COVID-19 Vaccination Rates and Vaccine Hesitancy Among Spanish-Speaking Free Clinic Patients

Latinx youth's and parents' covid-19 beliefs, vaccine hesitancy and vaccination rates: Longitudinal associations in a community sample

INTRODUCTION

The Latinx population has the second highest COVID-19 death rate among racial/ethnic groups in the United States and less than half of Latinx youth aged 5-17 years old completed their COVID-19 primary vaccination series as of September 2022. COVID-19 vaccine misinformation detrimentally impacts vaccination rates. In this study, we examined factors that predicted Latinx youth COVID-19 vaccine hesitancy and vaccination status.

METHODS

A community-based sample of 290 Latinx parent and adolescent dyads from a Southwestern metropolitan area of the United States who were recruited to complete an online survey at baseline at T1 (August 2020 -March 2021) and one year later. We tested a longitudinal mediation model in which we examined individual and family factors that would predict youth COVID-19 vaccine hesitancy and vaccination status over time.

RESULTS

Youth's pandemic disbelief (i.e., the belief that the COVID-19 pandemic is a conspiracy or not real) predicted greater youth's COVID-19 vaccine hesitancy, and in turn, a lower likelihood of youth's COVID-19 vaccination. Youth's pandemic disbelief also predicted greater parent's vaccination hesitancy which, in turn, predicted greater youth's vaccination hesitancy and a lower likelihood of COVID-19 vaccination. Parents' pandemic disbelief predicted their own COVID-19 hesitancy, but not youth hesitancy.

DISCUSSION

Our study findings provide initial evidence that general pandemic disbelief was a significant driver of vaccine hesitancy and vaccination among Latinx families. The study contributes to the limited research investigating COVID-19 vaccination in the Latinx community and among Latinx youth, further aiding how COVID-19 vaccine disparities can be mitigated among racial/ethnic populations.

Latino Parents' Reactions to and Engagement With a Facebook Group-Based COVID-19 Vaccine Promotion Intervention: Mixed Methods Pilot Study

BACKGROUND

Misinformation in Spanish on social media platforms has contributed to COVID-19 vaccine hesitancy among Latino parents. Brigada Digital de Salud was established to disseminate credible, science-based information about COVID-19 in Spanish on social media.

OBJECTIVE

This study aims to assess participants' reactions to and engagement with Brigada Digital content that sought to increase COVID-19 vaccine uptake among US Latino parents and their children.

METHODS

We conducted a 5-week intervention in a private, moderator-led Facebook (Meta Platforms, Inc) group with Spanish-speaking Latino parents of children aged ≤18 years (N=55). The intervention participants received 3 to 4 daily Brigada Digital posts and were encouraged to discuss the covered topics through comments and polls. To assess participants' exposure, reactions, and engagement, we used participants' responses to a web-based survey administered at 2 time points (baseline and after 5 weeks) and Facebook analytics to calculate the average number of participant views, reactions, and comments. Descriptive statistics were assessed for quantitative survey items, qualitative responses were thematically analyzed, and quotes were selected to illustrate the themes.

RESULTS

Overall, 101 posts were published. Most participants reported visiting the group 1 to 3 times (22/55, 40%) or 4 to 6 (18/55, 33%) times per week and viewing 1 to 2 (23/55, 42%) or 3 to 4 (16/55, 29%) posts per day. Facebook analytics validated this exposure, with 36 views per participant on average. The participants reacted positively to the intervention. Most participants found the content informative and trustworthy (49/55, 89%), easy to understand, and presented in an interesting manner. The participants thought that the moderators were well informed (51/55, 93%) and helpful (50/55, 91%) and praised them for being empathic and responsive. The participants viewed the group environment as welcoming and group members as friendly (45/55, 82%) and supportive (19/55, 35%). The 3 most useful topics for participants were the safety and efficacy of adult COVID-19 vaccines (29/55, 53%), understanding child risk levels (29/55, 53%), and the science behind COVID-19 (24/55, 44%). The preferred formats were educational posts that could be read (38/55, 69%) and videos, including expert (28/55, 51%) and instructional (26/55, 47%) interviews. Regarding engagement, most participants self-reported reacting to posts 1 to 2 (16/55, 29%) or 3 to 4 (15/55, 27%) times per week and commenting on posts 1 to 2 (16/55, 29%) or <1 (20/55, 36%) time per week. This engagement level was validated by analytics, with 10.6 reactions and 3 comments per participant, on average, during the 5 weeks. Participants recommended more opportunities for engagement, such as interacting with the moderators in real time.

CONCLUSIONS

With adequate intervention exposure and engagement and overall positive participant reactions, the findings highlight the promise of this digital approach for COVID-19 vaccine-related health promotion.

Assessing Changes in COVID-19 Vaccine Uptake and Intentions among the Brigada Digital Latino Social Media Audience: A Repeated Cross-Sectional Study

BACKGROUND

U.S. Latinos experienced disproportionate COVID-19 impacts in terms of morbidity and mortality. Vaccination against COVID-19 is an important strategy for mitigating health impacts, and yet, vaccine uptake was slower among U.S. Latino adults compared to other racial/ethnic groups. Vaccine hesitancy has been a significant barrier within Latino communities, and exposure to misinformation has been associated with negative attitudes toward vaccination. While some COVID-19 mitigation efforts have included community-based outreach, few studies have explored the impact of community-based digital messaging in Spanish to counter COVID-19 misinformation, build trust, and promote vaccination.

METHODS

To address this gap, we conducted a one-year repeated cross-sectional study to assess changes in COVID-19 vaccine uptake, intentions, and perceived norms, as well as barriers to accessing reliable information and levels of trust in COVID-19 information sources among Latino adults exposed to Brigada Digital de Salud social media content. This culturally-tailored content disseminated on Facebook, Instagram, and X platforms was amplified by community health workers and partners, and focused on COVID-19 risk and prevention, vaccine safety and efficacy, and correcting related misinformation.

RESULTS

Statistically significant increases in COVID-19 vaccination, intentions to vaccinate children, and vaccination subjective norms were observed from May 2022 (wave 1) to April 2023 (wave 2). Among perceived difficulties accessing information, respondents indicated the most difficulty in judging the reliability of COVID-19 information in the media; however, a statistically significant decrease in perceived difficulty was observed between waves. With regard to trust in COVID-19 information sources, levels of trust were highest for healthcare providers in both waves. From wave 1 to wave 2, there were statistically significant increases in trust in the FDA to ensure COVID-19 vaccine safety and trust in the federal government to ensure child COVID-19 vaccine safety.

CONCLUSIONS

Social media messaging by trusted community-based sources shows promise as a strategy for combating health misinformation and ameliorating information access gaps for language minority populations. This digital approach represents an important tool for deploying critical information to underserved populations in public health emergency and crisis contexts, and for supporting changes in attitudes, trust, and behaviors to improve health outcomes.