Abstract
In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97–5.26–91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99–27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.
Highlights
The COVID-19 global pandemic has devastated many countries and, to date, is responsible for more than 144 million cases and 3 million deaths [1]
We performed a cross-sectional analysis of survey data collected among a subsample of participants aged 18 and older recruited within the SeroPrevalence And Respiratory Tract Assessment (SPARTA) study during community events sponsored in partnership with The 100 Black Men of Augusta
We identified COVID-19 beliefs and experiences based on participants’ yes/no response to the following: (1) COVID-19 knowledge—“do you believe that COVID-19 can be spread from person to person via droplets through the air?”, (2) COVID-19 safety practices —“do you wear a facemask and wash your hands regularly when in public spaces?”, (3) job loss due to COVID-19—“have you or the primary provider of your household lost a job due to the COVID-19 pandemic?”, (4) housing insecurity due to COVID-19—“have you lost your home or had difficulties paying your rent due to the COVID-19 pandemic?”, and (5) “when seeking medical care, I have encountered unfair treatment or discrimination because of my race”
Summary
The COVID-19 global pandemic has devastated many countries and, to date, is responsible for more than 144 million cases and 3 million deaths [1]. Most notably, during the early phases of the COVID-19 pandemic, communities with predominantly AA and rural populations, such as Albany, Georgia, experienced higher rates of COVID-19 hospitalizations [9,10,11,12]. The Georgia Black Belt, which geographically ranges diagonally across the state of Georgia from the southwestern corridor (Albany area) through middle Georgia (Macon area) to central-eastern Georgia (Augusta area), has experienced disparate health outcomes over the past few decades for many diseases including, sepsis [16], infectious disease [17], cardiovascular disease [18], stroke [19], various cancers [20,21], and, more recently, COVID-19 [12,22,23]. The added burden of health inequities comes from structural features of these communities such as limited health care resources, higher area-level disadvantage, lower socioeconomic status, and a concentration of comorbidities [5,11]
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