Who Do Malaysians Trust in a Health Crisis? New Survey Maps the Messengers Behind Vaccine Confidence

When the COVID-19 pandemic swept across the world, it carried more than a virus. It carried an unprecedented flood of information, misinformation, and contradictory advice that public health researchers came to call the infodemic. In that environment, the identity of the messenger became almost as consequential as the message itself. A new study from Malaysia, one of Southeast Asia’s most ethnically diverse nations, now offers one of the clearest portraits yet of how different communities decide which voices to believe when their health is on the line. The research, published in PLOS Global Public Health, draws on a cross-sectional online survey of 5,784 participants conducted between April and June 2021, a period when Malaysia was battling severe waves of infection and racing to roll out vaccination. The findings carry implications that stretch far beyond the pandemic, touching on how any future health emergency might be communicated in plural societies.

The research team, led by Nicholas Yee Liang Hing and colleagues, set out to answer a deceptively simple question: does the messenger make the difference? To do so, they examined perceived reliability across seven distinct sources of health information. Three were formal sources: healthcare workers, scientists, and non-governmental organisations, commonly known as NGOs. Four were informal: religious leaders, community leaders, interpersonal sources such as family and friends, and social media influencers. This seven-way taxonomy allowed the researchers to capture the full spectrum of voices competing for public attention during the crisis, from clinicians in white coats to content creators on smartphones. Malaysia provided an ideal setting for such an investigation because its population encompasses Malays, Chinese, Indians, and Indigenous groups, each with distinct cultural frameworks, historical relationships to state institutions, and patterns of media consumption.

Methodologically, the study relied on logistic regression, a statistical technique well suited to modelling binary outcomes such as whether a respondent perceives a given source as reliable or not. The researchers used this approach to identify which information sources were associated with vaccination intentions, and then went a step further by estimating adjusted predicted probabilities. These probabilities translate regression coefficients into intuitive percentages, showing, for example, the likelihood that a Malay respondent with secondary education would rate a scientist as trustworthy. Crucially, the team stratified these estimates across ethnic groups, education levels, and age brackets, revealing patterns that a single national average would have concealed. This layered analytical design is what gives the study its diagnostic power: it does not merely ask whether people trust doctors, but which people trust doctors, and under what social conditions that trust weakens.

The headline finding is striking in its consistency. Across every ethnic group surveyed, formal sources emerged as the most reliable messengers of health information. Healthcare workers and scientists commanded particularly high confidence, with predicted probabilities of being perceived as reliable reaching 80 percent or higher among most groups. In practical terms, this means that even amid a noisy and often hostile information environment, the clinical and scientific communities retained a reservoir of public trust that no other category of messenger could match. Together with community leaders, these formal sources were also identified as the main influences on vaccination intention, suggesting that trust in the messenger translated directly into willingness to accept the vaccine. For public health authorities, this is an encouraging confirmation that investment in credible, professional communication channels pays measurable dividends during a crisis.

Yet the study’s most valuable contributions lie in its exceptions and nuances. Indigenous groups in Malaysia, who on average exhibit lower educational attainment and are older than the national population, showed somewhat lower predicted probabilities of perceiving healthcare workers and scientists as reliable, at 78 percent or below. The gap is modest but meaningful, because it identifies a population in which the usual channels of official health communication may not penetrate as effectively. The researchers’ stratified analysis suggests that this reduced confidence is intertwined with structural factors rather than simple scepticism: communities with less formal education and older age profiles may have different historical experiences with institutions, different levels of health literacy, and different everyday information ecologies. Any communication strategy that treats the entire population as a homogeneous audience risks leaving precisely these groups behind.

Ethnic differences also surfaced in attitudes toward NGOs, one of the three formal sources. Chinese and Indian respondents exhibited notably higher predicted probabilities of perceiving NGOs as reliable, averaging approximately 80 percent and 75 percent respectively. Among Malays and Indigenous groups, the corresponding figures hovered lower, at roughly 65 to 70 percent. This divergence likely reflects the varied institutional landscapes of Malaysian civil society, where different organisations have different histories of engagement with particular communities. The pattern matters because NGOs often serve as intermediaries between official health authorities and hard-to-reach populations, and their effectiveness depends on being trusted in the first place. The study suggests that NGOs cannot simply be deployed as a uniform national asset; their communicative leverage is community-specific and must be mapped before it is mobilised.

Perhaps the most sociologically intriguing findings concern community leaders, an informal source whose perceived reliability behaved in unexpected ways. At the lowest education level and the youngest age group, predicted probabilities of trusting community leaders were moderate across all ethnicities, ranging from 45 to 55 percent. From that baseline, the trajectories diverged sharply by ethnicity. Among Malay and Indigenous respondents, trust in community leaders remained relatively stable across higher education levels and older age groups. Among Chinese and Indian respondents, by contrast, that trust generally declined as education and age increased. In other words, the social gradient of trust in local, informal authority runs in opposite directions for different communities. For younger, less-educated citizens of all backgrounds, community leaders occupy a middle ground of credibility, neither dismissed nor fully relied upon, which makes them potential bridges between official messaging and communities that formal institutions struggle to reach.

The study’s authors draw a clear strategic conclusion from these patterns: healthcare workers and scientists should remain central to health communication strategies, while NGOs and community leaders can play complementary roles. They describe this as a multi-messenger approach, an architecture of communication in which different trusted voices reinforce one another rather than compete. The logic is analogous to redundancy in engineering systems. If a single channel fails, whether because of scepticism, inaccessibility, or simple information overload, alternative channels with independent reservoirs of trust can carry the message through. During the pandemic, this redundancy was not a luxury but a necessity, as misinformation frequently spread faster than official corrections. A multi-messenger framework formalises what effective local health workers have long done intuitively: recruit the figures a community already trusts to amplify and legitimise scientific guidance.

The broader significance of the research extends to the design of future public health responses, whether for pandemics, vaccination campaigns, or environmental health threats. Malaysia’s experience demonstrates that perceived reliability is not a fixed national attribute but a mosaic that varies by ethnicity, education, and age. Communication strategies calibrated to the median citizen will systematically underserve the tails of the distribution, and those tails, as the lower confidence among Indigenous respondents shows, often correspond to populations with the greatest health vulnerabilities. The study also offers a methodological template: by measuring trust in specific messenger categories and modelling it with adjusted predicted probabilities, public health agencies can diagnose where their communication networks are strong and where they are brittle before the next crisis arrives.

As the world absorbs the lessons of COVID-19, the Malaysian study adds an important piece to the puzzle of health communication in diverse societies. The messenger, it turns out, does make the difference, but the difference is not uniform. Doctors and scientists anchor public trust across the board, yet the supporting cast of NGOs, community leaders, and informal voices plays a decisive role in specific communities and demographics. Building resilient health communication means understanding this social topology in detail, mapping who trusts whom, and weaving formal expertise and local credibility into a single, coordinated fabric. In an era when the next infodemic is always one headline away, that preparation may prove as vital as any vaccine.

Subject of Research: Perceived reliability of formal and informal health information sources across ethnic groups in Malaysia during the COVID-19 pandemic

Article Title: Does the messenger make the difference? Perceived reliability of health information sources during the COVID-19 pandemic in multi-ethnic Malaysia

Article References: Hing, N. Y. L., Lee, Y. K., Kim, H. J., Lothfi, N. M., Wong, E., & Costa-Font, J. (2026). Does the messenger make the difference? Perceived reliability of health information sources during the COVID-19 pandemic in multi-ethnic Malaysia. PLOS Global Public Health, 6(10), e0007397. https://doi.org/10.1371/journal.pgph.0007397

Image Credits: AI Generated

DOI: 10.1371/journal.pgph.0007397

Keywords: COVID-19, infodemic, health communication, vaccine hesitancy, Malaysia, trust, healthcare workers, scientists, NGOs, community leaders, ethnicity, public health