

Article

Abstract

This study examines whether individuals’ exposure to and trust in COVID-19 vaccine misinformation can be used to segment audiences and explain variations in vaccine hesitancy and health beliefs. Using k-means clustering, a survey of 819 U.S. college students (March–May 2021) identifies four subgroups based on combinations of high or low misinformation exposure and trust: misinformation-shielded (low exposure, low trust), misinformation-vulnerable (low exposure, high trust), misinformation-resistant (high exposure, low trust), and misinformation-accepting (high exposure, high trust). These subgroups differ significantly in political ideology, vaccine hesitancy, and health beliefs. The misinformation-shielded subgroup reports more liberal views, lower hesitancy, and higher perceived efficacy, whereas the misinformation-vulnerable and misinformation-accepting subgroups perceive lower vaccine safety. Regression analyses show that perceived vaccine efficacy and perceived vaccine safety are relatively stable predictors of vaccine hesitancy. The misinformation exposure-trust framework offers a theory-based strategy for segmenting audiences and informs more targeted health interventions.

Digital Object Identifier (DOI)

https://doi.org/10.1177/13591053261419968

Rights

© The Author(s) 2026 

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License(https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Request permissions for this article.

APA Citation

Zeng, J., Li, J., Yu, N., Cui, X., & Xiao, A. (2026). Using the misinformation exposure-trust framework for audience segmentation: Predicting COVID-19 vaccine hesitancy among U.S. College Students. Journal of Health Psychology.https://doi.org/10.1177/13591053261419968

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