Background Few studies have focused on attitudes toward COVID-19 vaccination among Black or African American young adults (BYA) in the Southern United States, despite high levels of infection in this population. Objective To understand this gap, we conducted an online survey to explore beliefs and experiences related to COVID-19 vaccination among BYA (aged 18-29 years) in 3 southern states. Methods We recruited 150 BYA to participate in an online survey as formative research for an intervention to address vaccine hesitancy in Alabama, Georgia, and North Carolina from September 22, 2021, to November 18, 2021. Participants were recruited through social media ads on Facebook, Twitter, Instagram, and YouTube. Additionally, we distributed information about the survey through organizations working with BYA in Alabama, Georgia, and North Carolina; our community partners; and network collaborations. We used measures that had been used and were previously validated in prior surveys, adapting them to the context of this study. Results Roughly 28 (19%) of the participants had not received any doses of the COVID-19 vaccine. Half of the unvaccinated respondents (n=14, 50%) reported they wanted to wait longer before getting vaccinated. Motivators to get vaccinated were similar between unvaccinated and vaccinated respondents (eg, if required, to protect the health of others), but the main motivator for those vaccinated was to protect one’s own health. Among unvaccinated individuals, reasons for not receiving the COVID-19 vaccine included concern about vaccine side effects (n=15, 54%) and mistrust of vaccine safety (n=13, 46%), of effectiveness (n=12, 43%), and of the government’s involvement with vaccines (n=12, 43%). Experiences of discrimination (n=60, 40%) and mistrust of vaccines (n=54, 36%) were common overall. Among all respondents, those who said they would be motivated to get vaccinated if it was required for school, work, or travel were more likely to endorse negative beliefs about vaccines compared to those motivated for other reasons. Conclusions Mistrust in COVID-19 vaccine safety and efficacy is common among BYA in the Southern United States, irrespective of vaccination status. Other motivators, such as safety of family and community and vaccination requirements, may be able to tip the scales toward a decision to be vaccinated among those who are initially hesitant. However, it is unclear how vaccine requirements among BYA in the South affect trust in the government or health care in the long term. Interventions that include BYA in vaccination messaging and programs may more proactively build feelings of trust and combat misinformation.

No abstract

BACKGROUND Few studies have focused on attitudes towards novel coronavirus 2019 (COVID-19) vaccination among Black or African American young adults (BYA) in the Southern United States (US), despite high levels of infection in this population. OBJECTIVE To understand this gap, we conducted an online survey to explore beliefs and experiences related to COVID-19 vaccination among BYA (ages 18-29) in three southern states. METHODS We recruited 150 BYA to participate in an online survey as formative research for an intervention to address vaccine hesitancy/skepticism in Alabama, Georgia, and North Carolina between September 22, 2021, and November 18, 2021. Participants were recruited through social media ads on Facebook, Twitter, Instagram, and YouTube. Additionally, we distributed information about the survey through national organizations working with BYA, our community partners and network collaborations. We used validated measures from prior surveys on COVID-19 vaccination. RESULTS Less than half of vaccinated respondents planned to get a booster shot (47%, n=71) and 14% (n=28) had not received any doses of the COVID-19 vaccine. Half of unvaccinated respondents (50%, n=14) reported they wanted to wait longer before getting vaccinated. Motivators to get vaccinated were similar between unvaccinated and vaccinated respondents (e.g., if required, to protect the health of others); but the main motivator for those vaccinated was to protect one’s own health. Among unvaccinated individuals, reasons for not receiving the COVID-19 vaccine included concern about vaccine side effects (54%) and mistrust of vaccine safety (46%), of effectiveness (43%), and of the government’s involvement with vaccines (43%). Experiences of discrimination (40%) and mistrust of vaccines (36%) were common even among the vaccinated population. Among all respondents, those who said they would be motivated to get vaccinated if it was required for school, work, or travel, were more likely to endorse negative beliefs about vaccines compared to those motivated for other reasons. CONCLUSIONS Mistrust in COVID-19 vaccine safety and efficacy was common among this sample of BYA in the South, irrespective of vaccination status. Other motivators such as safety of family and community and vaccination requirements may be able to tip the scales towards a decision to be vaccinated among those who are initially hesitant. However, it is unclear how vaccine requirements among BYA in the South affect trust in government or healthcare in the long-term. Interventions that include young Black adults in vaccination messaging and programs may consider more proactively addressing trust and countering misinformation.