ORIGINAL RESEARCH article
Front. Commun.
Sec. Health Communication
When Knowledge Fades but Loyalty Persists: Examining the Contextual Dynamics of Media Effects on Vaccination Intentions in China
Provisionally accepted
- 1Soochow University, Suzhou, China
- 2Hong Kong Baptist University, Hong Kong, Hong Kong, SAR China
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Media exposure shapes health behaviors both directly and through cognitive-and affective/attitudinal-oriented mediators. However, how different types of mediating route's function and how evolving environments affect these mediators remains understudied. Drawing on three national survey waves fielded at distinct stages of China's COVID-19 response (April 2021 vaccine rollout; April 2022 zero-COVID debate; January 2023 post-lockdown), this study compares the mediating roles of biomedical knowledge, perceived risk, trust in scientists, and nationalism in linking media use to vaccination intentions. Across phases, affective/attitudinal pathways— especially nationalism, and trust in scientists except during the period of expert discord—were the most stable and consequential mediators. By contrast, cognitive pathways were weaker and context-dependent. These shifts track changes in vaccine novelty, policy coherence, and the intensity of state mobilization, suggesting that strong mobilization and conflicting expert cues can dampen cognitively demanding routes while amplifying identity-and authority-based heuristics. The findings underscore that evolving sociopolitical contexts reshape how media influence health behaviors and point to culturally informed, context-sensitive strategies that balance appeals to collective identity with clear, credible information.
Keywords: media exposure, Vaccination willingness, cognitive-oriented mediators, affective/attitudinal-oriented mediators, Zero-COVID
Received: 18 Sep 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Zhang, Jia, Wu, Chen and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hepeng Jia
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