Rates and Factors Related to COVID-19 Vaccine Uptake in Racialized and Indigenous Individuals in Canada: The Deleterious Effect of Experience of Racial Discrimination

Racialized and Indigenous communities have been disproportionately affected by COVID-19 infections and mortality, driven by systemic socioeconomic inequalities. However, how these factors specifically influence COVID-19 vaccine uptake is not documented among racialized individuals in Canada. The present study aims to examine COVID-19 vaccine uptake rates and related factors among racialized and Indigenous communities compared to White people in Canada. In total, 41,931 individuals aged 16 and older, consisting mainly of Arab, Asian, Black, Indigenous, and White individuals, were randomly invited to participate from a panel of 420,000 Canadian households. A total of 4220 participants completed this cross-sectional survey study in October 2023. In total, 89.60% of participants were vaccinated: 2.38% received one dose, 31.45% received two doses, 33.46% received three doses, 18.86% received four doses, and 13.86% received five doses and more. There were significant differences according to racial and ethnic background in vaccine uptake (χ = 57.45, p < 0.001), with Indigenous and Black individuals having lower vaccination rates (83.54%, OR = 1.98% and 84.76%, OR = 2.16, p < 0.01) compared to White individuals (91.66%). Confidence in health authorities was positively associated with vaccine uptake (B = 0.62, p < 0.001). Conspiracy beliefs partially mediated this association (B = -0.13, p < 0.001). Racial discrimination attenuated vaccine uptake, even if respondents had confidence in health authorities (B = -0.08, p < 0.001). Vaccine uptake was lowest amongst Indigenous and Black communities, placing them at higher risk of severe COVID-19 infection. In addition to mistrust of public health authorities due to racism, racialized communities are affected by conspiracy beliefs that hinder COVID-19 vaccine uptake. A whole-of-society approach to address barriers to vaccine uptake among racialized populations, including wage disparities, racial discrimination, is needed to eliminate racial health disparities and increase vaccination rates in racialized communities.