Correlates of COVID-19 conspiracy theory beliefs in Japan: A nationally-representative cross-sectional survey

Background The COVID-19 pandemic was associated with an increase in conspiracy theories worldwide. However, the prevalence of COVID-19 conspiracy beliefs among Japanese has remained unclear. This study aimed to estimate the prevalence and correlates of COVID-19 conspiracy beliefs in Japan using a nationwide survey of 28,175 residents aged 16–81 years old.

A nationally representative, cross-sectional self-administered survey was conducted from September to October 2021. To assess the number of COVID-19 conspiracy beliefs, we used three questions from the Oxford Coronavirus Explanations, Attitudes, and Narratives Survey. Independent variables included general vaccine conspiracy beliefs, sociodemographic variables, information sources for COVID-19, trust in authorities, and fear of COVID-19.

After applying sampling weights and imputation, the estimated prevalence of holding at least one COVID-19 conspiracy belief was 24.4%. From a linear regression model, several factors were independently associated with conspiracy beliefs. Notably, people with the lowest level of education (lower secondary school) endorsed fewer COVID-19 conspiracy beliefs (B -0.089, vs. upper secondary school). Furthermore, higher socioeconomic backgrounds–such as higher income, higher wealth, and regular employment–were associated with endorsing conspiracy beliefs. Additionally, only 37.3% of respondents trusted the government of Japan, but paradoxically, trust in the government was positively associated with conspiracy beliefs (B 0.175, vs. distrust).

Conspiracy beliefs about COVID-19 were prevalent in about a quarter of the Japanese population. Certain groups are more likely to endorse conspiracy beliefs, and targeting interventions towards these groups might be efficient in stemming the spread of conspiracy beliefs. Competing Interest Statement The authors have declared no competing interest. Funding Statement Yes Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics approval and consent to participate The study protocol was reviewed and approved by the Research Ethics Committee of the Osaka International Cancer Institute (approved on June 19, 2020 approval number 20084). The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All participants provided written informed consent online before responding to the questionnaire. Participants received Rakuten points as a reward, which can be used for online shopping. The exact number of points is not disclosed at the request of an internet research agency (Rakuten Insight, Inc., Tokyo, Japan). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable Data Availability Availability of data and material The data used in this study are not available in a public repository because they contain personally identifiable or potentially sensitive patient information. Based on the regulations for ethical guidelines in Japan, the Research Ethics Committee of the Osaka International Cancer Institute has imposed restrictions on the dissemination of the data collected in this study. All data enquiries should be addressed to the person responsible for data management, Dr. Takahiro Tabuchi at the following e-mail address: tabuchitak@ gmail.com