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=.682; 95% CI[.480, .969]), and those who had a primary care doctor had reduced odds of COVID-19 vaccine hesitancy (OR=.735; 95% CI[.542, .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.
