New research from the University of Michigan examines how long-standing distrust in the U.S. healthcare system has significantly impacted attitudes toward the COVID-19 vaccine. The research is led by Celeste Watkins-Hayes, Joan and Sanford Weill Dean of Public Policy at the Ford School of Public Policy and Dom Adams-Santos, managing director of the Ford School’s Center for Racial Justice.
“Even though much has been written about the formidable barriers to high-quality affordable health care in the United States, less is known about the relationship between these barriers and the decision-making processes surrounding COVID-19 vaccine uptake,” write Watkins-Hayes and Adams-Santos. “[There is] a pervasive sense of distrust in the very institutions that play critical roles in vaccine development and delivery."
The data, drawn from the American Voices Project (AVP), focused on a nationally representative sample and provided a snapshot of vaccine attitudes during the initial COVID-19 vaccine rollout in early 2021.
Using 137 qualitative interviews, the study categorizes vaccination attitudes: Pro-vax, Pro-vax hesitant, Undecided hesitant, Anti-vax hesitant, and Anti-vax. While Pro-vax individuals generally trusted science and healthcare, the Anti-vax group expressed deep skepticism, citing concerns about the vaccine’s rapid development and historical instances of medical abuse, such as the Tuskegee Study. Hesitant respondents across all categories shared common concerns about vaccine safety, with many adopting a “wait-and-see” approach, delaying their decision until more data became available.
Participants expressed frustration with high healthcare costs, poor insurance coverage, and opaque practices. Many who got vaccinated did so out of resignation, not trust in public health institutions, while trusted local figures, like pharmacists or community workers, often helped sway hesitant individuals toward vaccination.
The study concludes that rebuilding trust in the healthcare system is essential for combating vaccine hesitancy. Addressing long-standing issues like healthcare access, cost, and transparency, along with improving communication from trusted figures, is crucial for fostering greater confidence in future public health efforts.
Read: Discourses of Distrust: How Lack of Trust in the U.S. Health-Care System Shaped COVID-19 Vaccine Hesitancy in the Russell Sage Foundation Journal of the Social Sciences.
