wide consensus. The research team has retained the punctuation and capitalization of the typed responses from respondents to ensure consistency with respondents’ actual words. Respondents provided over 300 responses to open-ended questions; therefore, only the most representative quotes are presented. Quotes are organized within the theme that the quote best represents; however, participants’ comments were multi-faceted, and they often discussed multiple, interrelated experiences within the same sentence. 3. Results Table 1 provides descriptive characteristics of the study sample. Most respondents were between 30 and 49 years of age (42.66%), self-identified as women (70.42%), identified their race and ethnicity as non-Hispanic White (70.41%), and made less than $50,000 per year (66.77%). The present study uses a non-probability sample that is not fully representative of the population of Arkansas as a whole. The sample is diverse with regard to race and ethnicity but includes more women and individuals with a higher income than the median household income in Arkansas [27]. Table 1 also provides measures of general vaccine trust and hesitancy related to COVID-19 vaccines specifically. The majority of participants indicated a high trust for vaccines (56.48%) and were not hesitant regarding the COVID-19 vaccine (61.25%). Table 1. Sociodemographics, general vaccine trust, and COVID-19 vaccine hesitancy. Frequency Percentage (%) S.D. Range Age 754 16.31 18.2–90.6 18–29 112 15.36 30–49 311 42.66 50–64 177 24.28 65+ 129 17.70 Sex 752 0.45 0–1 Women 531 70.42 Men 221 29.31 Race/Ethnicity 747 0.65 1–4 Black/African American 128 17.14 White 526 70.41 Other Race or Multiracial 61 8.17 Hispanic/Latinx 32 4.28 Income 620 1.19 1–4 <$25K 281 45.32 $25K >< $50K 133 21.45 $50K < $75K 72 11.61 >$75K 134 21.61 Education 748 0.80 1–3 High School or Less 212 28.34 Some College 265 35.43 Four-Year Degree 271 36.23 Rural–Urban Commuting Area (RUCA) 522 0.44 0–1 Non-Metro 142 27.20 Metro 380 72.80 General Vaccine Trust 694 0.49 0–1 Low Trust 302 43.52 High Trust 392 56.48 COVID-19 Vaccine Hesitancy 720 0.49 0–1 Hesitant 279 38.75 Not Hesitant 441 61.25 Int. J. Environ. Res. Public Health 2021, 18, 8690 4 of 9 Qualitative responses indicating concerns regarding the COVID-19 vaccine were analyzed with the IVM domain of thoughts and feelings serving as an a priori code, with emergent themes arising within this overarching code category. Emergent subthemes within the IVM domain of thoughts and feelings are: not enough knowledge/information to judge the safety of the COVID-19 vaccine, the process for developing the COVID-19 vaccine was rushed and therefore cannot be trusted, do not want to be among the first to receive the COVID-19 vaccination, a lack of trust in those developing the COVID-19 vaccination, and a lack of trust in vaccines in general. The frequency of emergent themes is presented in Table 2. We describe each of these emergent themes below. Table 2. Qualitative themes and percentages of appearance in coded segments. Qualitative Themes Percentage (%) Not enough knowledge/information to judge the safety of the COVID-19 vaccine 40 The process for developing the COVID-19 vaccine was rushed and therefore cannot be trusted 34 Do not want to be among the first to receive the COVID-19 vaccination 12 A lack of trust in those developing the COVID-19 vaccination 13 A lack of trust in vaccines in general 4 3.1. Not Enough Knowledge/Information to Judge the Safety of the COVID-19 Vaccine Respondents reported distrust because of the lack of information available to judge the safety of the COVID-19 vaccine. One response succinctly stated, “It’s very scary because not enough is known about this vaccine. It’s not had time to prove itself or to prove how safe it is. Does it really work and for how long” (#634). Another respondent stated that she “would not put my trust in something that hadn’t stood the test of time as other vaccines have” (#192). One respondent wrote that she is “unsure [the COVID-19 vaccine] is safe,” (#566). Another respondent discussed his lack of security related to safety from another direction; he stated, “safety assurance is absolutely necessary” (#117). Respondents reported that more information about the safety of the COVID-19 vaccine would be needed before they would be comfortable with a vaccine. One respondent stated, “I will only get vaccinated against COVID19 if and when it has been thoroughly tested and proven to be safe and effective” (#98). Another respondent stated that she was hesitant and “would not rush to receive a vaccine until it has had more time to be tested for safety” (#217). Linked to her safety-related hesitancy, she added that she “would have to know more about a COVID-19 vaccine before I would take it” (#217). Another respondent stated that she “would like to know about the real safety of [a COVID-19 vaccine]” (#402). 3.2. The Process for Developing the COVID-19 Vaccine Was Rushed and Therefore Cannot Be Trusted The rapid COVID-19 vaccine approval process was a major theme reported. The speed of the emergency use authorization (EUA) process was often cited as a salient factor leading to distrust of the COVID-19 vaccine. Respondents frequently stated that “It was made way too fast for me to trust it at all” (#742), and “scared . . . because [the COVID-19