Gauging Public Trust in COVID-19 Vaccines

Hesitancy is a hurdle we have been struggling with in general when it comes to vaccines, but even more so when it comes to COVID-19. Throw politicization and the nuances of EUA into this mix, and it’s not surprising we’re having to work exceedingly hard to expand vaccine uptake.

When we talk about the COVID-19 pandemic, it’s hard to escape the politicization that has occurred. From response to vaccines and even the most basic intervention—masks—there has been an unprecedented amount of political affiliation with public health measures. In the early fall of 2020 and prior to Emergency Use Authorization (EUA) approval, President Trump had begun pushing for vaccine deployment before the election. This sparked discussion around the existing politicization, but also the impact to vaccine attitudes that were already challenging within the United States.

Hesitancy is a hurdle we’ve been struggling with in general when it comes to vaccines, but even more so when it comes to COVID-19. Throw politicization and the nuances of EUA into this mix, and it’s not surprising we’re having to work exceedingly hard to expand vaccine uptake. The Centers for Disease Control and Prevention (CDC) reports that currently, 40% of the U.S. is fully vaccinated, with 51% of the adult population vaccinated.

To assess the trust and willingness of people in the United States to the COVID-19 vaccine, a team of researchers surveyed 7420 participants from October 14, 2020 to March 29, 2021. Published in JAMA Network, this study studied changes in hesitancy and trust in the COVID-19 over a period of time. The team utilized seven waves of probability-based Understanding America Study among American adults, which surveys people online through questions every two to four weeks. Throughout this period, participants were asked how likely they were to get vaccinated and how much they trusted the federal approval process for safe vaccine development.

The authors reported that from the 42,153 survey responses they analyzed, “Estimates of vaccine hesitancy declined significantly by 10.8 percentage points (95% CI, 8.9-12.7), from 46% in October 2020 to 35.2% in March 2021. Significant declines in estimates of hesitancy were observed across demographic groups and were largest among Hispanic (15.8 percentage point decrease, from 52.3% to 36.5%) and Black participants (20.9 percentage point decrease, from 63.9% to 43%). In March 2021 hesitancy was high among adults aged 18-39 years (44.1%), those without a degree (42.9%), and households earning $50 000 or less (43.7%).” Overall, trust in vaccination was low across all demographic groups in October 2020, but did significantly grow by March 2021. The researchers noted that the most significant increases in public vaccination trust was among Black and Hispanic participants, as well as those with a college degree, in the survey.

Those increase in vaccination trust and decline in hesitancy corresponds with EUA approval and the initiation of vaccination and education programs. As the authors emphasized, “A significant decline in vaccine hesitancy was reported across all demographic groups, especially Black and Hispanic participants. This decrease is important because COVID-19 vaccine acceptance has been particularly low among these groups, who have experienced a disproportionate burden of severe illness and death because of COVID-19.” While this progress is good, there is still much work to be done as the U.S. works to vaccinate a significant portion of the population, which will further be challenged as pediatric vaccines are rolled out. Now more than ever, work to ensure equity in distribution, but also education and science communication to help address existing hesitancy.