The dynamics of trust and communication in COVID-19 vaccine decision making: A qualitative inquiry

Christy J.W. Ledford, Lauren A. Cafferty, Justin X. Moore, Courtney Roberts, Ebony B. Whisenant, Alejandra Garcia Rychtarikova, Dean A. Seehusen

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


In response to the COVID-19 pandemic, scientists coordinated a complex immunization effort that developed and distributed vaccines by December 2020. This study aimed to explain COVID-19 vaccination decision-making process to inform vaccine communication with patients and the public. Building on quantitative research on COVID-19 vaccine hesitancy, we conducted a grounded theory study, collecting 30 qualitative interviews with employees at a U.S. university that provided vaccine eligibility in December 2020. Analysis followed the Sort and Sift, Think and Shift method. Participants who had chosen to receive the vaccine and those who had not both described five factors that impacted their decision-making: emotional response, understanding, personal values, culture, and social norms. Across these factors, we identified three cross-cutting themes: time, trust, and communication tactics. In a time of emerging science and changing answers, the constant introduction of new information created information overload for participants. COVID-19 vaccine development was a “grand experiment globally,” which required trust, not only knowledge, to overcome hesitancy. The complex information environment surrounding COVID-19 vaccination requires multi-level intervention that cannot rely on knowledge translation alone. We need to help patients build trusting relationships with experts that can create scaffolding for future information processing.

Original languageEnglish
Pages (from-to)17-26
Number of pages10
JournalJournal of Health Communication
Issue number1
StatePublished - 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

ASJC Scopus subject areas

  • Health(social science)
  • Communication
  • Public Health, Environmental and Occupational Health
  • Library and Information Sciences


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