Experiences of discrimination and their impact on healthcare utilization: non-uptake of covid-19 vaccination

Objective This article examines the relationship between experiences of discrimination and COVID-19 vaccine non-uptake, with particular attention to the domains in which discrimination occurs (healthcare, employment, housing, and public services) and to the frequency of such experiences. Methods The analysis draws on the most recent wave of the Epidemiology and Living Conditions (EpiCov) cohort survey, conducted in October 2022, which included 65,403 adults living in metropolitan France. Results Although the vast majority of the population in France ultimately received the COVID-19 vaccine, a significant minority remained reluctant to take advantage of this free and widely accessible intervention. Our findings indicate that past experiences of discrimination exerted both specific and cumulative effects on vaccination behavior: discrimination encountered in interactions with healthcare professionals and public services had a stronger influence on non-vaccination than discrimination related to employment or housing. Moreover, the frequency of discriminatory experiences was positively associated with vaccine non-uptake. Importantly, these associations were not limited to racialized minorities. Conclusions By adopting a broad perspective on discrimination, the study demonstrates that feelings of social exclusion contribute to vaccine non-uptake across all social groups.