COVID-19 Vaccination Perceptions Among Young Adults of Color in the San Francisco Bay Area

Abstract

Background: COVID-19 vaccination rates among U.S. young adults, particularly in communities of color, remain lower than other age groups. We conducted a qualitative, community-based participatory study to explore beliefs and attitudes about COVID-19 vaccines among young adults in Black/African American, Latinx, and Asian American or Pacific Islander (AAPI) communities in the San Francisco Bay Area. Methods: We conducted six focus groups between June and August 2021. Participants were recruited by partnering with community-based organizations in the San Francisco Bay Area. Focus groups included Black/African American ( N =13), Latinx ( N =20), and AAPI ( N =12) participants between 18 and 30 years of age. Emerging themes were identified using a modified Grounded Theory approach. Results: Prominent themes among all three racial-ethnic groups included mistrust in medical and government institutions, strong conviction about self-agency in health decision-making, and exposure to a thicket of contradictory information and misinformation in social media. Social benefit and a sense of familial and societal responsibility were often mentioned as reasons to get vaccinated. Young adult mistrust had a generational flavor fueled by anger about increasing inequity, the profit-orientation of pharmaceutical companies and health institutions, society's failure to rectify injustice, and pessimism about life prospects. Conclusion: Factors influencing vaccine readiness among Black/African American, Latinx, and AAPI young adults have a distinct generational and life-course texture. Outreach efforts should appeal to young adults' interest in family and social responsibility and the social benefits of vaccination, while being cognizant of the friction mandates pose for young adults' sense of self-agency. Efforts will be most effective coming from trusted messengers with a proven commitment to communities of color and health equity.

Higher COVID-19 Vaccination Rates Are Associated with Lower COVID-19 Mortality: A Global Analysis

“…Several factors seem to be pertinent in this case. A lack of trust in medical and government institutions influences decisions to avoid vaccination [ 33 ]. Similarly, a lack of confidence in the vaccines themselves, in terms of potential side effects or lack of efficacy, has also been identified as a barrier to vaccination [ 34 ].…”

Determinants of Vaccine Hesitancy among African American and Black Individuals in the United States of America: A Systematic Literature Review

“…All 14 studies [ 10 , 15 , 17 , 18 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ] included in this analysis mentioned the construct of mistrust as a reason for vaccine hesitancy among African American and Black individuals. The following sub-themes were the most frequent types of mistrust mentioned in the literature: (a) historical mistrust, (b) mistrust of the vaccine development process, and (c) contemporary mistrust.…”

“…All 14 studies mentioned some form of mistrust in government, politicians, and the medical establishment as a reason for COVID-19 vaccine hesitancy among African American and Black individuals [ 10 , 15 , 17 , 18 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 ]. When asked about information sources which people do not trust, study participants mentioned politicians and the government [ 42 ].…”

“…When asked about information sources which people do not trust, study participants mentioned politicians and the government [ 42 ]. Many described structural racism [ 10 ], continued acts of injustice [ 43 ], neglect [ 48 ], and lower quality healthcare received by African American and Black individuals [ 44 , 48 ] as a reason not to trust the government and not to get vaccinated. Participants also expressed concerns regarding conflicting guidance from the government, which led to poor confidence in the overall COVID-19 response [ 41 ].…”

Perceptions of COVID-19 Vaccines: Protective Shields or Threatening Risks? A Descriptive Exploratory Study among the Italian Population

“…This finding contradicts the results of previous studies showing that older age was associated with low vaccine hesitancy [ 21 , 22 , 23 ]. A plausible explanation is that, during the COVID-19 pandemic, young adults viewed vaccination as an opportunity to return to their social life and enjoyable activities more than older adults [ 44 ].…”