Exploring COVID-19 Vaccine Hesitancy Among Stakeholders in African American and Latinx Communities in the Deep South Through the Lens of the Health Belief Model

Abstract

Purpose The purpose of this study was to qualitatively explore perceptions related to COVID-19 vaccination intention among African American and Latinx participants and suggest intervention strategies. Approach Ninety minute virtual focus groups (N = 8), segmented by county, race and ethnicity were conducted with stakeholders from 3 vulnerable Alabama counties. Participants Participants (N = 67) were primarily African American and Latinx, at least 19 years, and residents or stakeholders in Jefferson, Mobile, and Dallas counties. Setting Focus groups took place virtually over Zoom. Methods The semi-structured guide explored perceptions of COVID-19, with an emphasis on barriers and facilitators to vaccine uptake. Focus groups lasted approximately 90 minutes and were audio recorded, transcribed, and analyzed by a team of 3 investigators, according to the guidelines of Thematic Analysis using NVivo 12. To provide guidance in the development of interventions to decrease vaccine hesitancy, we examined how themes fit with the constructs of the Health Belief Model. Results We found that primary themes driving COVID-19 vaccine hesitancy, ordered from most to least discussed, are mistrust, fear, and lack of information. Additionally, interventions to decrease vaccine hesitancy should be multi-modal, community engaged, and provide consistent, comprehensive messages delivered by trusted sources.

COVID-19, science, vaccines and family in a multi origin Latinx population in South Florida

“…Those who expressed hesitancy unanimously expressed their concern for the speed at which the vaccine was developed—similar to findings reported from a recent study by Bateman et al ( 23 ). Though levels of mistrust were high at the time the focus groups were conducted, it was generally related to vaccine quality and effectiveness.…”

Does potential antibody-dependent enhancement occur during SARS-CoV-2 infection after natural infection or vaccination? A meta-analysis

“…More population studies of SARS-CoV-2 must be conducted to clarify the role of ADE. Some people are unwilling to be vaccinated because of concerns about the effectiveness and safety of the vaccines [ 33 – 36 ]. The findings of this review may alleviate vaccine hesitancy to a certain extent, and a change in the attitude of some individuals may increase COVID-19 vaccine acceptance rates.…”

Racial concentration and dynamics of COVID-19 vaccination in the United States

“…Largely, current discussions have focused on finding “issues” among racial and ethnic minorities, particularly pointing to their higher levels of vaccine hesitancy. Racial and ethnic minorities are often socioeconomically disadvantaged and their higher vulnerability to myths and misinformation, greater perceived barriers to obtaining COVID-19 vaccines, and higher concern about COVID-19 cost and safety could make them more hesitant toward vaccines ( Ruiz & Bell, 2021 ; Khubchandani & Macias, 2021 ; Momplaisir et al, 2021 ; Bateman et al, 2022 ). Their vaccine hesitancy could also come from their lower trust in science and medical establishments due to historical and ongoing discrimination and racial injustices including unconsented and unethical medical experimentation and research practices such as the Tuskegee Syphilis experiment ( Cardona et al, 2021 ; Kricorian et al, 2021 ; McFadden et al, 2021 ).…”