Effects of Government Mistrust and Group-Based Medical Mistrust on COVID-19 Vaccine Hesitancy Among a Sample of African Americans

• Published in: Annals of behavioral medicine 2024-12
• Main Authors: Manning, Mark, Dailey, Rhonda, Levy, Phil, Towner, Elizabeth, Cresswell, Sheena, Thompson, Hayley S
• Format: Article
• Language: English
• ISSN: 0883-6612; 1532-4796; 1532-4796
• DOI: 10.1093/abm/kaae067

Despite the demonstrated efficacy of coronavirus disease (COVID-19) vaccines, higher rates of vaccine hesitancy among African Americans remain concerning. As determinants of vaccine hesitancy, the simultaneous roles of government mistrust and group-based medical mistrust have not been examined via from a cognitive information perspective among African Americans. We examined the direct and indirect effects of government mistrust and group-based medical mistrust on COVID-19 vaccine hesitancy in a sample of African Americans. We obtained data from 382 African Americans in South-East Michigan via an online survey. We assessed demographic variables, government mistrust, group-based medical mistrust, COVID risk and COVID worry, and positive and negative beliefs regarding the COVID-19 vaccine (i.e., vaccine pros and cons), and vaccine hesitancy. We examined our hypotheses with path analyses. Results indicated significant direct effects of government mistrust on vaccine hesitancy; however, despite a significant correlation, there was no direct effect of group-based medical mistrust on vaccine hesitancy. The effect of group-based medical mistrust was fully mediated by both vaccine pros and cons, whereas the effect of government mistrust was partially mediated by vaccine pros. COVID risk and COVID worry did not mediate the effects of mistrust to vaccine hesitancy. Negative effects of group-based medical mistrust on COVID-19 vaccine hesitancy among African Americans may be amenable to interventions that focus on beliefs about the vaccine rather than beliefs about vulnerability to the virus. However, given its direct effect, it may be necessary to focus directly on government mistrust to diminish its effects on COVID-19 vaccine hesitancy.