Objectives: Understanding COVID-19 vaccination behavior can guide public health efforts to increase vaccination acceptance and uptake. We examined COVID-19 vaccination intention among Wisconsin residents and assessed racial and ethnic disparities in vaccine uptake.
Methods: We assessed vaccination intention during COVID-19 testing registration in February 2021 and used the Wisconsin Immunization Registry to ascertain COVID-19 vaccination uptake by July 2022. We described differences in intention to get vaccinated and assessed the association between racial and ethnic identity and vaccination. We analyzed vaccination likelihood by using Cox proportional hazards models and presented adjusted hazard ratios (AHRs) with 95% CIs.
Results: Of 12 196 people, 9843 (80.7%) intended to be vaccinated against COVID-19. A higher proportion of non-Hispanic Black people (21.1%) than people in all other racial and ethnic groups did not intend to get vaccinated. Adjusting for vaccination intention, age group, sex, and neighborhood Area Deprivation Index, Hispanic people were 41% (AHR = 0.59; 95% CI, 0.54-0.64) less likely than non-Hispanic White people to get vaccinated. Compared with non-Hispanic White people, non-Hispanic Black people were 24% (AHR = 0.76; 95% CI, 0.68-0.84) less likely to get vaccinated and Asian people were 18% (AHR = 0.82; 95% CI, 0.75-0.90) less likely to get vaccinated.
Conclusions: Racial and ethnic disparities in vaccination uptake persisted despite controlling for intention. Efforts to focus public health resources on increasing COVID-19 vaccination among racial and ethnic minority groups are important.
Keywords: COVID-19; racial disparities; vaccination behavior; vaccination intention.