Trust in Healthcare and Trust in Science Predict Readiness to Receive the COVID-19 Vaccine in Appalachia

BACKGROUND: The Appalachian Region faces multiple barriers to widespread COVID-19 vaccination. The purpose of this research study was to explore the role of trust in healthcare and trust in science on Appalachian residents’ readiness to receive the COVID-19 vaccine. Trust in health influencers and health information sources were also explored.

METHODS: A cross sectional survey study of Appalachian Region residents (n=1048) was completed between February 25 and March 6, 2021, with equivalent rural and non-rural sampling methods employed. Participants were >35 years of age and had not received the COVID-19 vaccine at the time of survey administration.

RESULTS: Overall, 31% of participants were extremely likely to receive the vaccine, while 42% were somewhat likely/neither unlikely or likely/somewhat unlikely, and 27% were extremely unlikely. Based on multiple linear regression analysis with backwards selection, trust in healthcare, trust in science, residence (rural vs. non-rural) and age were positive predictors of readiness to receive the vaccine (F(5, 1042)= 38.9, R2= 0.157, p< 0.01). Gender, education, household income, and political affiliation did not predict vaccine readiness. Trust in media for health information was modest, with ratings of none or not much for social media (64%), podcasts (61%), magazines (46%), radio (37%), newspapers (36%), and television (35%). Primary care providers emerged as the highest trusted health influencer of 15 options and a primary care provider’s office was the most common preference for location for receiving the COVID-19 vaccine, particularly in participants who rated themselves as extremely unlikely to receive the COVID-19 vaccine.

CONCLUSIONS: These findings suggest that trust in healthcare and science are prospective foci for initiatives aimed at improving vaccine acceptance in Appalachia, particularly in younger residents of rural areas. As highly trusted health influencers, primary care providers should be leveraged and supported in COVID-19 vaccine education and distribution.