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Relationships between vaccine knowledge, hesitancy, and conspiracy beliefs on Covid-19, influenza, and HPV vaccination
Dickey, S. L., Yigit, I., Maragh-Bass, A. C., Comello, M. L. G., Stoner, M. C. D., Larsen, M. A., Muessig, K. E., Pettifor, A. E., Budhwani, H., & Hightow-Weidman, L. B. (2025). Relationships between vaccine knowledge, hesitancy, and conspiracy beliefs on Covid-19, influenza, and HPV vaccination. Journal of racial and ethnic health disparities. https://doi.org/10.1007/s40615-025-02384-y
INTRODUCTION: The COVID-19 pandemic highlighted the centuries old issue of vaccine hesitancy and exposed healthcare inequities harming Black young adults. Despite vaccines being able to reduce COVID-19, human papillomavirus (HPV), and influenza morbidity and mortality, they are underutilized. An examination of socio-behavioral factors to understand motivators and barriers to vaccine uptake within Black communities is necessary to improve preventative health.
METHODS: We conducted an online survey of 360 Black young adults, aged 18 and 29 years in the southern United States. Participants were part of a larger randomized-controlled trial which evaluated a digital health intervention for receiving the COVID-19 vaccine. A correlation analysis and a series of logistic regressions were performed to examine the relationships between vaccination knowledge, hesitancy, and conspiracy beliefs for vaccination status for COVID-19, HPV, and influenza.
RESULTS: Vaccine hesitancy and conspiracy beliefs were negatively associated with COVID-19 vaccination (adjusted odds ratio (AOR) = .45, confidence interval (CI) [.284, .722], p < .001; AOR = .37, CI [.217, .628], p < .001, respectively, but vaccination knowledge was not (p = .295). Vaccination hesitancy was negatively associated with ever having accepted HPV vaccination (AOR = .66, CI [.477, 1.56], p = .011). Vaccination hesitancy, conspiracy beliefs, and knowledge were not significantly associated with influenza vaccination.
CONCLUSIONS: Vaccine hesitancy remains a pertinent factor affecting southern Black young adults. Vaccine-related conspiracy beliefs emerged amidst the COVID-19 pandemic and was significant for refusal of the COVID-19 vaccine. Results indicate the need for continued public health efforts to address vaccine hesitancy and conspiracies among southern Black young adults and providing reputable information from trusted sources recognized by this population.
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