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Racial and Ethnic Health Disparities"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Racial inequities related to COVID-19 exposure, morbidity, mortality, and access to care in the United States (U.S.) are notable, and COVID-19 vaccine uptake is lower among Black Americans than White Americans. Yet, mechanisms linking healthcare experiences to COVID-19 vaccination behavior among young adults are not well characterized. We analyzed cross-sectional data collected between March and June 2023 from 360 Black young adults (ages 18\u201329) enrolled in a digital health trial in Georgia, Alabama, and North Carolina (NCT05490329). Discrimination in medical settings and group-based medical mistrust were assessed. COVID-19 vaccination was measured as ever receiving at least one dose. Correlations and a mediation model (PROCESS Model 4; 5,000 bootstrap resamples) tested whether medical mistrust statistically mediated the association between discrimination in medical settings and COVID-19 vaccination, adjusting for age, sex at birth, state, insurance, education, and perceived COVID-19 risk. In mediation analyses, discrimination in medical settings had a significant total effect on COVID-19 vaccination (B=-0.44, SE=0.13,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;.001) and was associated with higher mistrust (B=0.42, SE=0.04,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;.001); higher medical mistrust was associated with lower likelihood of COVID-19 vaccination (B=-0.65, SE=0.24,\n                    <jats:italic>p<\/jats:italic>\n                    =.006). The indirect effect was significant (B=-0.28, SE=0.12, 95% CI [-0.557, \u2212\u20090.081]). Findings suggest that discriminatory healthcare encounters may reduce COVID-19 vaccination uptake partly through elevated medical mistrust, highlighting the need for trust-building, non-stigmatizing strategies to improve vaccination among Black young adults in the U.S. South.\n                  <\/jats:p>","DOI":"10.1007\/s40615-026-03120-w","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:51:05Z","timestamp":1785423065000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Healthcare Discrimination, Medical Mistrust, and COVID-19 Vaccine Uptake Among Young Black Adults in the Southern United States"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0556-9960","authenticated-orcid":false,"given":"Ibrahim","family":"Yigit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Baez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie C. 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