Exploring the Scope and Dimensions of Vaccine Hesitancy and Resistance to Enhance COVID-19 Vaccination in Black Communities

• Published in: Journal of racial and ethnic health disparities 2022-12, Vol.9 (6), p.2117-2130
• Main Authors: Okoro, Olihe, Kennedy, Janet, Simmons, Glenn, Vosen, Elyse Carter, Allen, Kay, Singer, Desiré, Scott, Desmond, Roberts, Renee
• Format: Article
• Language: English
• Subjects: Access; Accessibility; African Americans; Community; Conspiracy; COVID-19; COVID-19 - prevention & control; COVID-19 Vaccines; Credibility; Demography; Efficacy; Epidemiology; Focus groups; Health care; Humans; Immunization; Medicine; Medicine & Public Health; Needs assessment; Perceptions; Qualitative analysis; Qualitative research; Quality of Life Research; Resistance; Social Inequality; Social Structure; Surveys and Questionnaires; Trust; Vaccination; Vaccines
• ISSN: 2197-3792; 2196-8837
• DOI: 10.1007/s40615-021-01150-0

Background The long history of distrust that characterizes the relationship between the Black/African-American population and the US Medical community makes COVID-19 vaccine hesitancy of great concern. A needs assessment of the Black/African-American community assessed willingness and explored the perceptions of community members regarding COVID-19 vaccination. Methods The study used a mixed-methods approach. Respondents ( n  = 183) were surveyed with a web-based questionnaire. They were asked whether there would get vaccinated for COVID-19 barring any access or cost-related challenges. Perceptions of community members regarding vaccination were explored through one-on-one interviews ( n  = 30) and eight focus groups ( n  = 49), with participants drawn from across various demographic characteristics. Survey responses were summarized using frequencies and proportions. A thematic analysis was conducted on the qualitative data. Results Thirty-four percent of respondents indicated “Yes” (willing to get vaccinated); 26.8% indicated “No”, while 37.1% expressed hesitancy (“Maybe” or “I don’t know”). Themes emerging from the qualitative data are grouped into three broad categories: vaccine accessibility (transportation, information, navigating healthcare system); vaccine hesitancy (with sub-categories of compliance, complacency and confidence); and vaccine “resistance” (conspiracy theories, conflicting beliefs, distrust of Government, trustworthiness of Health care). Conclusion Findings demonstrate a nuanced expansion of “vaccine hesitancy” to delineate groups with varying issues and perspectives. Interventions to enhance vaccination rates in Black/African-American communities should incorporate components that assure accessibility at the minimum, but also address non-access-related issues. Priority should be given to enhancing vaccine literacy, information-sharing as efficacy and safety data emerge, and addressing specific concerns identified through community-engaged outreach efforts.