ArticleVaccine2026
Pathways to COVID-19 vaccine initiation: The roles of medical mistrust, conspiracy beliefs, hesitancy, and confidence among black young adults.
Article in Vaccine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Associations Between Healthcare Discrimination, Medical Mistrust, and COVID-19 Vaccine Uptake Among Young Black Adults in the Southern United States.Journal of racial and ethnic health disparities · 2026Article
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Authors and funding
5 authors.
Funding
Abstract
Medical mistrust, stemming from historical and contemporary inequalities in healthcare, poses a major barrier to vaccination, particularly among Black communities in the southern U.S. While medical mistrust is known to influence vaccine uptake, the underlying psychological mechanisms, such as conspiracy beliefs and attitudinal factors like vaccine hesitancy and confidence, are not well understood. This cross-sectional analysis used baseline data from the Tough Talks-COVID randomized controlled trial (N = 360), conducted among Black young adults (ages 18-29) in Alabama, Georgia, and North Carolina between March and June 2023, who had not completed the primary COVID-19 vaccine series at screening. Participants completed validated measures of medical mistrust, vaccine-related conspiracy beliefs, vaccine hesitancy, vaccine confidence, and COVID-19 vaccine initiation (ever receipt of ≥1 dose at baseline). Serial mediation models specifying a theoretically informed ordering (medical mistrust, vaccine-related conspiracy beliefs, vaccine hesitancy or vaccine confidence, and COVID-19 vaccine initiation) were tested adjusting for age, sex, and state. Medical mistrust was significantly associated with lower odds of COVID-19 vaccine initiation (B = -0.63, AOR = 0.53, p < .001). Serial mediation analyses revealed two significant indirect associations: (1) Greater medical mistrust was associated with stronger endorsement of vaccine-related conspiracy beliefs, which were linked to increased vaccine hesitancy, resulting in lower vaccine initiation (B = -0.26, CI[-0.463, -0.127]); and (2) Greater medical mistrust was associated with stronger vaccine-related conspiracy beliefs, which were associated with reduced vaccine confidence; higher vaccine confidence was associated with higher vaccine initiation, yielding an overall negative indirect association (B = -0.35, CI[-0.591, -0.191]). Findings highlight critical psychological mechanisms through which medical mistrust may undermine COVID-19 vaccine initiation in under-vaccinated Black young adults. Addressing mistrust and countering conspiracy beliefs while strengthening vaccine confidence may support vaccine initiation efforts in Black communities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.