COVID-19 vaccine hesitancy and racial discrimination among US adults

Don E. Willis · Brooke E. E. Montgomery · James P. Selig · Jennifer A. Andersen · Sumit K. Shah · Ji Li +3 more

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Vaccine Coverage and Hesitancy SARS-CoV-2 and COVID-19 Research COVID-19 and Mental Health

Abstract

Vaccination is a critical preventive measure to reduce COVID-19 health risks. We utilize full information maximum likelihood (FIML) logistic regression to analyze COVID-19 vaccine hesitancy in a national sample of United States (US) adults (N = 2,022). Online survey data was collected between September 7th and October 3rd, 2021. Before weighting, the racial composition of the sample was as follows: Asian American (15.0 %), Black/African American (20.0 %), Hispanic/Latino (20.0 %), American Indian or Alaska Native (12.6 %), Native Hawaiian or Pacific Islander (12.5 %), and White (20.0 %). Informed by the Increasing Vaccination Model (IVM), we assessed the relationship between COVID-19 vaccine hesitancy and experiences of racial discrimination (Krieger's 9-item measure). Odds of COVID-19 vaccine hesitancy were greater for most younger age groups, women (OR = 1.96; 95 % CI[1.54, 2.49]), Black/African American respondents (OR = 1.68; 95 % CI[1.18, 2.39]), those with a high school education or less (OR = 1.46; 95 % CI[1.08, 1.98]), Independent (OR = 1.77; 95 % CI[1.34, 2.35]) or Republican political affiliation (OR = 2.69; 95 % CI[1.92, 3.79]), and prior COVID-19 infection (OR = 1.78; 95 % CI[1.29, 2.45]). Odds of COVID-19 vaccine hesitancy were 1.04 greater for every-one unit increase in lifetime experiences of racial discrimination (95 % CI[1.02, 1.05]). Odds of COVID-19 vaccine hesitancy were lower for Asian American respondents (OR = 0.682; 95 % CI[0.480, 0.969]), and those who had a primary care doctor had reduced odds of COVID-19 vaccine hesitancy (OR = 0.735; 95 % CI[0.542, 0.998). Our primary finding provides support for a link between experiences of racial discrimination and hesitancy towards a COVID-19 vaccine among US adults. We discuss implications for public health officials and future research.

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References

2003Unequal treatment: confronting racial and ethnic disparities in health care 2005Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health 2020Determinants of COVID-19 vaccine acceptance in the US 2021Vaccine hesitancy in the era of COVID-19 2017Increasing Vaccination: Putting Psychological Science Into Action 2020Racial Health Disparities and Covid-19 — Caution and Context 2007Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present 2019Uncivil Agreement: How Politics Became Our Identity

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