The Role of Gubernatorial Affiliation, Risk Perception, and Trust in COVID-19 Vaccine Hesitancy in the United States

Background/Objectives: Vaccine hesitancy is becoming an increasing concern, leading to preventable outbreaks of infectious diseases. During the COVID-19 pandemic, the United States served as an intriguing case study for exploring how risk perception and trust in health authorities, including scientists, are influenced by government policies and how these factors affect vaccine hesitancy. Methods: We conducted a secondary analysis using the MIT COVID-19 Survey dataset to investigate whether risk perception and trust differ between states governed by Democratic or Republican governors. Results: Our analysis (n = 6119) found that participants did not vary significantly by state political affiliation in terms of their sociodemographic factors (such as age, gender, self-rated health, education, and whether they live in a city, town, or rural area), their perceived risk for the community, or their ability to control whether they become infected. However, there was a difference in the perceived risk of infection, which was higher in states governed by Republicans. Trust also varied by gubernatorial affiliation, with higher levels of trust reported among residents of Democratic-leaning states. We also found a strong mediation effect of trust on vaccine hesitancy, but this was not the case for risk perception. Conclusion: Therefore, it appears that vaccine acceptance relies on trust in health authorities, which is influenced by governmental policies. State officials should work with local health officials to build trust and increase timely responses to public health crises.