Listening to Voices from African American Communities in the Southern States about COVID-19 Vaccine Information and Communication: A Qualitative Study

Abstract

The high uptake of COVID-19 vaccines is one of the most promising measures to control the pandemic. However, some African American (AA) communities exhibit vaccination hesitancy due to mis- or disinformation. It is important to understand the challenges in accessing reliable COVID-19 vaccine information and to develop feasible health communication interventions based on voices from AA communities. We conducted 2 focus group discussions (FGDs) among 18 community stakeholders recruited from 3 counties in South Carolina on 8 October and 29 October 2021. The FGDs were conducted online via Zoom meetings. The FGD data were managed and thematically analyzed using NVivo 12. Participants worked primarily in colleges, churches, and health agencies. We found that the challenges of accessing reliable vaccine information in AA communities primarily included structural barriers, information barriers, and a lack of trust. Community stakeholders recommended recruiting trusted messengers, using social events to reach target populations, and conducting health communication campaigns through open dialogue among stakeholders. Health communication interventions directed at COVID-19 vaccine uptake should be grounded in ongoing community engagement, trust-building activities, and transparent communication about vaccine development. Tailoring health communication interventions to different groups may help reduce misinformation spread and thus promote vaccination in AA communities in the southern states.

COVID-19 vaccine attitudes among a majority black sample in the Southern US: public health implications from a qualitative study

“…Thus, receiving additional vaccine safety and efficacy information has been identified as a facilitator of vaccine willingness [ 21 ]. In our study, vaccine safety concerns, including misinformation and “conspiracy theories”, were brought up more frequently than efficacy as reasons for deciding not to take vaccine, echoing previous study findings in Black and Latino communities [ 22 , 23 ]. Healthcare providers and public health workers should prioritize addressing the safety concerns by providing scientific data, communicating honestly about anecdotes on the limited vaccine side effects, and disseminating a clear communication about the COVID-19 vaccine development timeline, such as graphic illustrations or brief talking points, while acknowledging historical events that inform current fears around vaccination [ 24 ].…”

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.…”

“…Historical mistrust refers to the history of abusive and unethical research practices conducted on African Americans and was mentioned in 12 of the 14 studies. The Tuskegee Syphilis Study [ 10 , 18 , 40 , 41 ], the Henrietta Lacks case [ 39 ], and terms such as “guinea pig” [ 42 ] were used by focus group participants and interviewees to describe how African American and Black people were abused in medical research. To improve vaccination uptake, most studies emphasized the importance of acknowledging historical malpractice and expressing historical empathy in communication efforts to overcome judgment and appreciate the motives which may lead to COVID-19 vaccine hesitancy.…”

“…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 ].…”

“…Several studies have demonstrated how mistrust in government and pharmaceutical organizations has emerged as the main reason for COVID-19 vaccine hesitancy [ 8 , 17 ]. Furthermore, other studies have highlighted how vaccine hesitancy can stem from exposure to misinformation or misconceptions about the risks and benefits of vaccines [ 4 , 18 ]. In the context of the COVID-19 pandemic, concerns about the rushed development of vaccines and their potential side effects, as well as historical memory of unethical medical practices, have been recognized as prominent reasons for vaccine hesitancy among African American and Black individuals [ 14 , 17 , 19 ].…”