Abstract

Black and Latinx communities have been disproportionately affected by the COVID-19 pandemic, yet little work has sought to understand their perspectives. To explore the experiences of Black and Latinx communities during the pandemic to better understand their perspectives on COVID-19 mitigation behaviors (eg, mask wearing), testing, and vaccines. In this community-engaged qualitative study conducted with 18 community-based organizations and 4 health care organizations between November 19, 2020, and February 5, 2021, in New Jersey counties severely affected by the pandemic, group and individual interviews were used to purposively sample 111 Black and Latinx individuals. A total of 13 group interviews were organized by race/ethnicity and language: 4 English-speaking groups with Black participants (n = 34), 3 Spanish-speaking groups with Latinx participants (n = 24), and 4 English-speaking groups with Black and Latinx participants (n = 36). To understand the views of health care workers from these communities, 2 additional groups (n = 9) were convened and supplemented with individual interviews. Description of Black and Latinx participants' experiences during the COVID-19 pandemic and their perspectives on mitigation behaviors, testing, and vaccines. The study included 111 participants (87 women [78.4%]; median age, 43 years [range, 18-93 years]). Participants described the devastating effects of the pandemic on themselves, loved ones, and their community. Their experiences were marked by fear, illness, loss, and separation. These experiences motivated intense information seeking, mitigation behaviors, and testing. Nevertheless, vaccine skepticism was high across all groups. Participants did not trust the vaccine development process and wanted clearer information. Black participants expressed that they did not want to be subjects of experiments. The remaining unknowns about new vaccines need to be acknowledged and described for Black and Latinx communities to make informed decisions. Ultimately, scientists and public officials need to work transparently to address unanswered questions and work collaboratively with trusted community leaders and health professionals to foster partnered approaches, rather than focusing on marketing campaigns, to eliminate vaccine skepticism.

Highlights

  • As of May 2021, the US has the highest number of cases and deaths in the world

  • Vaccine skepticism was high across all groups

  • Among Black participants, racism and medical experimentation were associated with distrust. Meaning These findings suggest that perspectives on COVID-19 mitigation behaviors, testing, and vaccines among Black and Latinx communities are informed by devastating experiences, and transparent information from public officials is needed to eliminate vaccine skepticism

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Summary

Introduction

As of May 2021, the US has the highest number of cases and deaths in the world. Within the US, the pandemic is disproportionately affecting Black and Latinx groups.[1,2] For example, age-adjusted mortality rates for Black and Latinx Americans far exceed those for White Americans.[3]. Factors such as residential segregation, wealth inequality, and mass incarceration impact the ability of members from different racial/ethnic and socioeconomic groups to avoid infection and seek care.[7,8,9,10,11] These factors are the legacy of slavery, Jim Crow laws (state and local laws enacted in the late 19th and early 20th centuries that enforced racial segregation in the southern United States), and discriminatory public health interventions that together are associated with a pervasive sense of distrust of public health authorities.[12,13]

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