Major articleSocial and political determinants of vaccine hesitancy: Lessons learned from the H1N1 pandemic of 2009-2010

•Vaccination hesitancy is a social problem that requires investigation.•We studied confidence in social institutions and willingness to take the H1N1 influenza vaccine.•Vaccination hesitancy is associated with confidence in local hospitals.•Disease perceived risk is a leading factor associated with vaccine hesitancy.

BackgroundPublic acceptance of vaccination programs is essential for vaccine preventable diseases. However, increasing sectors of the population have expressed hesitancy about participating in such programs, leading to the re-emergence of vaccine preventable diseases. In this study we rely on a recreancy hypothesis to test the association between confidence in the government and local hospitals and the willingness to take the vaccine.MethodsA secondary analysis of a survey that used a large sample of the U.S. population conducted in October 2009 was used (N = 968).ResultsThe results indicate that 36.1% of the respondents expressed willingness to be vaccinated. Those with the greatest trust in the government were the most likely to be vaccinated (43.4%), and those least confident were the least willing (15.8%). From the ones reporting being confident in the local health system, 38.4% were willing to be vaccinated, and from those not confident, only 23.5% were willing to be vaccinated.ConclusionThe decision to get vaccinated in the midst of a contagious outbreak involves many considerations. Trust in the government's technical and organization skill to deal with the infectious outbreak along with trust in medical organizations predict the adoption of recommended protection measures. The results indicate that public compliance with vaccination plans in health crisis requires the development of social and institutional trust.