South Dakota State University poll explores trust in physicians, COVID-19 booster shots


BROOKINGS — The COVID-19 pandemic is three years old, and two researchers at South Dakota State University have begun exploring the prevailing effects of the 21st century's defining event thus far.
David Wiltse, an associate professor of political science, and Filip Viskupic, an assistant professor of political science, collectively make up the SDSU Poll, a nonpartisan research unit that analyzes issues of importance to South Dakotans. In April 2021, the poll surveyed registered voters in South Dakota to gain insight into attitudes surrounding the pandemic. The respondents were randomly chosen from the list and in accordance with best practices, their responses were weighted by gender, party registration and location within the state. 
"We weight for region by basically clustering several counties together," Wiltse explained. "We have a Sioux Falls area, a Rapid City area and then clusters of counties outside of there. That way, we know that we're not over or under emphasizing one part of the state."
For this research, the SDSU Poll analyzed the level of trust South Dakotans had in physicians, and if that level of trust influenced their willingness to receive a COVID-19 booster vaccination, with a specific focus on the 65-years-and-older population. 
"Scholars have known for a very long time that trust is a really important component of society," Viskupic said. "It's kind of what holds us together. Trust in institutions is important, and when it comes to health care, trust in in physicians is very important."
As Viskupic notes, the pandemic—over time—became highly politicized. Subsequently, vaccines became highly politicized. As a consequence, some people's trust in science, scientists, physicians and the government has eroded. 
"What we have found in our research and what others have found in their research is that when it comes to the decision to receive a COVID vaccination, trust in the government is really important because they are this authority approving the vaccine," Viskupic explained. "Trust in science is also very important because if you're a regular person, you probably don't really know what goes into the science. You might have heard of mRNA, but you don't really know what it is. So basically, the decision to receive a vaccination comes down to you trusting the people developing vaccines, trusting the people in the government approving the vaccines and trusting the health care providers who are actually giving you those vaccines.

"If you don't really have that trust, then we see differences in vaccine uptake."
The Centers for Disease Control and Prevention notes that people between the ages of 65-74 are five times more likely to be hospitalized and have a 65 times greater chance of death after being infected with COVID-19 than those who are between the ages of 18-29. The 65-and-older age group does have a higher vaccination rate than the rest of the population. However, previous research has shown that there still is some vaccination hesitancy in this population group. 

The poll's research focused on whether the apparent erosion of trust had an effect on booster uptake among the most vulnerable population. 
"We found a very strong relationship between trust in government, trust in physicians and COVID vaccine uptake," Viskupic said. 
Age was positively correlated with booster uptake, the SDSU Poll's research showed. The older a person was, the more likely they were to trust their physicians and receive a booster shot.  
"If you're older, you're seeing your primary care physician more often. You're interacting with the health care system on a more regular basis, so you're probably going to have more trust in that system than somebody who’s younger who only goes in every few years for a physical," Wiltse said. "That's an important factor as well."
People with greater trust in physicians were more likely to receive at least one booster shot, the research showed. This is in line with previous research, which suggested that trust in physicians affects the likelihood of receiving a COVID-19 vaccination in the first instance. 

"We found those folks who have higher trust in the government and higher trust in physicians are more likely to get vaccinated compared to those folks who have lower trust," Viskupic said.
Further, the poll's research shows that self-identified evangelical Christians are less likely to receive a vaccine booster. This group also showed signs of initial vaccine hesitancy in previous research, Viskupic said. 
Past COVID-19 related research showed that partisan self-identification factored into a person's decision to get the initial vaccine. However, this study did not find evidence that differences in booster uptake among older adults were due to partisanship.


As a scientific study, this research was published in the Journal of Aging and Health Research under the title "Trust in physicians predicts COVID-19 booster uptake among older adults: Evidence from a panel survey." As Wiltse and Viskupic note, health care professionals can apply this research when determining how to approach individuals who may be vaccine hesitant.
"We hope our findings and data could possibly become a foundation for some evidence-based interventions that folks in public health or health care could use to bolster the public's trust in vaccines," Viskupic said. 
Another key takeaway is the importance of trust in the medical field. Building trust with patients and fostering a trusting environment are important, especially when discussing these types of decisions with someone who may be vaccine hesitant. 
"This is where policymakers and public health officials (for example) can really learn some lessons on how people process information about health in a politicized environment," Wiltse added.