Mistrust in public health institutions is a stronger predictor of vaccine hesitancy and uptake than Trust in Trump

• Published in: Social science & medicine (1982) Vol. 314; p. 115440
• Main Authors: Choi, Yongjin, Fox, Ashley M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2022
• Subjects: Adult; COVID-19; COVID-19 - prevention & control; COVID-19 Vaccines - therapeutic use; Health communication; Humans; Partisanship; Public Health; Trust; Trust in government; Vaccination Hesitancy; COVID-19; Partisanship; Trust in government; Public health; Health communication
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2022.115440

This study examines the sources of COVID-19 vaccine hesitancy and refusal in Americans by decomposing different forms of government trust/mistrust including trust in Trump and mistrust in public health institutions. Using linear panel regression models with data from 5,446 US adults (37,761 responses) from the Understanding America Survey, the likelihoods of vaccine hesitancy, uptake, and trust in various information sources were examined. We find that the likelihoods of hesitancy and having negative perceptions of COVID-19 vaccines were consistently much higher among PHI mistrusters, showing even a stronger hesitancy than Trump trusters. This tendency has persisted over time, resulting in only 49% of PHI mistrusters having been vaccinated in the most recent survey wave. However, a large portion of PHI mistrusters still trusted physicians, family, and friends. These findings suggest that mistrust in PHIs is a salient predictor of vaccine hesitancy and reduced uptake on its own, which is compounded by trust in Trump. •Conservatives, especially Trump supporters, have had low COVID-19 vaccine uptake.•Mistrust of health institutions is also a strong predictor of vaccine hesitancy.•Trust in Trump was less predictive of hesitancy than trust in health institutions.•Physicians may still be good channels for persuading mistrusters to vaccinate.