“You don't trust a government vaccine”: Narratives of institutional trust and influenza vaccination among African American and white adults

Abstract

Vaccine confidence depends on trust in vaccines as products and trust in the system that produces them. In the US, this system consists of a complex network connecting pharmaceutical companies, government agencies, and the healthcare system. We explore narratives from White and African American adults describing their trust in these institutions, with a focus on influenza vaccine. Our data were collected between 2012 and 2014 as part of a mixed-methods investigation of racial disparities in influenza immunization. We interviewed 119 adults, primarily in Maryland and Washington, DC, in three stages utilizing semi-structured interviews (12), focus groups (9, n=91), and in-depth interviews (16). Analysis was guided by grounded theory. Trust in institutions emerged as a significant theme, with marked differences by race. In 2018, we contextualized these findings within the growing scholarship on trust and vaccines. Most participants distrusted pharmaceutical companies, which were viewed to be motivated by profit. Trust in government varied. Whites described implicit trust of federal institutions but questioned their competency. African Americans were less trusting of the government and were more likely to doubt its motives. Trust in institutions may be fragile, and once damaged, may take considerable time and effort to repair.

The Role of News Consumption and Trust in Public Health Leadership in Shaping COVID-19 Knowledge and Prejudice

“…These findings challenge and extend previous findings on the role of trust in determining health attitudes and behaviors. Namely, extant research examining trust has identified mistrust in government as a critical barrier to positive health attitudes and behaviors (Jamison et al, 2019;Larson et al, 2018;Whetten et al, 2006). In contrast, our findings suggest that trust in governmental leadership can be a hindrance to health literacy when the messages issued by governmental leaders are at odds with those from public health organizations and emerging evidence-based practices.…”

Social distancing in response to the novel coronavirus (COVID-19) in the United States

“…However, it is difficult to interpret the differences in perceived risk, given that they are quite high in general, and so non-Hispanic Blacks’ lower perceived risk may be more realistic. Nonetheless, it is important to consider that minority groups may have less trust in governmental institutions as a result of longstanding structural racism [ 40 , 41 ]. Accordingly, governmental health promotions should focus on addressing higher risk of severe infection and morality in historically marginalized communities [ 42 , 43 ].…”

Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population

“…Together, our data further support low vaccination rates in non-Hispanic black women compared with high vaccination rates in Hispanic and non-Hispanic other race women. We speculate that communitylevel factors, such as the circulation of myths surrounding the influenza vaccine, social norms, and the level of trust in medical recommendations, may influence the differential uptake of antenatal influenza vaccine in these racial and ethnic groups [17,18].…”