UH Study: Native Hawaiian and Pacific Islander Vaccination Rates Affected by Trust Levels

A new study from the University of Hawaii at Mānoa explains vaccine hesitancy among Native Hawaiians and other Pacific Islanders in Hawaii early in the COVID-19 pandemic, and researchers say the findings could provide a basis for communication strategies for other health policies beyond the pandemic.

“The study revealed for the first time an opposite role of trust in vaccine uptake that we were able to quantify,” Ruben Juarez, professor of economics in the College of Social Sciences at UH-Mānoa and professor of Health Economics at the University of Hawaiʻi Medical Service Association. of the Hawaii Economic Research Organization, said in a press release. “The levels of confidence expressed by individuals were highly dependent on the source of information they relied on to make decisions about their health.”

Until last fall, Native Hawaiians and Pacific Islanders remained significantly undervaccinated compared to other ethnic groups in Hawaii. In collaboration with the Pacific Alliance Against COVID-19, a team of UH-Mānoa researchers interviewed 1,124 Hawaii residents between March and August 2021 during the group’s COVID-19 testing events. Of the respondents, 61.7% identified themselves as natives of Hawaii and the Pacific Islands.

The research team’s findings, published in June in Vaccines, describe how racial/ethnic differences in trust between sources of COVID information, coupled with the level of consumption of that information, corresponded to a divergence in the uptake of vaccines.

The researchers observed:

  • Respondents with a higher degree of trust in official sources of information about COVID were 20.68% more likely to get vaccinated.
  • Respondents with a higher degree of trust in unofficial sources were 12.49% less likely to get vaccinated.
  • Trust in unofficial sources, as well as consumption of COVID information from these sources, explains vaccine hesitancy, especially among Hawaiians and Pacific Islanders.

Vaccine hesitancy among Native Hawaiians and Pacific Islanders is concerning, as they are at a disproportionately higher risk of serious complications and death from COVID due to long-standing social inequalities associated with a higher prevalence of chronic diseases such as obesity and diabetes.


“The results of our study imply that public health strategies that promote confidence and health science literacy can augment COVID-19 mitigation efforts, an approach we are evaluating with a community-based and culturally relevant educational program that we have developed with our school partnerships that are coupled with supporting on-site COVID-19 testing,” said Alika Maunakea, associate professor at John A. Burns School of Medicine at UH-Mānoa, in the press release. .

May Okihiro, associate professor at the John A. Burns School of Medicine and pediatrician at the Waiʻanae Coast Comprehensive Health Center, added that the data provides critical information that health centers can use to develop strategies to more systematically address the diseases. health disparities.

The survey was part of a UH-Mānoa-Pacific Alliance Against COVID-19 partnership to increase capacity for COVID testing and vaccination in underserved communities while collecting meaningful data to address these issues.