COVID-19 Vaccine Hesitancy: Trust in Local Clinics Predict Perceptions of Vaccine Safety and Vaccination Status

Background. Despite widespread COVID-19 vaccine availability, vaccine hesitancy remains a barrier to achieving public health goals, especially in underserved communities. Trust in healthcare providers, scientists, and government institutions plays a critical role in shaping vaccine perceptions and uptake. Purpose. To inform targeted interventions, we tested a mediational path model examining predictors of perceived vaccine safety, effectiveness, and vaccination status among public housing residents. Methods. We surveyed 120 public housing residents in Central and Southeast Virginia. Participants completed questionnaires assessing trust in various people and institutions, a sense of community responsibility, beliefs about vaccination as a personal choice, and vaccination-related perceptions and status. A mediational path model was tested to examine direct and indirect associations. Results. Among 10 trust domains examined, only trust in the federal government and trust in local clinics and pharmacies significantly predicted vaccination-related perceptions and behavior. Trust in local clinics was directly associated with perceived vaccine safety (β = .42, 95% CI [.18, .66]) and effectiveness (β = .36, 95% CI [.11, .62]) and indirectly predicted vaccination status through perceived safety (β = .11, 95% CI [.01, .22]). Trust in the federal government directly predicted perceived effectiveness (β = .35, 95% CI [.04, .66]) but not safety. The final model explained 62% of the variance in vaccination status. Discussion. An indirect effect emerged where trust in local clinics predicted vaccination status via perceived safety, underscoring the critical role of local health centers in fostering vaccine confidence and uptake. Strengthening relationships between local providers and their communities may be a key strategy for addressing vaccine hesitancy. These findings highlight the importance of building trust to support vaccine uptake efforts.