Epidemic of Mistrust: Vaccine skepticism and public trust in the public health and the health system

Accompanying the current decrease in childhood vaccination rates is an increase in public skepticism about vaccine safety, indicative of an epidemic of mistrust in public health, health care, and scientific research. In 2014, we conducted a probability-based survey (n=1,024) of U.S. adults and found that 30% believed that the government is not telling the truth about the dangers of vaccinations. To better understand the population of vaccine skeptics, we conducted weighted logistic regression analysis to estimate the univariate relationship between vaccine skepticism and independent variables measuring the trustworthiness of the health system and its key brokers (public health departments, health care providers, and university researchers) and demographics.  We found that vaccine skeptics are three times more likely to believe that the health system makes a lot of mistakes (OR=2.93, p<0.001), and would try to hide a serious mistake (OR=3.03, p<0.001). Vaccine skeptics are 2.5–4 times more likely to believe that health care providers, public health departments, and university researchers care most about making money (p<0.001).  Vaccine skeptics are more likely to believe that providers (OR=2.94), public health departments (OR=3.10), and researchers (OR=3.47) do not care about helping people like them (p<0.001). While most demographic variables were not statistically significant, we found that vaccine skeptics were more likely to be in fair or poor health (OR=1.9, p = 0.0092) and to be politically moderate (p=0.013).   Based on our study there is some evidence of common ground.  Both skeptics and non-skeptics recognize that “all people who are unable to provide for their own needs should be helped by others,” for example (p=0.50). The results of this survey suggest that the “crisis of trust” in public health and science is a real and urgent phenomenon in need of leadership from the public health community.