Black in the pandemic: Comparing experiences of mistrust, anxiety, and the COVID-19 vaccine among Black adults in the U.S.

COVID-19 vaccine decisions are shaped by many factors including historical and contemporary patterns of medical mistreatment of marginalized communities. In attending to these concerns, we measured whether fear of COVID-19, general feelings of mistrust, and race-specific mistrust of the government and healthcare providers are indirectly associated with COVID-19 vaccination status via anxiety among Black Americans. We analyzed responses from 996 Black adults who participated in the AmeriSpeak panel – a nationally representative probability-based sample recruited from the National Opinion Research Center from April–June 2022. We used multiple-group structural equation modeling to compare outcomes among those who lost a loved one to COVID-19 to those who did not. Results indicate that fear of COVID-19 was associated with a greater probability of being fully vaccinated for those who lost a family member/friend. Race-specific mistrust was positively associated with anxiety, but was negatively associated with being fully vaccinated for bereaved Black Americans. Targeted efforts are needed to specifically reach those who lost a loved one to COVID-19. More within-group evaluations are needed to identify barriers to COVID-19 vaccination that are specific to Black Americans living with loss and grief. • Fear of COVID-19 is associated with more anxiety symptoms. • Race-specific mistrust is linked to more anxiety for one group, but not the other. • Race-specific mistrust is linked to lower probability of vaccination for one group. [ABSTRACT FROM AUTHOR]