Association among trust in health care providers, friends, and family, and vaccine hesitancy

Abstract

A health care provider's vaccination recommendation is one of the most important factors influencing parents' decisions about whether to vaccinate their children. Unfortunately, vaccine hesitancy is associated with mistrust of health care providers and the medical system. We conducted a survey of 2440 adults through the RAND American Life Panel in 2019. Respondents were asked to rate their trust in pediatricians, OB/GYNs, doulas, midwives, lactation consultants, friends and family for information about childhood vaccines. Respondents were also asked about willingness to vaccinate a hypothetical child as a measure of vaccine hesitancy. We used principal component analysis to characterize variance in responses on trust items and logistic regression to model the relationship between trust and vaccine hesitancy. Vaccine hesitancy was associated with: (1) lower overall trust; (2) reduced trust in OB/GYNs and pediatricians and greater trust in doulas, midwives, and lactation consultants; and (3) greater trust in friends and family.

Figure 1

Proportion of vaccine hesitant and non-vaccine hesitant respondents reporting each group as their most or least trusted source of information about childhood vaccines, based on ranked trust scores reported by each individual. Error bars show the estimated 95% confidence interval for each reported proportion. P-values are shown for differences in proportions calculated for the Vaccine Hesitant and Not Vaccine Hesitant groups. *** indicates a p-value <0.001.

Figure 2:

Loadings on the first three principal components from the PCA analysis of seven trust items from our survey.