Exploring the Scope and Dimensions of Vaccine Hesitancy and Resistance to Enhance COVID-19 Vaccination in Black Communities

Abstract

Background The long history of distrust that characterizes the relationship between the Black/African-American population and the US Medical community makes COVID-19 vaccine hesitancy of great concern. A needs assessment of the Black/African-American community assessed willingness and explored the perceptions of community members regarding COVID-19 vaccination. Methods The study used a mixed-methods approach. Respondents ( n = 183) were surveyed with a web-based questionnaire. They were asked whether there would get vaccinated for COVID-19 barring any access or cost-related challenges. Perceptions of community members regarding vaccination were explored through one-on-one interviews ( n = 30) and eight focus groups ( n = 49), with participants drawn from across various demographic characteristics. Survey responses were summarized using frequencies and proportions. A thematic analysis was conducted on the qualitative data. Results Thirty-four percent of respondents indicated “Yes” (willing to get vaccinated); 26.8% indicated “No”, while 37.1% expressed hesitancy (“Maybe” or “I don’t know”). Themes emerging from the qualitative data are grouped into three broad categories: vaccine accessibility (transportation, information, navigating healthcare system); vaccine hesitancy (with sub-categories of compliance, complacency and confidence); and vaccine “resistance” (conspiracy theories, conflicting beliefs, distrust of Government, trustworthiness of Health care). Conclusion Findings demonstrate a nuanced expansion of “vaccine hesitancy” to delineate groups with varying issues and perspectives. Interventions to enhance vaccination rates in Black/African-American communities should incorporate components that assure accessibility at the minimum, but also address non-access-related issues. Priority should be given to enhancing vaccine literacy, information-sharing as efficacy and safety data emerge, and addressing specific concerns identified through community-engaged outreach efforts.

Health Beliefs and Socioeconomic Determinants of COVID-19 Booster Vaccine Acceptance: An Indonesian Cross-Sectional Study

“…Health beliefs and trust were the primary independent variables in this study. These concepts fit quite neatly under the 3Cs model, where perceived threat corresponds with complacency, perceived benefits and harms correspond with confidence, and perceived barriers correspond with convenience [ 21 ]. Trust, meanwhile, can be seen as a modifying factor that affect health beliefs.…”

Multilevel determinants of COVID-19 vaccination hesitancy in the United States: A rapid systematic review

“… Fridman et al, 2021 , Teherani et al, 2021 , Akel et al, 2021 , Romer and Jamieson, 2021 , Keene Woods et al, 2021 , Ma and Ma, 2021 , Roberts et al, 2021 , Mondal et al, 2021 , Patil et al, 2021 , Rabin and Dutra, 2021 , Olanipekun et al, 2021 , Okoro et al, 2021 , Johnson et al, 2021 , Jacob et al, 2021 , Carson et al, 2021 , Bogart et al, 2021 , Rodriguez et al, 2021 , Ciardi et al, 2021 , Savoia et al, 2021 , Ofei-Dodoo et al, 2021 , Zheng et al, 2021 , Sharma et al, 2021 , Baniak et al, 2021 , Geana et al, 2021 , Hirshberg et al, 2021 , Rungkitwattanakul et al, 2021 .…”

Strengthened belief in vaccine effectiveness predicted increased COVID-19 vaccination intention and behaviour: Results from a nationally representative longitudinal survey of U.S. adults from July 2020 to April/May 2021

“…They also tend to identify as conservative or Republican, have higher religiosity, express lower trust and altruism, and report higher belief in vaccine conspiracy theories (see [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] ). In the context of the U.S. COVID-19 vaccine rollout, several societal-level changes may have also influenced changes in vaccine hesitancy – including government turnover (e.g., [18] , [19] , [20] ), widened accessibility (e.g., [21] , [22] , [23] ), and institutional norms, incentives, and mandates (e.g., [24] , [25] , [26] ). These factors may directly influence decisions to vaccinate; they may also influence changes in beliefs about the benefits and risks of vaccines, which in turn may influence decisions to vaccinate.…”