Profiles of COVID-19 vaccine hesitancy by race and ethnicity in eastern Pennsylvania

Abstract

Background Throughout US history, chronic and infectious diseases have severely impacted minority communities due to a lack of accessibility to quality healthcare and accurate information, as well as underlying racism. These fault lines in the care of minority communities in the US have been further exacerbated by the rise of the COVID-19 pandemic. This study examined the factors associated with COVID-19 vaccine hesitancy by race and ethnicity, particularly among African American and Latinx communities in Eastern Pennsylvania (PA). Methods Survey data was collected in July 2021 in Philadelphia, Scranton, Wilkes-Barre, and Hazleton, PA. The 203 participants (38.7% Black, 27.5% Latinx) completed the 28-question survey of COVID-19 vaccination attitudes in either English or Spanish. Result Out of the 203 participants, 181 participants met all the inclusion criteria, including completed surveys; of these participants, over three-fifths (63.5%) were acceptant of the COVID-19 vaccine whereas the remainder (36.5%) were hesitant. Binary logistic regression results showed that age, concern for vaccine efficacy, race, knowledge on the vaccine, and belief that the COVID-19 virus is serious significantly influenced COVID-19 vaccine hesitancy. Minorities were more likely to be hesitant toward vaccination (OR: 2.8, 95% CI: 1.1, 6.8) than non-Hispanic whites. Those who believed the COVID-19 vaccine was ineffective (OR: 8.3, 95% CI: 3.8, 18.2), and that the virus is not serious (OR: 8.3, 95% CI: 1.1, 61.8) showed the greatest odds of hesitancy. Conclusions Minority status, age less than 45 years, misinformation about seriousness of COVID-19 illness, and concern about vaccine efficacy were contributing factors of COVID-19 vaccine hesitancy. Therefore, understanding and addressing the barriers to COVID-19 vaccination in minority groups is essential to decreasing transmission and controlling this pandemic, and will provide lessons on how to implement public health measures in future pandemics.

The Moderating Effect of Vaccine Hesitancy on the Relationship between the COVID-19 Vaccine Coverage Index and Vaccine Coverage

“…To understand which psychological factors may be influencing the choice of predominantly white communities to not get vaccinated, we surveyed the literature. While there is a plethora of studies that focus on the barriers to vaccination faced by minoritized racial and ethnic groups [ 56 , 57 , 58 , 59 , 60 ], there is a dearth of research investigating psychological barriers to vaccine uptake among white Americans. Newer studies suggest that political ideology, rugged individualism, mediate intake and moral concerns may be factors to explore in additional research [ 50 , 61 , 62 , 63 ].…”

“…The vast majority of studies and interventions seek to understand lower vaccination rates among marginalized groups [ 56 , 57 , 58 , 59 , 60 , 65 ], but the results of this study importantly tell the part of the story that is often missed in health equity research: vaccination responsibility cannot be placed entirely on the shoulders of those experiencing health inequities, and socially vulnerable populations are not the only demographic group in which to invest research and intervention resources. Populations with social and structural advantages (white, high income, access to routine healthcare, health insurance coverage, etc.)…”