Infectious Disease
Trust in health system for COVID-19 vaccine information among unvaccinated US adults: Association between trust in other entities and trust in healthcare providers Victor Puac-Polanco* Victor Puac-Polanco Puac-Polanco SUNY Downstate Health Sciences University School of Public Health
Rising hesitancy toward vaccinations, especially COVID-19 vaccines, is influenced by trust. However, understanding how trust in other entities affects people’s health decisions remains limited. To address this gap, we assessed whether trust in other health entities and sex and racial concordance were associated with trust in a personal doctor or healthcare provider to provide COVID-19 vaccine information among unvaccinated individuals. We conducted a cross-sectional analysis using public data from the Urban Institute’s 2021 Health Reform Monitoring Survey. The outcome was trust in a personal doctor or health care provider as the source of information for the COVID-19 vaccine. The independent factors included trust in pharmacists, religious leaders, local elected officials, social services, and family and friends, and sex and racial concordance. Associations were examined using multinomial logistic regression models to estimate relative risk ratios (RRR) with 95% CIs, adjusting for sociodemographic factors. Analyses used post-stratification weights. Unvaccinated individuals were younger (mean age 38.6 vs. 44.1 years, p<0.0001), with the highest non-vaccination rates among those aged 18–24 (17.9%) and 25–34 (26.0%). Hispanic and Black non-Hispanic adults were more likely to be unvaccinated than white non-Hispanic individuals (p=0.0001). Adjusted models showed that distrust in elected officials significantly increased the likelihood of neither trust nor distrust (RRR 2.56, 95% CI 1.67-3.94) and of distrust (RRR 4.71, 95% CI 1.92-11.43) in a personal doctor or health care provider. Distrust in social services, family/friends, also increased the likelihood of neither trust nor distrust and of distrust in a personal doctor or health care provider. Gender and racial concordance showed no consistent associations. Partnering with local officials, social services, and family/friends may help address distrust in personal doctors and healthcare providers among the unvaccinated.
