Objective: Seasonal influenza is a preventable disease that may cause high morbidity and mortality. In the USA, the 2020 influenza season overlapped with the first wave of coronavirus disease 2019 (COVID-19) pandemic. There is a dearth of research on understanding influenza vaccination uptake and attitudes towards the vaccine among marginalised communities in the USA. The aim of this study was to examine general knowledge, misconceptions about, and barriers to influenza vaccination and determine if flu education delivered via trusted messengers improved knowledge among Asian Americans. Design: Quantitative prospective pre- and post-test design. Setting: Asian American communities in Metro Detroit area, Hamtramck, and Kent County in Michigan. Method: The study started with a training event in which 26 community leaders were trained to become trusted messengers to disseminate flu education. A total of 260 Asian American participants subsequently completed pre- and post-education surveys. Results: Asian Americans in the study reported low flu vaccination rate (48.5%). Reasons varied but included access-related issues (e.g. no access and no insurance) and health literacy (did not know they needed it). After education by trusted messengers, the paired t tests measuring improvement between pre- and post-survey scores showed a significant improvement ( p < .05) for all of the knowledge items. Conclusion: Educational campaigns using targeted messages to address specific barriers and acknowledge individuals’ concerns regarding misconceptions while providing equitable vaccine access can be key for the successful implementation of vaccination programmes.
The COVID-19 pandemic has exacerbated existing health disparities and had a disproportionate impact on racial and ethnic minority groups in the United States. Limited COVID-19 data for Asian Americans have led to less attention for this population; nevertheless, available statistics have revealed lesser known impacts of COVID-19 on this population. Even with significant increases in vaccine supply and recent increases in COVID-19 vaccination rates, racial and ethnic disparities in vaccine uptake still persist. These disparities are amplified for individuals with limited English proficiency (LEP). The purpose of this paper is to apply community-engaged and geographic information system (GIS) strategies to increase equitable access to COVID-19 vaccination uptake by decreasing the structural barriers to COVID-19 vaccine uptake, with a particular focus on Asian Americans with LEP. Building upon existing community-academic partnerships between the academic unit and community-based organizations, the project team established community-led mobile and pop-up COVID-19 vaccination clinics to reach underserved individuals in their communities, worked with commercial pharmacies and reserved appointments for community-based organizations, used GIS to establish COVID-19 vaccination sites close to communities with the greatest need, and deployed trusted messengers to deliver linguistically and culturally relevant COVID-19 vaccine messages which built vaccine confidence among the community members. The implementation of mobile clinics expanded COVID-19 vaccine access and community-driven, multi-sector partnerships can increase the capacity to enhance efforts and facilitate access to COVID-19 vaccination for hard-to-reach populations.
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