COVID-19 Vaccine Mistrust, Racial Discrimination, and Conspiracy Beliefs Among Parents in Canada: Implications for Public Health.

Despite studies documenting the evolution and factors related to COVID-19 vaccination in Canadian children, gaps in research on COVID-19 vaccine mistrust (VM) across ethnocultural groups hinder tailored public health responses. This study examines the sociodemographic characteristics and factors related to COVID-19 VM among racially diverse Canadian parents with children aged 0-12 years from Arab, Asian, Black, Indigenous, and White communities. A cross-sectional study was conducted among a representative sample of 2528 parents of children aged 0-12 years across Canada. They completed measures assessing COVID-19 VM, conspiracy beliefs, health literacy, everyday racial discrimination and sociodemographic data. Descriptive statistics, ANOVA, and multiple regression analyses explored factors associated with VM, with subgroup analyses for racialized and Indigenous groups. Significant mean differences in VM were observed across racial groups (p < 0.001). Post hoc analyses showed that Black individuals scored higher on COVID VM (M = 12.4; 95% CI: 11.9-12.9) compared to White individuals (M = 11.1; 95% CI: 10.8-11.3; p < 0.001). Indigenous participants scored higher on COVID VM (M = 14.4; 95% CI: 13.7-15.1) compared to White (p < 0.001), Black (p < 0.001), Arab (M = 12.9; 95% CI: 12.4-13.5; p = 0.017), and Asian participants (M = 11.8; 95% CI: 11.3-12.3; p < 0.001). Regression analyses revealed that conspiracy beliefs were strongly associated with VM in both White (β = 0.61, p < 0.001, R² = 42.1%) and racialized individuals (β = 0.51, p < 0.001, R² = 34.0%). Everyday racial discrimination significantly predicted VM among racialized groups (β = 0.10, p = 0.001) but not White participants (β = -0.02, p = 0.313). Significant racial, gender, and age-based disparities in COVID-19 VM among Canadian parents underscore the urgent need for targeted, community-driven, and antiracist public health strategies to enhance vaccine confidence, addressing unique barriers faced by racialized and Indigenous communities.