Trust in government actors and COVID-19 vaccination uptake among Hispanics and Latinos in the U.S.

Abstract

Although the federal government has made official recommendations to the public advocating vaccinations against COVID-19 various communities have decided against doing so. In this regard, various studies have indicated that trust in government to provide accurate information about vaccines during a pandemic are related to whether people get vaccinated. Various studies have investigated factors contributing to vaccine decision-making, but none specifically focus on Hispanic and Latinos in the United States. This study identifies factors associated with COVID-19 vaccination among Hispanics and Latinos using a nation-wide, phone-based survey. Using data generated by the Kaiser Family Foundation's COVID-19 Vaccine Monitor, collected in June 2021, a logistic regression on the decision to get vaccinated, trust in various governmental actors, in addition to demographic variables such as age, race, employment status, parental status, employment status, and income are observed to be significant in Hispanics' and Latinos' decision to be vaccinated against COVID-19. As a byproduct of these findings, recommendations for future research are provided that relate to expanding our understanding of these factors among different ethnicities of Latinos.

1. Introduction

Throughout the United States, the COVID-19 pandemic has been observed to disproportionately affect racial and ethnic groups, such as African Americans, Latinos, and Native Americans, in addition to those that are generally economically and socially disadvantaged [[1], [2], [3], [4], [5], [6]]. As Dahir [7] points outs, the pandemic, and its disproportional effects on various populations, particularly historically marginalized and low-income, has highlighted the continued inequity within society that has been caused by persistent social vulnerability. Hispanics and Latinos are one among various minority populations within the U.S. that have experienced relatively heightened levels of COVID-19 contraction and mortality. Despite the widespread effect that the virus has had on this population, there is a lack of understanding on how variations in the structural vulnerability indicative to different people that self-identify as this panethnic category [[8], [9], [10]]1 affect their public health behaviors. Specifically, most investigations of how ethnicity affects individual COVID-19 outcomes and public health behavior is typically only disaggregated by age, gender, and geography, which limits our ability to understand how various social determinants of vulnerability intersect to influence differences in behavior related to the pandemic among Hispanics and Latinos as opposed to simply comparing them to Whites [[3], [11], [12], [13]]. This lack of understanding and the availability of disaggregated data on minority groups limits public and nonprofit healthcare and social service providers’ ability to effectively utilize resources during a health crisis or pandemic [10] to service Hispanic and Latino communities.

In addition to understanding how individual characteristics affect pandemic related public health behavior, it is also important to understand the importance that trust in government actors plays in these decisions. Scholars have observed various differences between racial and ethnic group categories when it comes to risk perceptions related to epidemics and pandemics, and individuals' subsequent public health behaviors as a consequence of their level of trust in government messaging and actors [[14], [15], [16], [17], [18], [19], [20], [21]]. This is particularly true in reference to people's decision to vaccinate against various viruses in addition to social distancing and wearing a mask [[22], [23]]. However, despite the attention that trust in government actors and its effect on vaccination against viruses has received in the past, there continues to be a lack of understanding on how governmental trust, in addition to other indicators, effects Hispanics and Latino's decision to become vaccinated, which can help stave-off the spread of viruses like COVID-19.

As a result of this lack of understanding among Hispanics and Latinos, this research seeks to explore how various indicators viewed to be important influence individuals' decision to be vaccinated against COVID-19. Because of the lack of understanding on how Hispanics' and Latinos' trust in government actors influences this public health decision, this research also will observe the influence that trust in various government actors has on their choice to get the COVID-19 vaccine. In order to accomplish these goals, data from the Kaiser Family Foundation's COVID-19 Vaccine Monitor that was collected in June 2021 is analyzed. As a byproduct of the analysis, future research recommendations are provided as a means of progressing our understanding of the role trust in government plays in Hispanic and Latinos' public health choices during pandemics.

2. Trust in government actors and vaccination

In times of normalcy, but particularly in times of crisis, governments and their respective disaster response frameworks depend on the public to comply with recommended and mandated actions [24]. Along these lines, compliance with government recommendations related to reducing one's individual disaster vulnerability has the potential to mitigate subsequent and negative effects caused by a crisis event [24]; however, this requires the public to trust that their governments and/or the individuals speaking on behalf of their government [[16], [17], [25], [26], [27], [28]]. During public health emergencies, the public's trust in government to provide accurate and reliable information about appropriate public health behavior has been directly related to compliance with authorities' recommendations [[29], [30], [31]]. This has been especially problematic in relation to peoples' compliance with governmental recommendations and mandates related to COVID-19 health behaviors such as mask wearing and social distancing [[20], [32]]. Moreover, in relation to general disaster related behaviors, the public's trust in government actors to provide reliable information varies by one's racial or ethnic group, which subsequently results in members of these groups complying with official recommendations and mandates differently than Whites [33,34]. Along these lines, Perry and Lindell [30], Tierney et al. [33], and Lindell and Perry [34] have all observed how ethnic and racial minorities' general trust in government during times of disaster affects their disaster related behaviors. However, their observations neglect to observe this phenomenon in relation to epidemics or pandemics. This difference in the trust of government actors and its effect on individual behaviors among minority groups is important to understand so that disaster response and recovery personnel and organizations can more effectively deal with crises, or, in the case of COVID-19, manage the spread of the virus.

For example, in their study of the relationship between trust in government actors and people's decision to receive an H1N1 vaccine during the 2009 H1N1 pandemic, Freimuth et al. [35] observed differences between racial/ethnic groups in reference to how trust predicted vaccination behavior. Specifically, decisions to get vaccinated against H1N1 was observed to be positively related to trust in government; however, this relationship only held for Whites. Similarly, Yaqub et al. [36] Larson et al. [37] and Jamison et al. [38] all have observed a direct relationship between trust in government and people's uptake of vaccinations. However Jamison et al. [38], maintain that this relationship is typically context specific with each population, vaccine and geographic location being unique. Along these lines, in a more recent study of the intention to get vaccinated against COVID-19 across five major cities, Trent et al. [39] observed different behaviors related to vaccine uptake when controlling for trust in government. Specifically, within major cities in Australia (i.e. Sydney and Melbourne) trust in government had a positive influence on people's intent to get vaccinated; however, an inverse relationship was observed in cities within the United States (i.e. New York and Phoenix). Moreover, Larson and Heymann [40] argue that people's hesitancy to get vaccinated is not only about whether the public trusts government in general, but which government actors are conveying information about a vaccine during a pandemic. As such, trust in different government actors subsequently affects whether people uptake a vaccine differently.

3. Methods

The forthcoming analysis uses data from the KFF COVID-19 Vaccine Monitor that was designed and conducted by the Kaiser Family Foundation. The phone survey was administered between June 8 and Jun 21, 2021 among a national random sample of American adults aged eighteen and older. A disproportionate sampling strategy was used to reach Hispanic and non-Hispanic Black respondents living in areas with high rates of COVID-19 hesitancy. High hesitancy was defined as living in the top 25% of counties whose share of the population had not intended to get vaccinated based on the U.S. Census Bureau's Household Pulse Survey. Interviews were completed in both English and Spanish using cellular and landline telephone samples. The overall margin of error for the national sample was ± 3% points. However, not all respondents in the sample answered the questions needed for the forthcoming analysis. Moreover, because this current research is only interested in the decision to get a COVID-19 vaccination among Hispanics and Latinos, a subsample was created from the initial sample that only contained respondents that self-identified at Hispanic or Latino. As such, the final sample used in the forthcoming analysis is composed of 427 respondents that completed all of the germane questions in the survey and that indicated that they were Hispanic or Latino. Sampling weights were calculated to adjust for sample design aspects, such as unequal probability of selection, nonresponse bias resulting from differential response rates across various demographic groups, counties, areas with high levels of vaccine hesitancy, and phone type usage (i.e. landline vs. cellular) [41]. The resulting sample data reflects the national adult Hispanic and Latino population based on data from the Census Bureau's 2019 U S. American Community Survey (ACS).

4. Measurement of variables

The dependent variable under investigation is whether a respondent decided to receive a COVID-19 vaccination. Within the survey, respondents were asked, “Have you personally received the COVID-19 vaccine, or not?” The close ended responses were coded 0 and 1, with 0 indicating that a respondent had not received a vaccine and 1 indicating that they had. As such, the dependent variable is dichotomous and measures whether a respondent received a vaccination for COVID-19 by the time the survey was administrated.

As previously pointed out, although trust in government has been observed to be an important influence on people's decision to be vaccinated against a pandemic virus [[35], [36], [37], [38]], there is not a consensus on the direction of the relationship [39]. Moreover, although it is important for the public to have trust in government, the influence of trust may vary by governmental actor [40]. As such, several explanatory variables were created for this study that measure a respondent's relative level of trust in a particular actor. The first four of these variables measure a respondent's trust in the Center for Disease Control, President Biden to provide reliable information about COVID-19 vaccines, their respective state government officials to provide reliable information about COVID-19 vaccinations, and their respective local public health officials to provide reliable information about the COVID-19 vaccines, respectively. In the survey, respondents were asked to indicate their level of trust in each of these actors on a scale of 0–3, with 0 indicating that they have no trust in the CDC and 3 indicating that they trust the CDC a “great deal” to provide reliable information about the COVID-19 vaccines.

Some studies have begun to document a relationship between a respondent's political party affiliation in the United States and their decision or intention to get a COVID-19 vaccination [[42], [43], [44]]. Although these studies have observed this trend generally among the American population, there is a lack of understanding how party affiliation specifically influences Hispanics and Latino's decision-making related to COVID-19 vaccination. As such, this study observes the affect that party affiliation might have on Hispanics and Latinos' decision to receive a COVID-19 vaccination. Along these lines, the survey asked respondents to indicate their political party affiliation. Responses were coded from 0 to 4, with 0 indicating Democrat, 1 indicating Republican, 2 indicating they were Independent, 3 indicating that they belong to another party, and 4 indicating that they either did not know or refused to answer.

Additionally, it is also possible that an individual's personal experiences with COVID-19, or the lack thereof, might influence whether one would decide to get vaccinated against the virus [45,[46], [47]]. As such, this study controls for a respondent's personal experience with COVID-19. Along these lines, the survey asked respondents to indicate their experience with COVID-19 in one close-ended question. Respondents were given option to choose one of the following possible experiences: the responded tested positive for COVID (coded 0); someone in their household had tested positive for COVID (coded 1); someone they know had tested positive for COVID (coded 2); and neither they nor someone they knew had tested positive for COVID (coded 3). As such, this variable measures whether a respondent or someone a respondent knew had tested positive for COVID by the time the survey was administered.

Finally, various common demographic variables were chosen for inclusion in the forthcoming models. Demographic variables included gender, race, employment status, age, parental status, marital status, whether someone was covered by health insurance, income, educational attainment and whether someone identifies as LGBT. All of these variables have been included in the forthcoming analysis because of their argued importance in relation to COVID-19 outcomes, public health behaviors, and their access to public health services during the pandemic in the United States [[18], [42], [44], [47], [48], [49], [50], [51]].

5. Results

Prior to describing the analytic strategy used in this paper, it is important to understand a bit about the sample used in this study. As such, Table 1 depicts the demographic break down of the sample. Beyond commonly used demographic variables, several variables are important to this specific project. First, about 68.62% of the sample indicated that they had been vaccinated. Second, about 13.35% of respondents indicated that they had previously tested positive for COVID-19 versus 37.70% that indicated that they neither knew someone that had been diagnosed with COVID nor were they themselves diagnosed with the virus. Third, about 76.35% of the sample indicated that they either had a “fair amount” or “great deal” of trust in the CDC. Fourth, about 61.59% of the sample indicated that they either had a “fair amount” or “great deal” of trust in their respective local public health officials. Fifth, about 61.59% of the sample indicated that they either had a “fair amount” or “great deal” of trust in their respective state government officials. Finally, about 70.49% of the sample indicated that they either had a “fair amount” or “great deal” of trust in President Biden. As such, the sample analyzed in this study reflects the decision to get vaccinated for COVID-19 among Hispanic and Latinos in the U.S. as a function of trust in various government actors as of June 2021 when this manuscript was initially developed.

Table 1.

Descriptive statistics of sample (n = 427).

Variable	Frequency	% of Sample	Variable	Frequency	% of Sample
Level of Trust in the CDC			Level of Trust in President Biden
None	37	8.67	None	67	15.69
Not Much	64	14.99	Not Much	59	13.82
A Fair Amount	141	33.02	A Fair Amount	125	29.27
A Great Deal	185	43.33	A Great Deal	176	41.22
Level of Trust in State Government Officials			Level of Trust in Local Public Health Officials
None	42	9.84	None	33	7.73
Not Much	122	28.57	Not Much	122	28.57
A Fair Amount	134	31.38	A Fair Amount	134	31.38
A Great Deal	129	30.21	A Great Deal	129	30.21
Gender			Age Categories
Male	243	56.91	18–29 Years Old	98	22.95
Female	184	43.09	30–49 Years Old	159	37.24
Race			50–64 Years Old	94	22.01
White	253	59.25	65+ Years Old	76	17.80
Black of African American	48	11.24	Parental Status
Asian	6	1.41	Is Not a Parent	282	66.04
Other or Mixed	120	28.10	Is a Parent	145	33.96
Employment Status			Health Insurance Coverage
Employed	292	68.38	Covered	317	74.24
Student	11	2.58	Not Covered	110	25.76
Retired	50	11.71	Marital Status
On Disability	24	5.62	Married	171	40.05
A Homemaker or Stay at Home Parent	46	10.77	Living with a Partner	53	12.41
DK/Refused	4	0.94	Widowed	22	5.15
LGBT			Divorced or Separated	69	16.16
No	382	89.46	Never Been Married	110	25.76
Yes	28	6.56	DK/Refused	2	0.47
DK	7	1.64	Political Party Affiliation
Refused	10	2.34	Democrat	145	33.96
Tested Positive for COVID-19			Republican	57	13.35
Respondent Tested Positive	57	13.35	Independent	112	26.23
Someone in Respondent's Household Has Tested Positive	58	13.58	Other Party	78	18.27
Someone They Know has Tested Positive	145	33.96	DK/Refused	35	8.20
Respondent nor Someone They Know Tested Positive	161	37.70	COVID-19 Vaccination Status
DK/Refused	6	1.41	Unvaccinated	134	31.38
Educational Attainment			Vaccinated	293	68.62
Less than high school	110	25.76	Income
High school graduate	129	30.21	Less than $40 k	227	53.16
Some college	80	18.74	$40-$89 k	106	24.82
College +	108	25.29	$90 k +	61	14.29
			Don't Know/Refused	33	7.73

Because this research is interested in understanding how people's trust in various government actors influences Hispanics' and Latinos' decision to get a COVID-19 vaccination, which, in the context of this study, is measured dichotomously, a logistic regression was used to explore how the previously described explanatory variables influence this decision. Logistic regression is a technique that allows the researcher to relate a dichotomous dependent variable to a set of independent variables that may be continuous, categorical, and discrete or a combination of these [[52], [53], [54]]. According to Petersen [52], logit models allow a researcher to predict the probabilities of belonging to one of the categories on the dependent variable, in addition to predicting changes in probabilities resulting from changes in independent variables. This technique is therefore appropriate for exploring what variables may influence an individual to get a COVID-19 vaccine. To check for multicollinearity and adherence to proportional odds assumptions, Spearman correlations, approximate likelihood ratio tests, and Brant tests [55] were administered on the regression model. The results of these tests demonstrated that the proportional odds assumptions held for all independent variables in the model.

Table 2 highlights the results of the analysis of respondents' decision to get a COVID-19 vaccination among Hispanics and Latinos in the United States. It should be pointed out that adjusted odds ratios are presented in the table because this current exploratory research is interested in the potential relationships that might be occurring between independent and dependent variables while controlling for other factors, as opposed to the specific affect a particular variable might has on the decision to uptake a COVID-19 vaccination in isolation. As the analysis results indicate, two variables related to trust in government actors were observed to influence Hispanics' and Latinos' decision to get a COVID-19 vaccine. First, Hispanics' and Latinos’ trust in the CDC to provide reliable information on COVID-19 vaccines had a statistically significant and positive influence on the odds of someone getting vaccinated. Specifically, respondents with “a fair amount” of trust in the CDC were observed to have almost 10 times higher odds of vaccination compared to those with no trust (AOR = 9.78, 95%CI = 2.01 to 47.61), while holding all other variables constant. Additionally, a respondent indicating that they had “a great deal” of trust in the CDC to provide reliable information about COVID-19 vaccines was observed to have almost 7 times higher odds of vaccination compared to those with no trust in the CDC (AOR = 6.84, 95%CI = 1.34 to 34.92), while holding all other variables constant. Second, Hispanics and Latinos that indicated that they had “a great deal” of trust in President Biden to provide reliable information about COVID-19 vaccines had an statistically significant and positive influence on the odds of having received a vaccine, while holding all other variables constant. In relation to trust in President Biden, respondents with “a great deal” of trust were observed to have about a 7 times higher odds of vaccination than those with no trust in Biden (AOR = 7.33, 95%CI = 1.99 to 26.96).

Table 2.

Logistic regression on the decision to vaccinate against COVID-19.

Variable	Odds Ratio	Robust Standard Error	p-Value	Confidence Interval
Level of Trust in the CDC
Not Much	4.9748	4.3106	0.064	0.9104	27.1853
A Fair Amount	9.7821	7.8983	0.005	2.0097	47.6124
A Great Deal	6.8380	5.6883	0.021	1.3392	34.9155
Level of Trust in President Biden
Not Much	1.8802	1.1365	0.296	0.5750	6.1480
A Fair Amount	3.0962	2.0524	0.088	0.8444	11.3523
A Great Deal	7.3288	4.8704	0.003	1.9923	26.9600
Level of Trust in State Government Officials
Not Much	0.2513	0.1945	0.074	0.0551	1.1457
A Fair Amount	0.2416	0.1828	0.060	0.0548	1.0641
A Great Deal	0.3260	0.2545	0.151	0.0706	1.5055
Level of Trust in Local Public Health Officials
Not Much	2.9155	2.3866	0.191	0.5861	14.5037
A Fair Amount	4.1111	3.1704	0.067	0.9068	18.6376
A Great Deal	2.6884	1.9799	0.179	0.6348	11.3859
Gender
Female	1.0887	0.3885	0.812	0.5409	2.1912
Age Categories
30–49 Years Old	2.7588	1.1223	0.013	1.2430	6.1233
50–64 Years Old	2.3422	1.2457	0.110	0.8259	6.6428
65+ Years Old	4.1512	3.3186	0.075	0.8664	19.8904
Race
Black of African American	0.6443	0.3398	0.405	0.2291	1.8114
Asian	0.1519	0.1204	0.017	0.0321	0.7187
Other or Mixed	0.7872	0.3028	0.534	0.3703	1.6734
Parental Status
Is a Parent	0.3731	0.1444	0.011	0.1748	0.7965
Employment Status
Student	5.4916	4.3523	0.032	1.1617	25.9604
Retired	3.7499	3.5618	0.164	0.5828	24.1280
On Disability	0.2205	0.1573	0.034	0.0544	0.8929
A Homemaker or Stay at Home Parent	1.0442	0.4699	0.923	0.4322	2.5226
DK/Refused	3.4671	2.9833	0.148	0.6420	18.7238
Health Insurance Coverage
Not Covered	0.8268	0.2988	0.599	0.4072	1.6788
Marital Status
Living with a Partner	1.3082	0.6955	0.613	0.4614	3.7088
Widowed	1.8306	1.5738	0.482	0.3394	9.8720
Divorced or Separated	1.2288	0.6065	0.676	0.4671	3.2339
Never Been Married	0.8657	0.4013	0.756	0.3489	2.1477
DK/Refused	0.3392	0.3705	0.322	0.03987	2.8854
LGBT
Yes	0.7170	0.3617	0.510	0.2668	1.9271
DK	4.3567	5.0863	0.207	0.4420	42.9440
Refused	0.2296	0.2123	0.111	0.0375	1.4056
Political Party Affiliation
Republican	0.4893	0.2475	0.158	0.1816	1.3185
Independent	1.4230	0.6391	0.432	0.5900	3.4315
Other Party	1.2473	0.5480	0.615	0.5273	2.9507
DK/Refused	0.5128	0.3079	0.266	0.1581	1.6634
Tested Positive for COVID-19
Someone in Respondent's Household Has Tested Positive	0.4004	0.2286	0.109	0.1307	1.2263
Someone They Know has Tested Positive	0.8210	0.3948	0.682	0.3199	2.1071
Neither Respondent nor Someone They Know Tested Positive	1.3030	0.6904	0.618	0.4611	3.6811
DK/Refused	0.0829	0.1468	0.160	0.0026	2.6668
Educational Attainment
High school graduate	0.5601	0.2476	0.190	0.2355	1.3320
Some college	0.6606	0.3550	0.440	0.2305	1.8935
College +	0.9501	0.5362	0.928	0.3143	2.8720
Income
$40-$89 k	1.3200	0.5712	0.522	0.5650	3.0823
$90 k +	3.4300	1.9810	0.033	1.1056	10.6383
Don't Know/Refused	0.5530	0.3458	0.343	0.1622	1.8841
Constant	0.1079	0.1396	0.085	0.0085	1.3618
Pseudo R2					0.2857
Observations					427

Although the main goal of this study is to understand how trust in government actors influences Hispanics' and Latinos' decision to get vaccinated against COVID-19, it is also important to understand how other characteristics among the ethnic group potentially influence this decision. Along these lines, several demographic variables were observed to be statistically significant in influencing the odds of Hispanics and Latinos making this decision. First, one's age was found to be statistically significant. Specially, being 30-to 49-year-olds, had an increase in the odds of getting vaccinated in comparison to the base age category of 18- to 29-year-olds (AOR = 2.76, 95%CI = 1.24 to 6.12), while holding all other variables constant. Second, Hispanic and Latino respondents that indicated their race to be Asian had a decrease in the odds of them having decided to get vaccinated in comparison to the base category of White (AOR = 0.15, 95%CI = 0.03 to 0.72), while holding all other variables constant. Third, respondents that indicated that they are a parent were observed to have a decrease in the odds of having decided to receive a COVID-19 vaccination in comparison to the non-parent base category (AOR = 0.37, 95%CI = 0.18 to 0.80), while holding all other variables constant. Fourth, respondents that indicated that they were a student had an increase in the odds of having received the vaccine in comparison to the employed base category (AOR = 5.49, 95%CI = 1.16 to 25.96), while holding all other variables constant. Alternatively, respondents that indicated that they were on disability for their employment status had a decrease in the odds of having been vaccinated for COVID-19 in comparison to the employed base category (AOR = 0.22, 95%CI = 0.05 to 0.89), while holding all other variables constant. Finally, respondents that indicate that their annual income was $90,000 or more exhibited an increase in the odds of having received a vaccine in comparison to the “less than $40,000” a year base category (AOR = 3.43, 95%CI = 1.11 to 10.64), while holding all other variables constant.

6. Discussion

As previously described this research sought to observe the influence that trust in government actors among Hispanics and Latinos had on members of this ethnic group to decide to get vaccinated for COVID-19. Because extant literature indicated that trust in government actors might vary in relation to their respective influence on an individual's decision, the effect of one's relative level of trust in the CDC, President Biden, one's respective state authorities, and one's local public health officials were all observed on Hispanics' and Latinos' decision to get a COVD-19 vaccine. As a byproduct of the analysis, it was observed that for Hispanics and Latinos, trust in the CDC to provide accurate information about vaccinations had a positive influence on the odds of someone being vaccinated. Additionally, trusting the President to provide accurate information about vaccines also had a positive influence on the odds of Hispanics and Latinos deciding to get vaccinated, but only when respondents indicated that they trusted the President in this regard “a great deal”. As such, this research confirms what has been argued by Larson and Haymann [40] that trust in different government actors has varying respective effects on a population's uptake of vaccines in a pandemic.

Therefore, to reduce public health vulnerabilities in the future through preventative health-related behaviors, such as vaccination uptake, the overall trust in public health agencies and government must be strengthened [56]. argue that government public health agencies, in addition to public officials responsible for disseminating health information, should develop communication strategies that are clear, transparent and appropriate for various target audiences that reflect various communities’ differentiated trust in information sources. However, this requires an enhanced understanding of the factors affecting trust in various actors as a function of intersecting identities indicative to different communities [15,[57], [58], [59]]. Additionally, enhancing trust in government actors in relation to communicating public health information must include these same communities. Specifically, Sopory et al. [60] argue that building and maintaining trust requires participatory dialog and inclusion of various communities in the planning, exercise and testing of communication plans related to public health. Along these lines, government actors responsible for disseminating public health information need to engage in a continuing dialog with the communities they serve, particularly those that have been historically marginalized, if trust is to be enhanced. Although direct participation is preferable, the use of community and/or faith-based organizations that both represent these communities and act as information hubs themselves should continue to be brought into the communication strategic process [61]. Through these more participatory and inclusive processes government organizations have the potential of enhancing their ability to affect better preventive health-related behaviors among the public.

In addition to observing the role that trust in government plays in Hispanic and Latino's decision to be vaccinated against COVID-19, this study was also interested in the influence that various demographic and social characteristics among this population played in this decision. Along these lines, various demographic factors such as age, race, parental status, employment status, and income all were statistically significant in influencing Hispanic and Latino's decision to get vaccinated against COVID-19. As such, this research confirms some extant studies' observations on the influence of these variables in relation to vaccination [[18], [42], [44], [47], [48], [49], [50], [51]]. Alternatively, variables such as political party affiliation and gender that have been observed to affect aggregated national samples' decision to get vaccinated were not observed to be statistically significant among Hispanics and Latinos.

The potential reasons for these observed relationships are beyond the scope of this project and the instrument from which the data was analyzed. However, Lu et al. [18] (see also [[62], [63], [64]]) reminds us that the factors that contribute to differences in vaccine uptake among ethnic communities are many, and are typically a byproduct of interactions between demographic characteristics, socialization and previous experiences with medical providers, government actors, and/or illnesses. Moreover, others have observed that difficulties indicative to certain racial and ethnic minorities that relate to access to medical insurance and the COVID-19 vaccines themselves also affect the decision to get vaccinated [42,65]. But, the instrument did not account for these potential dynamics either. As such, future research should attempt to explore whether and how these potential dynamics may have affected Hispanic's and Latino's hesitancy to get vaccinated for COVID-19 with specific interest on the characteristics of race, ability, and parental status.

Alternatively, the role income plays in the decision to be vaccinated might be hypothesized. Along these lines Khubchandani et al. [42] and Khubchandani and Macias [66], maintain that COVID-19 vaccination rates have been observed to be relatively lower in minority-dominated and low-income communities due to disproportionate allocations of vaccines that benefit more affluent communities. A such, vaccination uptake may be a byproduct of neighborhood effects related to factors such as distance to vaccination sites, rurality, and lack of facilities within or close to low-income or ethnically concentrated populations [[67], [68], [69], [70]]. As a result, it might be reasoned that individual's income is highly and positively correlated with one's choice to live in residential locations that have access to relatively higher levels of access and quality amenities and social services [[71], [72], [73]]. Based on this logic, one might speculate that Hispanics and Latinos with relatively higher incomes, in this case making $90,000 a year or more, live in communities with greater access to facilities, organizations, and/or services that would provide COVID-19 vaccination in comparison to their lower-earning counterparts. Although this is one potential hypothesis, it is not testable with this data and should be explored in future studies that are specifically developed to investigate neighborhood effects and their role in vaccination uptake behavior.

However, despite this study's ability to observe how different variables influence Hispanic's or Latino's decision to get vaccinated against COVID-19, this study suffers from several limitations that should be accounted for in future studies related to public health behavior. First, this study is limited in its ability to observe differences between sub-ethnic classifications of groups that compose the Hispanic/Latino category. The Hispanic/Latino classification used in the United States lumps many different people into one category and has been problematic when making inferences about the group itself. Specifically, many of the nationalities that compose the Hispanic/Latino classification have their own unique cultures, political affiliations/interests, relative levels of trust in government, and socioeconomic dynamics that might lead us to hypothesize that what was observed in this study is not necessarily applicable across all subgroup classifications. Along these lines, although this study is able to observe potential relationships aggregated to Hispanics/Latinos in the United States, it is not able to provide information on differences between Puerto Ricans, Dominicans, Mexicans, Cubans, etc., for example. As such, future research should seek to observe whether differences exist between these subclassifications in relation to the decision to get vaccinated against COVID-19 because understanding these nuances can help local public health agencies better communicate and moderate the effects of the virus where these people are geographically concentrated.

Second, and in relation to the previous point, although this study observed how trust in different government actors influenced the decision to get vaccinated against COVID-19 amongst Hispanics and Latinos, it did not observe what factors contributed to varying levels of trust in those same actors. Understanding this dynamic could contribute to how the governmental actors investigated in this study might work to further enhance their respective level of trust from various Hispanic and Latino communities. However, to holistically achieve this goal, studies should attempt to undertake this type of research with an eye toward differences between sub-ethnic groups. This is particularly important in relation to observing what factors contribute to trust in local government actors due to many Hispanic and Latino sub-ethnic groups being hyper-concentrated in different states and regions of the United States. Moreover, this type of investigation should be expanded to not only understand the factors that influence one's trust in various government actors to provide accurate information about vaccinations, but trust in government more generally as a means of improving governmental service provision.

7. Conclusion

Trust in government during pandemics is extremely important because it relates to whether the public conforms to official recommendations or mandates related to mitigating the effects of dangerous viruses. This has been exceptionally important in the case of the COVID-19 pandemic in which trust in government has influenced public health behavior of different populations in the United States. Although typically only compared to their White and African American counterparts, this research observed how different demographic and social characteristics among Hispanics and Latinos influenced their decision to conform to federal recommendations to receive a COVID-19 vaccination. Along these lines, we have only begun to scratch the surface of what factors contribute to this particular decision among members of this ethic group. Enhancing service provision during a pandemic among members of the Hispanic and Latino community can only happen if we are able to observe important factors among the group itself, as opposed to simply comparing them to other racial/ethnic categories. This study helps move us in that direction by providing some understanding of factors influencing their public health behavior.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Data availability

The authors do not have permission to share data.