Analysis of Trust in Different Sources of Health Information and Predicting Adult Vaccine Uptake in the United States, United Kingdom, and France Open Access

Tuttle, Alexandra (Spring 2021)

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Background: Adult vaccine coverage trails high rates of childhood immunization globally, threatening protection from vaccine preventable diseases. Fewer policies and social pressures surround adult vaccines, leaving the decision to individuals. Vaccine information can vary widely depending on the source. The objective of this study was to determine which sources adults trust most for information about two routinely recommended adult vaccines, the seasonal influenza vaccine and tetanus containing booster, and determine if this trust predicts vaccine uptake.

Methods: Results of a cross-sectional survey conducted February to March of 2014 were analyzed. Participants from the US, UK, and France reported their level of trust in doctors, health departments, news media, and social media. Participants also reported receipt of the seasonal influenza vaccine in the past 6 months and tetanus containing booster in the past 10 years. Descriptive statistics were calculated and log binomial regression was used to evaluate associations between vaccine uptake and trust in information sources.

Results: A total of 2,541 responses were collected. Trust in doctors was most strongly associated with uptake of both vaccines (influenza PR: 3.48, 95% CI: 2.77, 4.37; tetanus PR: 1.38, 95% CI: 1.23, 1.55) followed by health departments (influenza PR: 3.11, 95% CI: 2.64, 3.66; tetanus PR: 1.29, 95% CI: 1.19, 1.44). Trust in news and social media were also positively associated with influenza vaccine receipt (news PR: 2.19, 95% CI: 1.97, 2.45; social media PR: 1.67, 95% CI: 1.48, 1.87). Tetanus containing booster receipt was weakly associated with trust in news media (PR: 1.08, 95% CI: 1.01, 1.15); it was not associated with trust in social media (PR: 1.02, 95% CI: 0.94, 1.11). After adjusting for trust in other sources, all observed effects were attenuated. Trust in social media was no longer significantly associated with influenza vaccine receipt, nor was trust in news media significantly associated with tetanus containing booster receipt. Effects were further attenuated after adjusting for demographic covariates.

Conclusions: Traditional sources of health information are influential in adult vaccinations. Health departments should communicate clear guidelines for adult vaccines and providers should regularly check immunization histories to recommend vaccines when gaps are identified.

Table of Contents

Literature Review


Traditional sources of health information

New sources of health information




Data Collection

Statistical Analysis


Factors associated with influenza vaccine receipt

Factors associated with tetanus containing booster receipt





Tables & Figures

Public Health Implications

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