A multivariable model of barriers to COVID-19 vaccination: Using cross sectional data from a nationally distributed survey in the United States.

Abstract

Discrimination has had longstanding effects on mental and physiological health, which became more evident and synergized during the COVID-19 pandemic. The role of discrimination on vaccination for COVID-19 during the pandemic, however, is not well understood. As such, we examined the relationship of everyday discrimination on COVID-19 vaccination. Using a multivariate logistic regression on data collected from a nationally distributed survey in the United States (US), we examined the relationship of discrimination measured by the Everyday Discrimination Scale on self-reported COVID-19 vaccination while adjusting for US nativity, as well as sociodemographic (i.e., age; gender; sexual orientation; race, and ethnicity) and socioeconomic (i.e., educational attainment; employment status; household income) factors. We found that participants reporting monthly to weekly discrimination and multiple times a week to daily discrimination had decreased odds of reporting COVID-19 vaccination (adjusted odds ratio [AOR] = 0.78, 95% confidence interval [CI]:0.68-0.90; and AOR = 0.75, 95% CI = 0.62-0.91, respectively) compared to those that reported no discrimination experienced. Educational attainment of high school equivalent or above, employment as an essential worker, and household-annual income of $50,000 or greater were significant socioeconomic factors. Age, sexual orientation, and race/ethnicity had mixed associations with COVID-19 vaccination. Discrimination overall remained a significant barrier to vaccination, while nativity was not significant when accounting for socioeconomic and sociodemographic factors. Discrimination must become a public health priority in addressing disparities in health and access and barriers that may affect preventive behaviors.