Publication date: Jun 05, 2025

Stark disparities in COVID-19 infection, mortality and vaccine uptake have been observed between racial groups. However, differences in COVID-19 vaccine confidence between racialized groups and contextual factors that account for such differences have not been explored. We sought to determine socioeconomic profiles associated with COVID-19 vaccine confidence using both conventional and latent profile analyses (LPA). A representative sample of 4220 Arab, Asian, Black, Indigenous, Mixed and White adults completed a survey conducted to examine COVID-19 vaccine confidence. We determined vaccine confidence by racial groups, and analyzed factors associated with vaccination confidence between different racialized groups. Regression analysis and LPA were used to determine profiles of vaccine confidence by race. Arab, Black, Indigenous and Mixed group respondents had lower vaccine confidence compared to White individuals, while Asian respondents had higher vaccine confidence compared to other racial groups. Vaccine confidence varied by age, gender, conspiracy beliefs, health literacy and experiences of racial discrimination. LPA produced Profile 1 with high vaccine confidence and health literacy, with low experience of discrimination and conspiracy beliefs; Profile 2 had low vaccine confidence and health literacy, with greatest experiences of discrimination and conspiracy beliefs. Compared to White respondents, Arab (odds ratio = 2. 86;95 % CI 2. 33-3. 52), Indigenous (odds ratio = 2. 29; 95 % CI, 1. 88-2. 78), and Black (odds ratio = 2. 19; 95 % CI 1. 80-2. 66) respondents were more likely to belong to Profile 2. Vaccine confidence profiles for COVID-19 converge at the intersection of health literacy, experience of discrimination and conspiracy beliefs. COVID-19 vaccine confidence is heterogenous between racialized communities, with lowest confidence among Arab, Black and Indigenous individuals and highest confidence among Asian individuals. Understanding the source of this heterogeneity is crucial to design public health approaches that equitably ensure vaccine coverage among populations at highest risk of COVID-19 and its complications.

Semantics

Original Article