Background National data indicate low intentions for COVID-19 vaccination among a substantial minority of Black Americans, and disproportionately lower vaccination rates among Black Americans than White Americans. Methods A total of 207 of the 318 Black participants (65%) in the RAND American Life Panel, a nationally representative internet panel, were surveyed about COVID-19 vaccine intentions in November-December 2020. Participants’ census tracts were geocoded using the Centers for Disease Control and Prevention's Social Vulnerability Index. Results Overall, 35% agreed or strongly agreed that they would not get a COVID-19 vaccine, 40% agreed or strongly agreed that they would get vaccinated, and 25% reported “don't know.” Significant multivariable predictors of not wanting to get vaccinated included high mistrust of the vaccine itself (e.g., concerns about harm and side effects), OR (95% CI ) = 2.2 (1.2–3.9), p = .007, and weak subjective norms for vaccination in one's close social network, OR (95% CI ) = 0.6 (0.4–0.7), p < .001. Residence in an area of higher socioeconomic vulnerability was a marginally significant predictor, OR (95% CI ) = 3.1 (0.9–11.0), p = .08. Conclusions High mistrust around COVID-19 vaccines may lower vaccine confidence. Social network members’ attitudes can be influential in encouraging vaccination. Public health communications could use transparent and clear messaging on safety and efficacy, and acknowledge historical and ongoing discrimination and racism as understandable reasons for low confidence in COVID-19 vaccines. Future research is needed to consider vaccine access challenges in tandem with mistrust as contributing to low vaccination rates across health conditions.

An effective Zika virus (ZIKV) vaccine will require long-term durable protection. Several ZIKV vaccine candidates have demonstrated protective efficacy in nonhuman primates, but such studies have typically involved ZIKV challenge shortly following vaccination at peak immunity. In this study, we show that a single immunization with an adenovirus vector-based vaccine, as well as two immunizations with a purified inactivated virus vaccine, afforded robust protection against ZIKV challenge in rhesus monkeys at 1 year following vaccination. In contrast, two immunizations with an optimized DNA vaccine, which provided complete protection at peak immunity, resulted in reduced protective efficacy at 1 year that was associated with declining neutralizing antibody titers to sub-protective levels. These data define a microneutralization log titer of 2.0-2.1 as the threshold required for durable protection against ZIKV challenge in this model. Moreover, our findings demonstrate that protection against ZIKV challenge in rhesus monkeys is possible for at least 1 year with a single-shot vaccine.

Background COVID-19 vaccination rates among Black Americans have been lower than White Americans and are disproportionate to their population size and COVID-19 impact. This study examined reasons for low vaccination intentions and preferred strategies to promote COVID-19 vaccination. Methods Between November 2020 and March 2021, we conducted semi-structured interviews with 24 participants who expressed low vaccination intentions in a RAND American Life Panel survey; we also interviewed five stakeholders who represent organizations or subgroups in Black communities that have been highly affected by COVID-19. Results Many interviewees discussed the “wait-and-see” approach, citing that more time and evidence for vaccine side effects and efficacy are needed. Perceived barriers to COVID-19 vaccination included structural barriers to access (e.g., transportation, technology) and medical mistrust (e.g., towards the vaccines themselves, the government, healthcare providers and healthcare systems, and pharmaceutical companies) stemming from historical and contemporary systematic racism against Black communities. Interviewees also discussed strategies to promote COVID-19 vaccines, including acknowledging systemic racism as the root cause for mistrust, preferred messaging content (e.g., transparent messages about side effects), modes, and access points (e.g., a variety of medical and non-medical sites), and trusted information sources (e.g., trusted leaders, Black doctors and researchers). Conclusions These insights can inform ways to improve initial and booster vaccination uptake as the COVID-19 pandemic progresses.

No abstract

The United States has made tremendous progress in delivering COVID-19 vaccines. As of January 2022, more than 79% of the eligible population had received ≥1 dose of the vaccine. 1 Encouragingly, the relative proportions of administered vaccines among Black and Latinx populations have increased compared with their population sizes. 2 As of late July 2021, among the 58% of people who had received ≥1 vaccine dose and for whom race and ethnicity were known, Latinx and Black people had begun to receive a larger share of recent vaccinations compared with their total population share (30% vs 17% and 13% vs 12%, respectively). 3 These recent trends provide reason for optimism. However, because vaccinations among Black and Latinx populations, who have been disproportionately impacted by COVID-19, have only just begun to match or exceed their population proportions, their overall vaccination rates continue to lag relative to White populations. While we lack vaccination data in more granular race and ethnicity categories, it seems likely that many other racial and ethnic groups, in addition to Black and Latinx populations, included under the broader term Black, Indigenous, and People of Color (BIPOC), are experiencing the same lag relative to White populations.