Estimating the effect of policy entrepreneurship on individual vaccination behavior during the COVID-19 pandemic

Most studies of policy entrepreneurship seek to understand how entrepreneurs influence the behavior of policy-makers in the agenda-setting or decision-making phases of the policy process. Recent scholarship has sought to understand what role entrepreneurs might play in policy implementation by focusing on their ability to influence bureaucrats' discretion and behavior. However, these studies overlook the potentially critical influence of policy entrepreneurs during the implementation of "opt-in" policies that require voluntary compliance by individuals to be successful. Here, we consider whether and how a visible policy entrepreneur can impact opt-in policy implementation, focusing on their credibility-or ability to gain public trust-as a potential driving factor of their influence. Using the empirical context of COVID-19 vaccination recommendations, we identify Dr. Anthony Fauci as a highly visible policy entrepreneur and assess his influence on individual vaccine intention and uptake. Drawing on data from a novel panel survey of the American public on attitudes about the virus, risk, politics, and vaccination during the first several months of the COVID-19 vaccine rollout in the United States, we test the relationship between respondent trust in Dr. Fauci and changes in reported intention to vaccinate and vaccination uptake across time. We find that trust in Dr. Fauci is an important predictor for influencing individuals' intention to vaccinate and actual vaccination behavior.