What is trust? Does trust impact the US COVID-19 vaccine response effort?

Social and Racial Justice Uncertainty and Misinformation Vaccines

A: Trust in our health system is influenced by our beliefs about its benefits and consequences to ourselves and others.

Low trust can derail the best of public health and medical treatments. Trust in the US health system is complicated by experiences and historical events that non-majority communities. People need time, reliable information, and repeated positive new experiences to form trust. Many health-based institutions are acknowledging the negative connections of history and trust in the health system, particularly as we seek beneficial COVID-19 treatment outcomes.

*Trusting (the verb) and the role of trust (the noun) are critical to successful outcomes through healthcare systems.*

In the US, many broad-scale health initiatives, like no-smoking and seatbelt use campaigns, have launched to improve health in the population at large. But some big health initiatives have been rooted in discrimination. These eroded public trust because they were based in deceit, driven by political or financial motives, or were discriminatory in their enrollment–even though they were led by strong scientists and health care providers.

Many people in the US have living family members that can attest to the impact of discriminatory and divisive health experiences of the past, and their trust in the health system may have never been restored-especially Black and Native people. As the saying goes, trust is easily broken and hard to earn- and this is definitely the case when it comes to health.

*We Decide To Trust.* Implicitly, we rely on the knowledge and rigor used by scientists and health care providers to identify, design, or recommend health interventions. Scientists and health care providers use guidelines to do their best work to create treatments that balance their benefits and consequences to individual people and the population.

As individuals, we then decide whether to trust in scientific and healthcare systems by evaluating the experts (scientists and health care providers), their process, and our own definitions of the benefits and consequences of the intervention–for ourselves and our communities. We make health decisions based on information (current and historical) and people we trust. If some of the details don’t fit well into our thinking–either agreeing or disagreeing with our prior experiences–it is harder to change our actions.

Fast forward now to 2020, as we watch our current scientists and health care providers find strategies and solutions to navigate COVID-19. Trust is a major determinant in what information we decide is important to our own wellbeing. Widespread trust in the scientific process is required if we expect to see population-level benefits of the COVID-19 vaccine. We need to create & maintain trust that we will be fairly treated in terms of accessing the vaccine, the vaccine will not have undue consequences for us, and that we are not an experimental group to measure harm of the vaccine for a larger population.

Trust and health-related decision making is influenced by different information for many people. We may not understand why other people make choices different than our own. As more health initiatives emerge in response to COVID-19, health teams are working to build trust with the goal of supporting population health.

For additional reading:


Time Magazine

#Misinformation #Vaccines #Trust #Mistrust #SystemicRacism #HealthDisparities

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