Abstract

Black and Latinx communities have faced disproportionate harm from the COVID-19 pandemic. Increasing COVID-19 vaccine acceptance and access has the potential to mitigate mortality and morbidity from COVID-19 for all communities, including those most impacted by the pandemic. To investigate and understand factors associated with facilitating and obstructing COVID-19 vaccine access and acceptance among Black and Latinx communities. This community-partnered qualitative study conducted semistructured, in-depth focus groups with Black and Latinx participants from March 17 to March 29, 2021, using a secure video conferencing platform. Participants were recruited through emails from local community-based organizations, federally qualified health centers, social service agencies, the New Haven, Connecticut, Health Department, and in-person distribution of study information from community health workers. A total of 8 focus groups were conducted, including 4 in Spanish and 4 in English, with 72 participants from a diverse range of community roles, including teachers, custodial service workers, and health care employees, in New Haven, Connecticut. Data were analyzed from March 17 to July 30, 2021. Interviews were audio-recorded, transcribed, translated, and analyzed using an inductive content analysis approach. Themes and subthemes were identified on the acceptability and accessibility of the COVID-19 vaccine among participants who identified as Black and/or Latinx. Among 72 participants, 36 (50%) identified as Black, 28 (39%) as Latinx, and 8 (11%) as Black and Latinx and 56 (78%) identified as women and 16 (22%) identified as men. Participants described 3 major themes that may represent facilitators and barriers to COVID-19 vaccinations: pervasive mistreatment of Black and Latinx communities and associated distrust; informing trust via trusted messengers and messages, choice, social support, and diversity; and addressing structural barriers to vaccination access. The findings of this qualitative study may impact what health care systems, public health officials, policy makers, health care practitioners, and community leaders can do to facilitate equitable uptake of the COVID-19 vaccine. Community-informed insights are imperative to facilitating COVID-19 vaccine access and acceptance among communities hardest hit by the pandemic. Preventing the further widening of inequities and addressing structural barriers to vaccination access are vital to protecting all communities, especially Black and Latinx individuals who have experienced disproportionate death and loss from COVID-19.

Highlights

  • Community-informed insights are imperative to facilitating COVID-19 vaccine access and acceptance among communities hardest hit by the pandemic

  • Preventing the further widening of inequities and addressing structural barriers to vaccination access are vital to protecting all communities, especially Black and Latinx individuals who have experienced disproportionate death and loss from COVID-19

  • Key Points Question What factors are associated with facilitating and obstructing COVID-19 vaccine acceptance and access among Black and Latinx communities?. This qualitative study of 72 participants who identified as Black and/or Latinx identified 3 themes to understanding factors associated with facilitating or obstructing COVID-19 vaccination: pervasive mistreatment of Black and Latinx communities and associated distrust; informing trust via trusted messengers and messages, choice, social support, and diversity; and addressing structural barriers to vaccination access. Meaning These findings suggest that community-informed insights may inform health care strategies to maximize vaccine acceptance and access in communities hardest hit by the COVID-19 pandemic

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Summary

Introduction

More than 99% of deaths from COVID-19 are among unvaccinated individuals.[1,2] Black and Latinx communities experience 2-fold the rate of death due to COVID-19 compared with their White counterparts, and factors rooted in structural racism continue to impede equal access to health for all.[3,4] Striking racial and ethnic disparities exist in COVID-19 vaccination rates and vaccine access.[5,6,7] As of July 2021 in the US, among individuals who have received 1 dose of the vaccine, 58.9% were White, 16.1% Hispanic, and 9.3% were Black, which lags behind national racial and ethnic representation.[8]Data continue to show lower vaccination coverage in Black and Latinx communities, even as the supply of COVID-19 vaccines outpaces demand.[8,9,10,11,12] COVID-19 cases continue to increase as variants surge and vaccination rates stagnate, making it imperative to understand barriers to vaccine acceptance and access.[8].

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