Does Experience of Vaccination Improve Vaccine Confidence and Trust? Policy Feedback Effects of Mass COVID-19 Vaccination in the United States

Context: Policy feedback research has demonstrated that a highly tangible policy that shapes public attitudes through direct and day-to-day experiences often reshapes public opinion, with the effect of generating supportive or skeptical constituencies that determine the sustainability of future programs. This article examines the impact of mass vaccination efforts on attitudes toward vaccines in a context of high vaccine hesitancy in the United States. Methods: The authors analyzed 73,092 survey responses from 9,229 participants in the longitudinal data from the Understanding America Study project, covering December 2020 to July 2023. Using two-way fixed-effects ordinary least squares regression and ordinal logistic regression, the authors estimated the changes in attitudes toward vaccines, including trust in vaccine manufacturing and approval processes, following COVID-19 vaccinations. Findings: COVID-19 vaccination was associated with improved perceptions of vaccine effectiveness and social benefits and reduced mistrust in vaccine-related processes. However, it did not significantly alleviate concerns regarding vaccine side effects and severe illness stemming from vaccination. The strongest effects were observed among initially hesitant respondents who eventually received vaccinations. Conclusions: The experience of COVID-19 vaccination generally improved attitudes and confidence in COVID-19 vaccines among the US public, particularly among vaccine-hesitant people. These effects could have positive impacts on future immunization programs by mitigating vaccine hesitancy.