Publication date: Feb 06, 2025

To investigate the association between nativity and COVID-19 vaccine acceptance and its interaction with race/ethnicity, education, and English proficiency. Differences in vaccine acceptance among propensity-score matched foreign- and US-born persons using 2021 California Health Interview Survey Data were measured using a survey-weighted multivariable logistic regression model with interaction terms and average predicted probabilities between nativity and: race/ethnicity, education, English proficiency. A total of 4,234,655 survey-weighted persons (8504 unweighted) met inclusion criteria; 2251,279 (53 %) were foreign-born (1,983,376 US-born), and 55 % of all persons were Hispanic/Latino, 22 % were Non-Hispanic White, 17 % were Non-Hispanic Asian/Pacific Islander, 3. 6 % were Non-Hispanic Black/African American, and 2. 5 % were categorized as ‘Other’. Foreign-born status was significantly associated with greater odds of acceptance (adjusted odds ratio [aOR], 2. 81 [95 %CI, 1. 16-6. 83]). Foreign-born Hispanic persons had a significantly greater probability of acceptance compared to their US-born counterparts (average probability difference, +0. 11 [95 %CI, +0. 023, +0. 20]). Foreign-born persons with poor English proficiency had a lower probability of acceptance versus US-born persons (APD, -0. 081, [95 %CI, -0. 43, 0. 27]). Nativity was significantly associated with COVID-19 vaccine acceptance, and this relationship varied by race/ethnicity and English proficiency. These findings may be used to direct future interventions aimed at improving COVID-19 vaccination rates.

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Semantics

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