Vaccination in the shadow of uncertainty: Exploring the links between government trust and COVID-19 vaccine acceptance

This study examined the impact of trust in government on COVID-19 vaccination in the Republic of Korea during the 2021-2022 period and determined if this impact is unique to COVID-19 vaccines or can be generalized to other vaccines such as influenza. We utilized the Korea Community Health Survey with 458,311 respondents focusing on individuals aged 65 and older. We conducted chi-square tests to analyze differences in vaccination uptake and multivariable logistic regressions, adjusting for age, education level, employment status, social security income, marital status, and comorbidities to determine the association between government trust and vaccination rates. Significant differences were found in vaccination uptake by the level of trust in government. Logistic regression showed that residents in high trust regions had 66.4% higher odds of COVID-19 vaccination (OR = 1.664, 95% CI [1.444, 1.919], <i>p</i> < .01) and 42.9% higher odds of influenza vaccination (OR = 1.429, 95% CI [1.270, 1.607], <i>p</i> < .01) compared to low trust regions. The influence of government trust was statistically significant for both vaccines, with a relatively larger odds ratio observed for COVID-19 vaccination. These findings indicate that trust in government is vital for the success of public health interventions, particularly during times of significant uncertainty such as the COVID-19 pandemic.