Background Minorities have been disproportionately affected by the COVID-19 yet have the lowest COVID-19 vaccine rate. Vaccine hesitancy has been reported at higher rates in African-Americans and young adults. Objectives To assess COVID-19 vaccine hesitancy, determine the rationale for receiving or declining the COVID-19 vaccine, and propose strategies to address confidence in faculty, staff, and students at a rural historically black college and university (HBCU). Methods A study was conducted using an electronic survey administered to a convenient sample of 210 faculty, students, and staff at the University of Maryland Eastern Shore (UMES) a historical black college and university (HBCU) in a rural community. Results The majority of participants were 18-24 years old (69%), college students (73.89%), identified as a woman (70%), and African-American (70%). Eighty-seven percent of participants were non-hesitant (received one dose or intended to be vaccinated). Approximately 54% had already received at least one dose of a COVID-19 vaccine. Only 13% of participants were hesitant and did not plan to receive the COVID-19 vaccine. The most common rationale for vaccine hesitancy was mistrust of the healthcare system/government towards African-Americans. Conclusion The results show that vaccine hesitancy was low in the predominantly young-adult, African-American population at a rural HBCU. Opportunities exist for pharmacists and other accessible health care professionals to contribute to efforts aimed at decreasing vaccine hesitancy and improving vaccine confidence.