PandemicInsights into COVID Vaccine Hesitancy

Published 5 October 2021

Two recent studies looked at COVID-19 vaccine acceptance in minority groups and opinions around less-preferred vaccines, provide clues for how officials might better encourage immunization.

Two JAMA Network Open studies last Thursday that looked at COVID-19 vaccine acceptance in minority groups and opinions around less-preferred vaccines provide clues for how officials might better encourage immunization.

The first study, involving 13 focus groups, reaffirmed a lack of communication and trust among racially and ethnically diverse communities in the United States.

The second study examined the effect of emphasizing different data around the Johnson & Johnson and AstraZeneca/Oxford COVID-19 vaccines: People were more interested in uptake when they were presented with the vaccines’ effectiveness against death versus their effectiveness against symptomatic infection.

Concerns about Trust, Unequal Treatment
The virtual focus groups involved 70 Los Angeles residents from Nov 16, 2020, to Jan 28, 2021. (Pfizer/BioNTech, the first emergency-use approved vaccine in the United States, received its emergency-use authorization in mid-December 2020.)

Most participants (71.4%) were female, and none were White (24.3% Black, 24.3% American Indian, 21.4% Latino, 15.7% Filipino, and 14.3% Pacific Islander). About 55.7% lived in a zip code area with high poverty, and 48.6% were essential workers.

Overall, 52.9% said they were likely to be vaccinated against COVID-19 when an option became available, and 77.1% said it was important for all people in the community to receive a COVID-19 vaccine. However, themes of medical mistrust, concern about inequitable access or differential treatment, fears around politicization or pharmaceutical influence, and uncertainty around COVID-19 vaccine information, cost, and scheduling contributed to vaccine hesitance.

For instance, participants brought up specific examples of unethical or exclusionary research as well as worries that they were being experimented on. Some were concerned that White people or those having more power might be the first to receive the vaccine or simply get a better vaccine than those offered to the marginalized. And still others discussed the difficulties that they had in scheduling and attending a COVID vaccine appointment.

Consistent with prior COVID-19 vaccine acceptability qualitative research, we found information gaps, concerns about the vaccine’s rapid development, and an absence of scientific evidence translated for diverse communities,” write the researchers.

Recommendations offered or endorsed by study participants include using community engagement; improving empathetic bidirectional deliberation; ensuring timely access to critical information; promoting altruistic and culturally congruent messaging; increasing data transparency, translation, and data collection for diverse populations; and increasing accessibility through navigational and logistical vaccination support.