Table 3.
Associations of medical mistrust with positive COVID-19 vaccine attitudes and vaccination uptake, Michigan COVID-19 Recovery Surveillance Study, 2020–2023.
|
Positive vaccine attitudesa (n = 3865) |
Vaccination uptakeb (n = 3741) |
|||
|---|---|---|---|---|
| Unadjusted | Adjusted | Unadjusted | Adjusted | |
| Coef. (95 % CI) | Coef. (95 % CI) | RR (95 % CI) | RR (95 % CI) | |
| Medical Mistrust Index (range: 1–4) | −0.71*** | −0.64*** | 0.81*** | 0.83*** |
| (−0.78, −0.63) | (−0.71, −0.56) | (0.78, 0.84) | (0.80, 0.86) | |
| Age (ref: ≥65) | ||||
| 18–34 | −0.49*** | 0.83*** | ||
| (−0.62, −0.35) | (0.78, 0.88) | |||
| 35–54 | −0.57*** | 0.80*** | ||
| (−0.70, −0.44) | (0.76, 0.84) | |||
| 55–64 | −0.30** | 0.90*** | ||
| (−0.45, −0.14) | (0.85, 0.95) | |||
| Sex (ref: male) | ||||
| Female | 0.14** | 1.02 | ||
| (0.05, 0.22) | (0.98, 1.06) | |||
| Race and ethnicity (ref: NH White) | ||||
| Hispanic | 0.41*** | 1.10† | ||
| (0.23, 0.60) | (1.00, 1.22) | |||
| NH Black | 0.28*** | 1.00 | ||
| (0.12, 0.44) | (0.93, 1.08) | |||
| Another NH race and ethnicity | 0.23** | 1.05 | ||
| (0.09, 0.37) | (0.98, 1.13) | |||
| Marital status (ref: Not married/cohabiting) | ||||
| Married/cohabiting | −0.13* | 0.96 | ||
| (−0.23, −0.03) | (0.92, 1.01) | |||
| Education (ref: college graduate) | ||||
| High school or less | −0.54*** | 0.77*** | ||
| (−0.66, −0.42) | (0.72, 0.83) | |||
| Some college | −0.37*** | 0.88*** | ||
| (−0.47, −0.27) | (0.84, 0.92) | |||
| Household income (ref: ≥$75,000) | ||||
| <$35,000 | −0.15* | 0.93* | ||
| (−0.27, −0.02) | (0.87, 1.00) | |||
| $35,000–74,999 | −0.13* | 0.95† | ||
| (−0.24, −0.03) | (0.91, 1.00) | |||
| Health insurance (ref: private insurance) | ||||
| Medicare/Medicaid/others | −0.24*** | 0.95 | ||
| (−0.36, −0.13) | (0.86, 1.06) | |||
| None | −0.14 | 0.85*** | ||
| (−0.30, 0.03) | (0.80, 0.90) | |||
| Pre-existing diagnosed comorbidities | ||||
| Yes | 0.11* | 1.08*** | ||
| (0.02, 0.20) | (1.04, 1.13) | |||
| COVID-19 symptom severity (ref: asymptomatic/mild) | ||||
| Moderate | 0.12* | 1.01 | ||
| (0.02, 0.22) | (0.96, 1.05) | |||
| Severe | 0.09 | 1.00 | ||
| (−0.03, 0.21) | (0.95, 1.06) | |||
| Very severe | 0.14 | 0.98 | ||
| (−0.03, 0.31) | (0.91, 1.07) | |||
COVID-19 = Coronavirus disease 2019; Coef. = Coefficient; RR = Risk Ratio; CI = Confidence Interval; NH = non-Hispanic.
a. Vaccine attitudes variable was determined by calculating the average of two items to get a continuous score ranging from 1 to 5, with a higher score indicating a higher level of positive vaccine attitudes.
b. Vaccination uptake variable was determined at follow-up by asking respondents if they had ever had the COVID-19 vaccine (yes or no).
Notes: Coefficients for positive vaccine attitudes are from linear regression models. Adjusted models include survey mode and pandemic phase.
† p < 0.1, * p < 0.05, ** p < 0.01, *** p < 0.001.