Background: In the United States, underserved communities including Blacks and Latinx are disproportionately affected by COVID19, and widespread vaccination is critical for curbing this pandemic. This study sought to estimate the prevalence of COVID19 vaccine hesitancy, describe attitudes related to vaccination, and identify correlates among racial minority and marginalized populations across 9 counties in North Carolina.
Methods: We conducted a cross-sectional survey with a self administered questionnaire distributed at free COVID19 testing events in underserved rural and urban communities from August 27 to December 15, 2020. Vaccine hesitancy was defined as the response of NO or DO NOT KNOW/NOT SURE to whether the participant would get the COVID19 vaccine as soon as it became available.
Results: The sample comprised 948 participants including 27.7% Whites, 59.6% Blacks, 12.7% Latinx, and 63% female. Thirty-two percent earned <$20K annually, 60% owned a computer and ~80% had internet access at home. The prevalence of vaccine hesitancy was 68.9% including 62.7%, 74%, and 59.5% among Whites, Blacks, and Latinx, respectively. Between September and December, the largest decline in vaccine hesitancy occurred among Whites (27.5 percentage points), followed by Latinx (17.6) and the smallest decline was among Black respondents (12.0). 51.2% of the respondents reported vaccine safety concerns, 23.7% wanted others to get of the respondents reported they would trust health care providers with information about the COVID19 vaccine. Factors associated with hesitancy in multivariable logistic regression included being female (OR=1.90 95%CI[1.36, 2.64]), being Black (OR=1.68 [1.106 2.45]), calendar month (OR=0.76 [0.63, 0.92]), safety concerns (OR=4.28 [3.06, 5.97]), and government distrust (OR=3.57 [2.26, 5.63]).
Conclusions: This study reached underserved minority populations in a number of different locations to investigate COVID19 vaccine hesitancy. We built on existing relationships and further engaged the community, stake holders and health department to provide free COVID19 testing. This direct approach permitted assessment of vaccine hesitancy (which was much higher than national estimates), distrust, and safety concerns.