Keyword: Vaccine Communication

ABSTRACT: Effective vaccine communication has become a defining challenge of global health emergency preparedness, as scientific advances in vaccine development have not been accompanied by comparable gains in public trust. Experiences from recent outbreaks, particularly Ebola, COVID-19, and mpox, demonstrate that vaccine availability alone is insufficient to achieve high vaccine uptake when communication is inconsistent, misinformation proliferates, and public confidence in health institutions is weakened. This narrative review critically synthesizes current evidence to examine the determinants of public trust, evaluate the strengths and limitations of existing vaccine communication strategies, and identify priorities for future research and policy. The review highlights five interconnected determinants of effective vaccine communication: institutional transparency, evidence-based messaging, trusted community partnerships, digital information monitoring, and continuous communication adaptation. It further identifies persistent challenges, including reactive communication approaches, political polarization, inequitable access to trustworthy information, and the growing influence of artificial intelligence-driven misinformation. Current evidence is also limited by the predominance of cross-sectional studies, underrepresentation of low- and middle-income countries, and insufficient evaluation of long-term trust-building interventions. To address these challenges, we propose the Adaptive Vaccine Trust Communication (AVTC) Framework, which conceptualizes vaccine communication as a continuous adaptive process rather than a one-way transfer of information. By integrating institutional transparency, evidence-based messaging, trusted community partnerships, digital information monitoring, and continuous feedback, the framework provides a practical roadmap for strengthening public trust, improving vaccine confidence, and enhancing preparedness for future global health emergencies.