Willingness to Receive the COVID-19 Vaccine in California: Disparities by Race and Citizenship Status

Abstract

Although it is widely acknowledged that racialized minorities may report lower COVID-19 vaccine willingness compared to non-Hispanic white individuals, what is less known, however, is whether the willingness to receive the COVID-19 vaccine also differs by citizenship. Understanding disparities in vaccine willingness by citizenship is particularly important given the misleading rhetoric of some political leaders regarding vaccine eligibility by citizenship status. This study used the 2020 California Health Interview Survey ( n = 21,949) to examine disparities in vaccine willingness by race/ethnicity and citizenship among Asian, Latinx, and non-Hispanic white individuals. Overall, 77.7% of Californians indicated that they were willing to receive the COVID-19 vaccine if it was made available. However, there were distinct differences by race/ethnicity and citizenship. Asian people, regardless of citizenship, had the highest predicted probability of vaccine willingness, accounting for demographic, socioeconomic, and health factors. Non-citizen Latinx and non-citizen non-Hispanic white people had higher predicted probabilities of vaccine willingness compared to their US-born counterparts, accounting for demographic, socioeconomic, and health factors. Our results reveal that although vaccine willingness may be high among non-citizen individuals, it may not necessarily translate into actual vaccine uptake. Furthermore, while individual-level factors may account for some of the differences in vaccine willingness by race/ethnicity and citizenship, other institutional and structural barriers prevent vaccine uptake.

Associations between area-level health-related social factor indices and risk of acute COVID-19: An EHR-based cohort study from the RECOVER program

“…It is well established that social factors play a role in diagnosis, treatment, and outcomes of medical conditions. The COVID-19 pandemic has magnified health-related social factors impacting disparities in rates of COVID-19 and therefore, the development of PASC (23)(24)(25). Children bear the risk of being doubly impacted by their own health and their families' health.…”

‘They’ve all endorsed it…but I’m just not there:’ a qualitative exploration of COVID-19 vaccine hesitancy reported by Black and Latinx individuals

“…This vaccination gap is especially concerning because Black and Latinx people diagnosed with COVID-19 have experienced worse clinical outcomes 4. Structural and social determinants of health such as racism, socioeconomic status, access to transportation and access to information or trusted healthcare practitioners make it difficult for people in some communities who want to be vaccinated to get vaccines, but even as vaccine uptake gaps have narrowed, a number of people continue to choose not to be vaccinated 5–7…”

“…4 Structural and social determinants of health such as racism, socioeconomic status, access to transportation and access to information or trusted healthcare practitioners make it difficult for people in some communities who want to be vaccinated to get vaccines, but even as vaccine uptake gaps have narrowed, a number of people continue to choose not to be vaccinated. [5][6][7] COVID-19 vaccine hesitancy defined as 'indecision around accepting a vaccination', 8…”

Modes of COVID-19 Information and Vaccine Hesitancy Among a Nationally Representative Sample of Asian Americans: The Moderating Role of Exposure to Cyberbullying

“…Asian Americans in California, for example, reported lower vaccine hesitancy than Latinx and non-Hispanic White individuals. 17 …”