Nathaniel J Maxey, Jemar R Bather, Taliyah S Griffin, Plamena P Powla, Felix M Pabon-Rodriguez
Distrust in federal statistical agencies was associated with lower COVID-19 and influenza vaccine uptake, highlighting the importance of institutional trust in vaccination behavior. Unlike prior studies focused on trust in healthcare systems or government broadly, this study specifically identifies trust in federal statistical agencies as a factor associated with vaccine decision-making. Future longitudinal and mixed-methods research should examine how institutional trust develops over time and whether communication and transparency-focused interventions can improve vaccine uptake and public confidence in health information.
BACKGROUND: In the United States (US), COVID-19 vaccination saved 3.2 million lives from 2020 to 2023, yet vaccine uptake remains a public health challenge. Seasonal influenza vaccination also remains an important public health priority because influenza contributes substantially to preventable morbidity and mortality each year. Examining the administration of COVID-19 and influenza vaccines provides an opportunity to understand the factors influencing vaccine uptake.
METHODS: Repeated cross-sectional data were obtained from the Household Pulse Survey. COVID-19 and influenza vaccine uptake were based on self-reported vaccination status since August 2024. Independent variables of interest were (1) trust in federal statistics, (2) confidence in the US Census Bureau, and (3) confidence in US statistical agencies. Weighted logistic regression quantified the association between trust measures and non-vaccine uptake, adjusting for sociodemographic factors.
RESULTS: Compared to those who trusted federal statistics, individuals who did not trust federal statistics had significantly higher odds of COVID-19 non-vaccine uptake (adjusted odds ratio [aOR]: 2.61, 95% CI: 2.05-3.32) and influenza non-vaccine uptake (aOR: 1.87, 95% CI: 1.58-2.21). Similarly, individuals with very little confidence in the U.S. Census Bureau (COVID-19: aOR: 2.16, 95% CI: 1.16-4.02; influenza: aOR: 2.67, 95% CI: 1.74-4.10) or U.S. statistical agencies (COVID-19: aOR: 2.28, 95% CI: 1.52-3.43; influenza: aOR: 1.86, 95% CI: 1.35-2.57) exhibited a greater likelihood of non-vaccine uptake.
CONCLUSION: Distrust in federal statistical agencies was associated with lower COVID-19 and influenza vaccine uptake, highlighting the importance of institutional trust in vaccination behavior. Unlike prior studies focused on trust in healthcare systems or government broadly, this study specifically identifies trust in federal statistical agencies as a factor associated with vaccine decision-making. Future longitudinal and mixed-methods research should examine how institutional trust develops over time and whether communication and transparency-focused interventions can improve vaccine uptake and public confidence in health information.