Patterns and mediators of racial and ethnic disparities in COVID-19 vaccine hesitancy among young adults

Hongying Dai, Jessica L. Barrington-Trimis, Jennifer B. Unger, Lourdes Baezconde-Garbanati, Adam M. Leventhal

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


COVID-19 vaccines have been available for over a year, yet 26% of U.S. young adults remain unvaccinated. This study examines racial and ethnic disparities in young adult vaccine hesitancy and attitudes/beliefs that mediate disparities in vaccine hesitancy. Young adults (n = 2041;Mean[SD]:21.3[0.7] years-old) from a Los Angeles, CA, USA cohort were surveyed online in January–May 2021 and classified as vaccine hesitant (those who reported “Not at all likely”/“Not very likely” /“Slightly likely” to get vaccinated) versus non-hesitant (those who reported “Moderately likely”/”Very likely”/”Definitely likely” to get vaccinated or already vaccinated). Multivariable logistic regression was performed to examine racial/ethnic disparities in vaccine hesitancy. Factor analysis was conducted to create three subscales toward vaccination: positive, negative, and lack-of-access beliefs. Mediation analyses were performed to assess pathways from attitude/belief subscales to racial disparities in vaccine hesitancy. Overall 33.0% of respondents reported vaccine hesitancy. Black vs. White young adults had a higher prevalence of vaccine hesitancy (AOR[95%CI] = 4.3[2.4–7.8]), and Asians vs. Whites had a lower prevalence (AOR[95%CI] = 0.5[0.3–0.8]). Mediators explained 90% of the Black (vs. White) disparity in vaccine hesitancy, including significant indirect effects through positive belief–reducing (β = 0.23,p <.001) and negative belief–enhancing (β = 0.02,p =.04) effects. About 81% of the Asian (vs. White) disparity in vaccine hesitancy was explained by the three combined subscales, including significant positive belief–reducing (β = −0.18,p <.001) indirect effect. Substantial racial and ethnic disparities in young adult COVID-19 vaccine hesitancy were found, which were mediated by differences in attitudes and beliefs toward vaccination. Targeted education campaigns and messages are needed to promote equitable utilization of the effective vaccine.

Original languageEnglish (US)
Article number107077
JournalPreventive Medicine
StatePublished - Jun 2022


  • Attitude and belief
  • COVID-19
  • Race/ethnicity
  • Vaccine hesitancy
  • Young adults

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Patterns and mediators of racial and ethnic disparities in COVID-19 vaccine hesitancy among young adults'. Together they form a unique fingerprint.

Cite this