Primary Submission Category: Race/Ethnicity
Determinants of COVID-19 Vaccine Intentions and Uptake
Authors: Rick DeVoss Katie Dickinson
Presenting Author: Rick DeVoss*
Vaccines are a powerful public health tool and have been central to ongoing efforts to manage the global COVID-19 pandemic. While the rapid development of vaccines was a major victory in this battle, efforts to ensure widespread and equitable vaccine uptake faced (and continue to face) significant challenges. In this paper, we examine intention to vaccinate and vaccine uptake over time using a nationally representative panel survey dataset collected between January and June 2021, the key rollout period for the first round of COVID-19 vaccines in the United States. Our sample intentionally overrepresents non-White racial/ethnic groups, allowing us to assess and potentially explain well-documented inequities in vaccination outcomes across these groups. Using panel data, we explore concordance between early intentions and ultimate vaccine uptake. We then use the Health Belief Model to examine how perceptions/beliefs mediate relationships between vaccine outcomes (intention, uptake) and socio-demographic factors (e.g., age, race/ethnicity, income, education). Consistent with other analyses, we find that both intention to vaccinate and vaccine uptake are lower among Black respondents than White respondents, controlling for other socio-demographic variables. However, a substantial portion of these differences are mediated by health beliefs. In particular, Black respondents were less likely to believe vaccines were effective and safe compared to White respondents, and these beliefs significantly decreased vaccine intentions and uptake. These results highlight the need to address structural factors, including systemic racism, that contribute to vaccine mistrust in order to successfully protect public health in the context of this and other threats.