Associations of Racism and COVID-19 Vaccination Intention among Asian Americans and Other Ethnic Groups in the United States

Objectives: The COVID-19 pandemic, vaccine hesitancy, and vaccine distribution are intimately linked to race and ethnicity. The study investigates COVID-19 vaccine uptake intention and related predictors including demographic, medical and mental health, and racism-related experiences in a diverse U.S. sample with focus on Asian Americans. Methods: The study sample consisted of 1,469 adults in the United States. Participants completed an electronic survey which queried demographic variables, medical history and health behaviors, mental health status, COVID-19 vaccine intention, and three racism-related measures (racial ethnic discrimination, cultural racism, and anticipatory racism-related stress scales) Results: Bivariate and multivariate analyses showed that vaccine intention differed by demographic characteristics including gender, race/ethnicity, education, income, and age as well as physical and medical conditions. Study participants who reported greater experiences with cultural racism and racism anticipatory-related stress expressed higher vaccine intention while racial discrimination predicted lower intention for COVID-19 vaccine uptake. Conclusion: We found racism-related experience can influence vaccine intention, albeit in a complex way. This work contributes to understanding the complicated relationships between racial discrimination and COVID vaccine uptake intention. There is a critical need to develop and implement evidence-based intervention strategies to improve COVID-19 vaccine uptake to achieve herd immunity against COVID-19 and community protection.