Associations between the Self-Reported Likelihood of Receiving the COVID-19 Vaccine, Likelihood of Contracting COVID-19, Discrimination, and Anxiety/Depression by Sexual Orientation

There is limited evolving literature on COVID-19 vaccine uptake and its barriers among sexual minority populations (lesbian, gay, bisexual, transgender, and queer [LGBTQ]), despite their increased COVID-19 risk factors. We assessed the differences in intention to receive the COVID-19 vaccine by self-reported likelihood of contracting COVID-19, anxiety/depression, discrimination frequency, social distancing stress, and sociodemographic factors across sexual orientation. An online national cross-sectional survey was conducted in the United States between 13 May 2021, and 9 January 2022, among adults aged ≥18 (n = 5404). Sexual minority individuals had a lower intention of receiving the COVID-19 vaccine (65.62%) than heterosexual individuals (67.56%). Disaggregation by sexual orientation, however, showed that gay participants had a higher intention of COVID-19 vaccination (80.41%) and lesbian (62.63%), bisexual (64.08%), and non-heterosexual, non-LGB sexual minority (56.34%) respondents had lower intentions of receiving the COVID-19 vaccine than heterosexual respondents. Sexual orientation significantly moderated the association between the perceived likelihood of receiving the COVID-19 vaccine and the self-reported likelihood of contracting COVID-19, anxiety/depression symptoms, and discrimination. Our findings further underline the importance of improving vaccination efforts and access among sexual minority individuals and other vulnerable groups.