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Latent class analysis of medical mistrust and COVID-19 vaccine hesitancy among adults in the United States just prior to FDA emergency use authorization
Institution:1. NORC, 55 East Monroe Street 30th Floor, Chicago, IL 60603, United States;2. Department of Sociology, University of Chicago, 1126 East 59th Street, Chicago, IL 60637, United States;3. Center for International Social Science Research, University of Chicago, 5828 South University Avenue, Chicago, IL 60637, United States;4. Crown Family School of Social Work, Policy, and Practice, University of Chicago, 969 E. 60th Street, Chicago, IL 60637, United States;5. Department of Medicine, University of Chicago, 5841 South Maryland Ave, MC 6092, Chicago, IL, United States
Abstract:Using a nationally representative household sample, we sought to better understand types of medical mistrust as a driver of COVID-19 vaccine hesitancy. We used survey responses to conduct a latent class analysis to classify respondents into categories and explained this classification as a function of sociodemographic and attitudinal variables using multinomial logistic regression models. We then estimated the probability of respondents agreeing to receive a COVID-19 vaccine conditional on their medical mistrust category. We extracted a five-class solution to represent trust. The high trust group (53.0 %) is characterized by people who trust both their doctors and medical research. The trust in own doctor group (19.0 %) trust their own doctors but is ambiguous when it comes to trusting medical research. The high distrust group (6.3 %) neither trust their own doctor nor medical research. The undecided group (15.2 %) is characterized by people who agree on some dimensions and disagree on others. The no opinion group (6.2 %) did not agree nor disagree with any of the dimensions. Relative to the high trust group, those who trust their own doctors are almost 20 percentage points less likely to plan to get vaccinated (average marginal effect (AME) = 0.21, p <.001), and those who have high distrust are 24 percentage points less likely (AME = -0.24, p <.001) to report planning to get the vaccine. Results indicate that beyond sociodemographic characteristics and political attitudes, people’s trust archetypes on parts of the medical field significantly predict their probability of wanting to get vaccinated. Our findings suggest that efforts to combat vaccine hesitancy should focus on building capacity of trusted providers to speak with their patients and parents of their patients, to recommend COVID-19 vaccination and build a trusting relationship; and increase trust and confidence in medical research.
Keywords:Vaccine hesitancy  COVID-19  Medical mistrust  AME"}  {"#name":"keyword"  "$":{"id":"k0025"}  "$$":[{"#name":"text"  "_":"Average marginal effect  BIC"}  {"#name":"keyword"  "$":{"id":"k0035"}  "$$":[{"#name":"text"  "_":"Bayesian Information Criterion  CDC"}  {"#name":"keyword"  "$":{"id":"k0045"}  "$$":[{"#name":"text"  "_":"Centers for Disease Control  LCA"}  {"#name":"keyword"  "$":{"id":"k0055"}  "$$":[{"#name":"text"  "_":"Latent class analysis  NIS"}  {"#name":"keyword"  "$":{"id":"k0065"}  "$$":[{"#name":"text"  "_":"National Immunization Survey  PCP"}  {"#name":"keyword"  "$":{"id":"k0075"}  "$$":[{"#name":"text"  "_":"Primary care provider  MM"}  {"#name":"keyword"  "$":{"id":"k0085"}  "$$":[{"#name":"text"  "_":"Medical mistrust  ACS"}  {"#name":"keyword"  "$":{"id":"pc_mM8BJ7whN8"}  "$$":[{"#name":"text"  "_":"American Community Survey
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