Perception of COVID-19 vaccine effectiveness perception in older racialized communities: role of major racial discrimination and health literacy.

Objective

Vaccination has been scientifically proven to be safe and to prevent infectious diseases. The COVID-19 vaccine has been crucial in combating the pandemic. In Canada, despite widespread vaccine hesitancy, little has specifically addressed older adults from racialized communities. This study investigates perceptions of COVID-19 vaccine effectiveness among older adults by racial background, examining the influence of major racial discrimination and health literacy. STUDY

Design

A cross-sectional pan-Canadian study.

Methods

Data were collected using Computer-Assisted Web Interviewing (March 2025). The COVID-19 vaccine effectiveness was tested with t-tests, ANOVA, and multivariable linear regression.

Results

581 participants were included: Arab (11.5%), Asian (15.8%), Black (16.2%), Indigenous (9%), and White (35.8%); including men (48.2%), women (43.0%), and 8.8% identifying as non-binary. Participants 65 years and above reported significantly greater perceived COVID-19 vaccine effectiveness versus 55-64 years old (t(579) = 2.17, p = .015)). Asian and White participants were more likely to have a good perception of COVID-19 vaccines versus Black and Indigenous (F(6,574) = 2.88, p = .009) participants. Multivariable linear regression revealed that major racial discrimination was the strongest predictor of lower perception of vaccine effectiveness (β = -0.42, p = .006), along with literacy (β = 0.09, p = .002) and identifying as Black compared to White (β = -1.49, p = .020).

Conclusions

Perceptions of COVID-19 vaccine effectiveness among 55+ in Canada varied substantially across racial groups, with differences linked to experiences of discrimination and literacy levels. These findings highlight the need for targeted, equity-oriented public health strategies that address both structural racism and misinformation to improve vaccine confidence among older adults in marginalized communities.