We consider how trust in government, trust in physicians, and interpersonal trust affect the likelihood of COVID-19 vaccine uptake. Methods: A survey of 3057 registered South Dakota voters was fielded in April 2021 that measured COVID-19 vaccine uptake, three aspects of trust, and several other factors related to vaccine hesitancy. Logistic regression was utilized to analyze the responses. Results: We found positive, statistically significant, and substantively impactful effects for trust in government and trust in physicians on the likelihood of COVID-19 vaccine uptake, and null results for interpersonal trust. Conclusions: Our findings provide a more nuanced understanding of the relationship between trust and COVID-19 vaccine uptake, and suggest that public health official as well as physicians should strive to increase the public's trust in the medical community. THE CHALLENGE OF COVID-19 VACCINE HESITANCYVaccination is considered the most effective protection against COVID-19 and the best way to prevent further COVID-19 caused deaths. Governments and public health officials in the United States and around the world have been striving to vaccinate a critical portion of the population. Despite an abundance and availability of Food and Drug Administration (FDA)-approved vaccines and evidence of their high effectiveness, the pace of vaccination has slowed down throughout many parts of the United States. In 2021, President Biden did not succeed in reaching the goal of having 70 percent of adults receive at least the first dose of a vaccine by Independence Day despite making it a priority. More worryingly, large portions of the American society, such as evangelical Christians and residents of rural areas, report an unwillingness to be vaccinated (Dias and Graham 2021). According to a Gallup poll, the total number of people who do not want to get vaccinated could be over 1 billion globally (Ray 2021). Unwillingness to vaccinate, or in some cases hostility toward vaccination, is one of the central challenges of bringing the COVID-19 pandemic under control. Discovering underlying contributors to citizens' unwillingness to receive a COVID-19 vaccination is necessary to address vaccine hesitancy.

Experts agree that vaccination is the most effective way to bring the COVID-19 pandemic under control. Nevertheless, vaccination rates have slowed nationwide and substantial segments of the population report an unwillingness to get vaccinated. We conducted an online survey experiment to investigate whether endorsement messages from various types of leaders can encourage the unvaccinated population to receive the vaccine. We surveyed 709 unvaccinated registered voters in South Dakota in April 2021 and presented them with identical messages endorsing vaccination from a political, religious, or medical leader. Our results show that messaging from a religious leader had a positive and statistically significant effect on interest in getting vaccinated, whereas messages from a political or medical leader had no statistically significant effect. These results strongly suggest that religious leaders are more effective messengers than other potential messengers and that public health officials would be well served to coordinate their efforts with leaders in faith communities.

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Due to the slow rate of COVID-19 vaccine uptake and the spread of the highly contagious Omicron variant, governments are considering mandating COVID-19 vaccination for specific professions and demographic groups. This study evaluates popular attitudes toward such policies. We fielded a survey of 535 registered voters in South Dakota to examine popular attitudes towards vaccine mandates for five groups—children 12 and older, K-12 teachers, medical staff, nursing homes staff, and police personnel. We estimated a series of logistic regression models and presented predicted probabilities to find the primary determinants of these attitudes. Results revealed that political partisanship and trust in government are strong predictors of support for vaccine mandates across all models. Should government and public health officials wish to increase the proportion of people vaccinated for COVID-19, they must recognize the limitations of current public health campaigns, and reshape their efforts in congruence with scientific findings.