UC San Diego

COVID-19 vaccination trends for children aged 5-17 have fallen behind in comparison to older age groups in the United States; this is due to vaccine hesitancy and, potentially, the rise of institutional mistrust. Our objective was to determine whether institutional mistrust is associated with lower parental vaccination endorsement. We defined vaccination endorsement as having a child age 5+ who received at least one COVID-19 vaccine dose or being very likely to vaccinate their child aged 0-4 when eligible. We distributed an online survey among parents from 32 different schools in areas with high levels of social vulnerability relative to the rest of San Diego County. Mistrust reflected level of confidence in institutions using an aggregate score from 11 to 44. We built a multivariable logistic regression model to assess the association between mistrust and vaccination endorsement. Out of 290 parents in our sample, most were female (87.6%), reported that their child was Hispanic/Latinx (73.4%), and expressed vaccination endorsement (52.1%). In our logistic regression model, for every one-point increase in mistrust score, there was an 8% reduction in the likelihood of participants endorsing vaccination for their child. Other statistically significant correlates included parent vaccination status, child age, parent age, and Hispanic/Latinx ethnicity. Institutional mistrust can undermine public health interventions and, likewise, public health interventions can reduce the trustworthiness of the entity and foster mistrust. When mistrust is high, institutions can improve their trustworthiness by fostering collaboration with key stakeholders and aligning themselves with the interests and goals of their constituents.