Publication date: Jul 30, 2026
Racial inequities related to COVID-19 exposure, morbidity, mortality, and access to care in the United States (U. S.) are notable, and COVID-19 vaccine uptake is lower among Black Americans than White Americans. Yet, mechanisms linking healthcare experiences to COVID-19 vaccination behavior among young adults are not well characterized. We analyzed cross-sectional data collected between March and June 2023 from 360 Black young adults (ages 18-29) enrolled in a digital health trial in Georgia, Alabama, and North Carolina (NCT05490329). Discrimination in medical settings and group-based medical mistrust were assessed. COVID-19 vaccination was measured as ever receiving at least one dose. Correlations and a mediation model (PROCESS Model 4; 5,000 bootstrap resamples) tested whether medical mistrust statistically mediated the association between discrimination in medical settings and COVID-19 vaccination, adjusting for age, sex at birth, state, insurance, education, and perceived COVID-19 risk. In mediation analyses, discrimination in medical settings had a significant total effect on COVID-19 vaccination (B=-0. 44, SE=0. 13, p
| Concepts | Keywords |
|---|---|
| Black | African Americans |
| Georgia | COVID-19 |
| Healthcare | Discrimination |
| June | Medical mistrust |
| Nct05490329 | Preventative health |
| Young adult |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |