Trust in government, public health authorities, health scientists and medical care providers and COVID-19 vaccines among Canadian adults.

Although the acute phase of the COVID-19 pandemic has passed, skepticism regarding vaccine safety, efficacy, and trust in public institutions continues to influence public attitudes toward vaccination in Canada and internationally. Recent outbreaks of vaccine-preventable diseases, including measles, have renewed concerns about trust in vaccines and the factors that shape it. This study examined associations between trust in government, public health authorities, health scientists, and medical care providers, and trust in COVID-19 vaccines among 5607 Canadian adults. Participants were recruited in May 2024 through quota sampling, and weighted to reflect the 2021 Canadian Census. Trust in federal and provincial/territorial government, public health authorities, health scientists, and medical care providers was based on their performance during the COVID-19 pandemic. Vaccine trust (outcome variable) was categorized as trusting, neutral, or distrusting. Covariates included sociodemographic characteristics, vaccination behaviours, and information sources. Multivariable multinomial regression estimated relative risk ratios with 95% confidence intervals. Overall, 63% of participants trusted COVID-19 vaccines, and 20% reported distrust. Support for family vaccination and willingness to be vaccinated were the strongest predictors of trust. Trust in health scientists, medical providers, public health authorities, and federal and provincial government was positively associated with vaccine trust. Vaccine trust was lower among adults aged 35-54 years, women but higher among residents of the Prairie provinces and northern territories compared with Ontario residents. Vaccine distrust was higher among unvaccinated individuals, and lower among higher-income households. These findings highlight the role of institutional trust in shaping trust in COVID-19 vaccines and informing targeted public health strategies to address persistent vaccine hesitancy.