“Vaccine wars”; harbinger of conflict to come?
Study unearths disturbing distrust across US.

The most widespread driver of resistance to COVID vaccines in the US was distrust; specifically of political leaders of both parties, the federal government and traditional print & cable news.

That is the conclusion reached by a recent e.pluribus.US survey of some of America’s least- and most-vaccinated communities.  The survey dug into the reasoning behind Americans’ viewpoints on COVID vaccines and achieved key insights into why people hold their beliefs about the vaxxes, as well as — importantly — what information sources most influenced those rationales (leaders, cable news, doctors?). 

Among interesting findings, the results call into question common perceptions that vaccine opponents’ views are primarily influenced by populist politicians or polarized cable news.  Indeed, among eleven potential sources of information about vaccines, Americans across the spectrum reported they depended the least upon political leaders, even those leaders ordinarily trusted from within their own parties.

These findings suggest that the nation’s confrontational and ultimately disjointed experience with COVID vaccination policy bodes poorly for a future where a divided people find themselves unwilling to trust each other or leaders even from their own parties.

“I do not trust the government and the news media is just an arm of the Democratic Party so they are not trustworthy either. The vaccine has proven itself to be unreliable and is not preventing people from getting or transmitting the virus.”

Hattiesburg, MS resident (See all respondent quotes here)

“I trust the democratic government not the Republican one. I trust the New York Times and the Washington Post and that’s who I trust.“

Miami Beach Resident (See all respondent quotes here)

This recent December through March e.pluribus.US polled participants in community-oriented online forums in Hattiesburg, Mississippi, the San Francisco Bay Area and Miami-Dade County, Florida.  Hattiesburg’s Forest County at this writing has a 44% fully-vaccinated rate, which is below that of even the least vaccinated US state (Alabama, 51%), according to CDC data.  The six counties surrounding southern San Francisco Bay have an average 84% fully-vaccinated rate, which is above that of the US’ most-vaccinated state (Rhode Island, 82%).  Miami Dade has an 85% rate.

Survey Results: Confidence in, versus concern about the COVID vaccine

Our respondents mirrored the CDC data, with Bay Area respondents the most vaccinated and Mississippians the least.  We found that even many vaccinated respondents nonetheless harbored concerns about the vaccine, particularly Mississippians.  Figure 1 combines whether respondents were confident vs concerned about the vaccines with whether they chose to be vaccinated.

Survey Learnings: Reasons why people did or did not trust the vaccines

The insights begin to get interesting when we ask people why they were either confident in or concerned about the vaccines.  It turned out that the state location of the vax proponent or opponent had little impact upon his/her reasons for believing as they do.  Figure 2 illustrates that the vaccine opponent in San Francisco has essentially the same rationales as the vaccine opponent in Mississippi (there are minor variations within each rationale, but the distribution across rationales is remarkably similar).  Figure 3 illustrates the same for proponents (we believe the few variances among Mississippi vax proponents are the result of the small sample size in that specific group, addressed at bottom).

Here’s where things get interesting.  Among those concerned about the vaccines, the two main drivers of their resistance — the only rationales influencing greater than 30% of them — were (a) the belief that the vaccines are unproven, unsafe or unnecessary and (b) “Distrust of authorities.”   Of course, those two are closely related, because in the 15 months leading up to and through the survey period, national authorities emphatically argued that the vaccines were proven, safe and necessary.  Indeed it is fair to say that distrust was the exclusive driver of vaccine resistance, because without distrust, the other three main drivers would not have existed.

Among those confident in the vaccines, there were three primary rationales that influenced at least 30% of them: (a) that reducing their own COVID risk was worth potential side-effects, (b) they felt a civic duty, or (c) to prevent a resurgence and end the pandemic.

But don’t overlook a surprising commonality between the two groups.  At the same time that 51% of the “vax-concerned” reported they did not trust authorities, only 16% of the “vax-confident” reported that they did trust authorities.  Neither side conveyed significant trust in authorities.  Certainly the vax-confident were more likely to do so than the vax-concerned. And we can ask what “authorities” really meant to respondents in this context; one can argue it is ambiguous (and that might be an interesting avenue of subsequent inquiry).  But in any case, lack of trust is clearly an issue.

“I don’t trust the government, the media or health bodies. They’ve spread so much conflicting information in the past 2 years.”

San Francisco Bay Area resident (See all respondent quotes here)

“I don’t really trust the mainstream media nor the Federal government. “

Florida resident outside Miami-Dade (See all respondent quotes here)

“I have little trust of the government and zero trust of the media.”

Hattiesburg, MS resident (See all respondent quotes here)

Survey Learnings: What influences drove people’s beliefs about COVID vaccines?

These rationales explaining why each side is pro or anti-vax are not entirely surprising.  But it begs the question, “Where did they get these rationales?”  We wanted to know, what influenced people to come to these conclusions?

And that is where real insights lie.  Because, in common perception, the Left often thinks “anti-vaxxers” are ignorant and easily swayed by Trump and Fox News, while the Right often thinks “pro-vaxxers” are naive “sheeple” who swallow everything on MSNBC and lock-step follow any draconian Fauci commandment.  Is any of this accurate?

To find out, we asked both sides what sources most influenced their opinions on the vaccines.  Multiple interesting insights then ensued.  Figure 4 contrasts the sources of influence most often cited by the vax-concerned with those cited by the vax-confident.  To accentuate the gap between the two sides’ primary information sources, we’ve ordered the sources top-to-bottom by how disproportionately each source influenced the vax-concerned (at top) vs the vax-confident (at bottom).

Some key observations to draw out:

First, you’ll see there is a dramatic difference in the sources each side most heavily relied upon.

• ● The vax-concerned claim to rely mostly upon their own research and experiences.   70% of them credited their own research while only 46% of the vax-confident did so.   Similarly, 47% credited their own witnessed experiences, vs only 16% among the confident.

“I implore to please do your own research. Read carefully, listen to what is said carefully, question everything. This government has proven it will lie and follow zero logic!“

MS resident from other than Hattiesburg (See all respondent quotes here)

• ● By contrast, the vax-confident were much more likely to rely upon healthcare authorities (70% vs 33%) and the federal government (39% vs 9%).  They also claim to avail themselves of their own research, but to a much lesser extent than do the vax-concerned.

“After working in healthcare I have witnessed the effects of not listening to the CDC .”

San Francisco Bay Area resident (See all respondent quotes here)

Beyond their primary sources, both groups relied to a degree upon their own doctors, with the vax-confident much moreso (42%) than the vax-concerned (27%).

Curiously, no type of news media was a primary influence for either side.  In fact, contrary to a popular belief on the Left, only a negligible number of the vax-concerned reported that cable news sources (eg: FoxNews) meaningfully influenced their opinions.  Indeed, far more of the vax-confident listed cable or TV News as an influence, 17% vs 4%.  Notable, though, is that 16% of the vax-concerned reported being influenced by Internet news sources.

Social Media also played a meaningful role for 22% of the vax-concerned, but only 3% of the vax confident.

But one of the most educational insights was that neither side trusted politicians.  We asked to what degree respondents were influenced by “My Trusted political leaders’ perspectives.”  Note we specifically asked about the leaders they trusted.  Both sides reported this was either the least, or second least influential information source:

• ● Among the vax-concerned, politicians were their least influential source — dead last. It influenced only 1% (technically, politicians tied with newspapers for dead last).  This is noteworthy given a common impression on the Left that anti-vaxxers are heavily influenced by former President Trump.
• ● The vax-confident listed politicians as their second least influential source, ahead of only social media.

“Certainly don’t trust our political leaders!”

Miami Beach resident (See all respondent quotes here)

Discussion: So what do we learn from these results?

From the perspective of one side trying to explain why “the other side” has different opinions on the vaccines, it is common on each side to perceive the other as ignorant, naive, easily influenced by both wrong-headed leaders and a polarized media that incites passions solely to attract viewers.  This study paints a different picture.

We should acknowledge that in some cases there are inconsistencies in the survey responses that suggest participants may not have painted a complete, or fully self-aware picture of all factors influencing their opinions, and that could draw one to misleading conclusions. We address those inconsistencies at bottom.  But even if we assume the responses don’t tell the whole story, we cannot deny that they demonstrate a pervasive lack of trust in American leadership.  The main driver of different opinions on vaccines is a lack of trust in federal authority, political leadership and traditional news media.

“don’t trust any of these establishments”

San Francisco Bay Area resident (See all respondent quotes here)

Now, the Left would argue, “Science is science.  If you don’t trust the scientists at the CDC, you’re ignorant.”  But would they sing that same tune if the CDC were run by Trump appointees?   And advocating for ivermectin and hydroxychloroquine?

On the Right, in 2021 Florida Governor Ron DeSantis criticized federal vaccine mandates, arguing it was over-reach for the federal government to deny lower jurisdictions’ ability to make their own decisions on the matter.  By that point DeSantis had already implemented regulations prohibiting his own lower jurisdictions — Florida cities and counties — from making their own decisions about mask mandates.  He then signed a law additionally prohibiting lower jurisdictions — including school districts and private businesses — from making their own decisions on vaccine requirements.

The vaccine issue was quite deliberately politicized, across the nation.

The current Vice President, during the 2020 campaign, voiced skepticism about trusting any vaccine released before the election.  She said she would only trust a “credible” source.  Now we see in this survey that many in the general population wrestle with who to trust as “credible.”  Do they trust who Kamala Harris says is credible?  Or do they trust Ron DeSantis’ take?  According to our survey, they trust neither.  And therein lies the problem.

“Particularly after 2021’s Federal Executive Branch played flip flop Partisan Politics with the same Vaccine that they claimed to reject during their 2020 Election Campaign only now to Cram it down our throats … the Hypocrisy is clearly untrustworthy. Likewise, Dr. Fauci’s agenda appears to line the deep pockets of Pharmaceutical Companies who are no longer liable for adverse patient cases.”

Miami Beach resident (See all respondent quotes here)

It is impractical to expect 330 million people to do their own research on vaccine safety and efficacy.  They have to rely on sources more qualified to evaluate such issues.  When the obvious sources — federal health authorities, reported through the media — become politicized, then who does the citizen rely upon?  It is not unreasonable for citizens to distrust traditional “authority” in that environment.  When we politicize an issue that, perhaps, we ought not, there are repercussions that few of us will welcome.

More broadly, the nature of a political environment in which we aggressively work to undermine trust in our opponents — without thoughtful limitations — itself has repercussions, including potentially becoming self-fulfilling.  If the public is conditioned to completely distrust its leaders, then why does a party need to nominate a leader that embodies trust?

How do we fix this?  That is a longer discussion and is all about what we are doing here at e.pluribus.US.  You can separately read about how we work to overcome partisan divisiveness. But suffice to say, there are important reasons behind why it is wise to interact with opponents in a manner that will result in a productive outcome.

In that vein, I’ll close with a lesson from my tech career.  When we negotiated major contracts with customers, we commonly had to grapple with contentious terms that often could appear zero-sum.  In these situations it was important to keep in mind that at some point we would be done with that confrontation, the contract would be signed, and we would then have to actually work with the other party.  In harmony.  Indeed that was the whole point of the engagement. It’s very similar to the whole point behind having a nation.

“Eventually we have to work with these people.”

It’s a lesson America could take to heart.

Explanations, caveats and known limitations of the study

Full Survey Results: Full results and over a hundred quotations from participants are available on the main page for the e.pluribus.US COVID Vaccine Survey.

Newly developed survey system:  This was the third political topic surveyed as part of e.pluribus.US‘ project LISTEN and as such the third application of our nascent online community survey system.  It was also its first deployment in communities outside of Florida.  The objective of Project LISTEN is to develop a scalable method of understanding why opposing sides believe as they do on contentious topics.  What underlying rationales drive these perspectives and where do the rationales come from?  Learn more about Project LISTEN here, and about the survey methodology here.

Ambiguities and inconsistencies among expressed perspectives.  Some of the responses can be considered ambiguous due to vague wording of survey response options and/or our failure to provide detailed definitions. For instance, was “vaccinated” interpreted to mean one or both of the shots in a two-shot regimen? Additionally, some responses suggest a lack of respondent consistency, which raises questions about influences that may lie yet deeper, below those we queried.  For instance, at the same time many on both sides reported that they relied mostly upon their own research, they denied that they were influenced by many of the sources one might typically use for such research, such as the media, government agencies, healthcare authorities, etc. It seems doubtful they were conducting their own clinical trials, or surveys of scientific literature on Pubmed, so what were the sources of their own research? Had we known so many people relied on their own research, we may have asked that follow-up question. Alas we did not, but the existence of so much “own research” is a meaningful learning nonetheless. Finally, there are situations where it is difficult to parse out whether a curious result reflects the former issue of vague wording or the latter one of inconsistency. For example, when a respondent asserts that they “distrust authorities,” then cite “healthcare authorities” as a leading influence on their opinions, is that an inconsistency or a reflection of poor survey wording? Honestly, probably the latter. Another learning for future surveys.

There are additional limitations discussed on e.pluribus.US’ official publication page for this study, including:

• ● Sample size
• ● Skew associated with using an online sample pool
• ● How the three communities were selected
• ● That national enthusiasm for the vaccine topic waned during the term of the survey.