The Moderating Effect of Vaccine Hesitancy on the Relationship between the COVID-19 Vaccine Coverage Index and Vaccine Coverage

To examine COVID-19 vaccination barriers in the US, this study drew on publicly available county-level data (n = 3130) to investigate impact of vaccine hesitancy relationship between social/structural and coverage. A hierarchical regression was performed establish Vaccine Coverage Index (CVAC) coverage, assess moderating effect relationship, explore influence ethno-racial composition significant, negative (r2 0.11, f2 0.12) CVAC coverage by county established (step 1). When introduced as a moderator 2), model significantly explained additional variance 0.21, 0.27). Simple slopes analysis indicated significant interaction effect, whereby CVAC–vaccine stronger low counties compared with high counties. Counties but were projected have 14% lower 3), higher proportions white residents predicted decreased rates (p < 0.05). Findings indicate that should be paired measures better predict uptake. Moreover, led decreases uptake, suggesting future intervention strategies also target whites reach herd immunity. We conclude public health leaders practitioners address both psychological maximize particular focus communities minimal barriers.