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Purvis RS, Moore R, Willis DE, Li J, Selig JP, Kraleti S, Imran T, McElfish PA. Exploring Hesitancy, Motivations, and Practical Issues for COVID-19 Vaccination Among Vaccine-Hesitant Adopter Parents Using the Increasing Vaccination Model. J Pediatr Health Care 2024; 38:456-467. [PMID: 38430095 PMCID: PMC11222047 DOI: 10.1016/j.pedhc.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/12/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION COVID-19 vaccination coverage among children remains low, and many parents report being hesitant to get their children vaccinated. This study explores factors influencing hesitancy and the facilitators that helped hesitant adopter parents choose to vaccinate their children against COVID-19 despite their hesitancy. METHOD We use a qualitative descriptive design with individual interviews (n = 20) to explore COVID-19 vaccine hesitancy and facilitators of vaccination among hesitant adopter parents. The Increasing Vaccination Model domains (thoughts and feelings, social processes, and practical issues) provided the framework for initial coding, and the research team identified nine emergent themes. RESULTS Findings document the factors influencing hesitancy and the facilitators motivating COVID-19 vaccination among hesitant adopter parents. DISCUSSION Findings fill the gap in the literature by providing hesitant adopters' lived experience, perspectives on vaccine hesitancy, and the influential factors that helped participants overcome their hesitancy and choose to vaccinate their children against COVID-19.
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Affiliation(s)
- Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of
Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - James P. Selig
- Fay W. Boozman College of Public Health, University of
Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Shashank Kraleti
- College of Medicine, University of Arkansas for Medical
Sciences, Little Rock, AR, USA
| | - Tabasum Imran
- College of Medicine, University of Arkansas for Medical
Sciences West, Fort Smith, AR, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
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McCollum G, Allgood A, Agne A, Cleveland D, Gray C, Ford E, Baral S, Mugavero M, Hall AG. Associations Between Social Networks and COVID-19 Vaccine Uptake in 4 Rural Alabama Counties: Survey Findings. Public Health Rep 2024:333549241250223. [PMID: 38780015 DOI: 10.1177/00333549241250223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic demonstrated how vaccination decisions are influenced by misinformation, disinformation, and social pressures, leading to varied and inequitable uptake rates. In this study, we examined how COVID-19 vaccine messages received via social networks were associated with vaccine uptake in rural Alabama. METHODS From November 2021 through March 2022, we collected 700 responses to a telephone survey administered in 4 rural Alabama counties. We asked respondents to indicate whether certain social relationships (eg, family, businesses) tried to influence them to (1) obtain or (2) avoid a COVID-19 vaccine. We used χ2 tests, Kruskal-Wallis tests, Mantel-Haenszel χ2 tests, and Fisher exact tests to examine the associations between vaccination status and survey responses. RESULTS Respondents in majority-African American counties were significantly more likely than those in majority-White counties to have received ≥1 dose of COVID-19 vaccine (89.8% vs 72.3%; P < .001). Respondents who received ≥1 dose had a significantly higher mean age than those who had not (58.0 vs 39.0 years; P < .001). Respondents who were encouraged to get vaccinated by religious leaders were more likely to have received ≥1 dose (P = .001), and those who were encouraged to avoid vaccination by family (P = .007), friends (P = .02), coworkers (P = .003), and health care providers (P < .001) were less likely to have received ≥1 dose. Respondents with more interpersonal relationships that encouraged them to avoid vaccination were more likely to be unvaccinated (P < .001). CONCLUSIONS Interpersonal relationships and demographic characteristics appeared to be important in COVID-19 vaccine decision-making in rural Alabama. Further research needs to identify how to facilitate vaccine-positive interpersonal relationships, such as peer mentoring and trusted messenger interventions.
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Affiliation(s)
- Greer McCollum
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ashleigh Allgood
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - April Agne
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dave Cleveland
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cicily Gray
- Community Health Program, Department of Health and Human Services, School of Education, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric Ford
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stefan Baral
- Department of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
| | - Michael Mugavero
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allyson G Hall
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Bateman LB, Hall A, Hannon L, Ryan M, Osborne T, Whitfield S, Okoro G, Stager C, Driggers S, Jones V, Rhinehart J, Fouad MN. Partnering With Churches to Address COVID-19 Vaccine Hesitancy and Uptake in Trustworthy Contexts. Am J Public Health 2024; 114:S392-S395. [PMID: 38776503 PMCID: PMC11111367 DOI: 10.2105/ajph.2024.307683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/25/2024]
Abstract
The Black church has long been seen as a crucial partner in addressing public health issues. This paper describes the development, implementation, and evaluation of a community-engaged church intervention addressing COVID-19 vaccine hesitancy in underserved Black communities in Jefferson County, Alabama. We partnered with churches to implement and evaluate the intervention between March and June of 2022 and found that our church partners were capable of significant messaging reach, particularly through electronic means. (Am J Public Health. 2024;114(S5):S392-S395. https://doi.org/10.2105/AJPH.2024.307683).
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Affiliation(s)
- Lori B Bateman
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Allyson Hall
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Lonnie Hannon
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Melissa Ryan
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Tiffany Osborne
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Samantha Whitfield
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Grace Okoro
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Catanya Stager
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Susan Driggers
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Valerie Jones
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Jessica Rhinehart
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
| | - Mona N Fouad
- Lori Bateman, Melissa Ryan, Tiffany Osborne, Samantha Whitfield, Samantha, Grace Okoro, Catanya Stager, Susan Driggers, Jessica Rhinehart, and Mona Fouad are with the Heersink School of Medicine, University of Alabama at Birmingham. Allyson Hall is with the School of Health Professions, University of Alabama at Birmingham. Lonnie Hannon is with the School of Public Health, University of Alabama at Birmingham. Valerie Jones is with the New Rising Star Missionary Baptist Church, Birmingham, AL
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Zhang R, Byrd T, Qiao S, Torres ME, Li X, Liu J. Is It Safe for Me to Get It? Factors Influencing COVID-19 Vaccination Decision-Making among Postpartum Women Who Are Black and Hispanic in Deep South. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01931-3. [PMID: 38356011 DOI: 10.1007/s40615-024-01931-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND COVID-19 vaccination is vital for ending the pandemic, yet safety concerns persist among pregnant and postpartum women, especially those who are Black and Hispanic. This study aims to explore factors that influence postpartum women's vaccination decision-making during pregnancy and postpartum through women's lived experiences and maternal care providers' (MCPs) observations. METHODS From January to August 2022, we conducted semi-structured interviews with postpartum women who are Black and Hispanic and with MCPs. Participants were recruited from obstetric and pediatric clinics in South Carolina and had given birth in 2021. Thematic analysis was employed for data analysis. RESULTS The study involved 19 Black and 20 Hispanic women, along with 9 MCPs, and revealed both barriers and facilitators to COVID-19 vaccination. The factors that influence pregnant and postpartum women's decision about COVID-19 vaccine uptake included: 1) awareness of health threats associated with COVID-19 vaccines, 2) vaccine availability and accessibility, 3) vaccine-related knowledge and exposure to misinformation, 4) concerns regarding pre-existing health conditions and potential side effects of COVID-19 vaccines, 5) emotional factors associated with vaccination decision-making processes, 6) concerns about the well-being of infants, 7) cultural perspectives, and 8) encouragement by trusted supporters. CONCLUSION The findings suggest that reliable information, social support, and trusted MCPs' advice can motivate COVID-19 vaccination among pregnant and postpartum women who are Black and Hispanic. However, barriers such as misinformation, mistrust in the health care system, and fears of potential side effects impede vaccination uptake. Future interventions should address these barriers, consider health disparities, involve trusted MCPs, and initiate conversations about vaccines to promote vaccination among these populations.
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Affiliation(s)
- Ran Zhang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Tiffany Byrd
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Myriam E Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Newman PA, Dinh DA, Nyoni T, Allan K, Fantus S, Williams CC, Tepjan S, Reid L, Guta A. Covid-19 Vaccine Hesitancy and Under-Vaccination among Marginalized Populations in the United States and Canada: A Scoping Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01882-1. [PMID: 38117443 DOI: 10.1007/s40615-023-01882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Amid persistent disparities in Covid-19 vaccination and burgeoning research on vaccine hesitancy (VH), we conducted a scoping review to identify multilevel determinants of Covid-19 VH and under-vaccination among marginalized populations in the U.S. and Canada. METHODS Using the scoping review methodology developed by the Joanna Briggs Institute, we designed a search string and explored 7 databases to identify peer-reviewed articles published from January 1, 2020-October 25, 2022. We combine frequency analysis and narrative synthesis to describe factors influencing Covid-19 VH and under-vaccination among marginalized populations. RESULTS The search captured 11,374 non-duplicated records, scoped to 103 peer-reviewed articles. Among 14 marginalized populations identified, African American/Black, Latinx, LGBTQ+, American Indian/Indigenous, people with disabilities, and justice-involved people were the predominant focus. Thirty-two factors emerged as influencing Covid-19 VH, with structural racism/stigma and institutional mistrust (structural)(n = 71) most prevalent, followed by vaccine safety (vaccine-specific)(n = 62), side effects (vaccine-specific)(n = 50), trust in individual healthcare provider (social/community)(n = 38), and perceived risk of infection (individual)(n = 33). Structural factors predominated across populations, including structural racism/stigma and institutional mistrust, barriers to Covid-19 vaccine access due to limited supply/availability, distance/lack of transportation, no/low paid sick days, low internet/digital technology access, and lack of culturally- and linguistically-appropriate information. DISCUSSION We identified multilevel and complex drivers of Covid-19 under-vaccination among marginalized populations. Distinguishing vaccine-specific, individual, and social/community factors that may fuel decisional ambivalence, more appropriately defined as VH, from structural racism/structural stigma and systemic/institutional barriers to vaccination access may better support evidence-informed interventions to promote equity in access to vaccines and informed decision-making among marginalized populations.
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Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Duy A Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kate Allan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Sophia Fantus
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | | | - Luke Reid
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Adrian Guta
- School of Social Work, University of Windsor, Windsor, ON, Canada
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Purvis RS, Moore R, Willis DE, Kraleti SS, Gurel-Headley MP, CarlLee S, McElfish PA. Key Conversations and Trusted Information Among Hesitant Adopters of the COVID-19 Vaccine. JOURNAL OF HEALTH COMMUNICATION 2023; 28:595-604. [PMID: 37599458 PMCID: PMC10528835 DOI: 10.1080/10810730.2023.2244458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
COVID-19 vaccines effectively protect against COVID-19-related hospitalization or death, and 67.1% of the US population is fully vaccinated. However, the disparity in COVID-19 vaccination persists among minority and rural populations who often report greater hesitancy about COVID-19 vaccines. This exploratory study aimed to understand and document trusted sources of information about the COVID-19 vaccine among a diverse sample of hesitant adopters with in-depth interviews. Participants (n = 21) described how information from trusted sources influenced their decision to get a COVID-19 vaccine despite being hesitant. Participants reported health care professionals, family members, friends, coworkers, community leaders, public health experts, government officials, and the mainstream media as trusted sources of information about the COVID-19 vaccines. Participants discussed obtaining trusted information from multiple modes, including direct conversations with trusted messengers and public health communications from public influencers who reinforced the information shared with trusted messengers. Notably, participants discussed having multiple conversations with trusted messengers during their decision-making process, and these trusted messengers often facilitated the participants' vaccination process. Study findings highlight the continued need for clear, understandable information about vaccine side effects, safety, and efficacy to address concerns that contribute to vaccine hesitancy.
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Affiliation(s)
- Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR
| | - Shashank S. Kraleti
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Morgan P. Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR
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Zhang R, Byrd T, Qiao S, Torres ME, Li X, Liu J. Factors influencing COVID-19 vaccination decision-making among African American and Hispanic pregnant and postpartum women in Deep South. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.20.23292951. [PMID: 37546980 PMCID: PMC10402215 DOI: 10.1101/2023.07.20.23292951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background COVID-19 vaccination is vital for ending the pandemic but concerns about its safety among pregnant and postpartum women, especially among African American (AA) and Hispanic women, persist. This study aims to explore factors that influence vaccination decision-making among AA and Hispanic pregnant and postpartum women through women's experiences and maternal care providers' (MCPs) observations. Methods From January and August 2022, we conducted semi-structured interviews with AA and Hispanic women and MCPs. Participants were recruited from obstetric and pediatric clinics in South Carolina, and all births took place after March 2020. Thematic analysis was employed for data analysis. Results The study involved 19 AA and 20 Hispanic women, along with 9 MCPs, and revealed both barriers and facilitators to COVID-19 vaccination. The factors that influence pregnant and postpartum women's decision about COVID-19 vaccine uptake included: 1) awareness of health threats associated with COVID-19 vaccines, 2) vaccine availability and accessibility, 3) vaccine-related knowledge and exposure to misinformation, 4) concerns regarding pre-existing health conditions and potential side effects of COVID-19 vaccines, 5) emotional factors associated with vaccination decision-making processes, 6) concerns about the well-being of infants, 7) cultural perspectives, and 8) encouragement by trusted supporters. Conclusion Findings suggest that reliable information, social support, and trusted doctors' advice can motivate COVID-19 vaccination. However, barriers such as misinformation, mistrust in the health care system, and fears related to potential side effects impede vaccination uptake among AA and Hispanic pregnant and postpartum women. Future interventions should target these barriers, along with health disparities, involve trusted doctors in outreach, and initiate vaccine conversations to promote vaccination among this population.
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Affiliation(s)
- Ran Zhang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Tiffany Byrd
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Myriam E. Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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Huang W, Dove-Medows E, Shealey J, Sanchez K, Benson L, Seymore DD, Sullivan PS, Bradley HM, Siegler AJ. COVID-19 vaccine attitudes among a majority black sample in the Southern US: public health implications from a qualitative study. BMC Public Health 2023; 23:88. [PMID: 36631819 PMCID: PMC9834032 DOI: 10.1186/s12889-022-14905-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic continues to have high caseloads in the US, with vaccines a critical component of the response. Disparities in COVID-19 morbidity and mortality have been identified across states and racial/ethnic groups, which are likely in part due to disparities in COVID-19 vaccine uptake. This study aims to better understand and contextualize COVID-19 vaccine hesitancy among persons from under-represented racial/ethnic populations in the Southern US. METHODS We conducted 29 in-depth interviews with a sample of households in Atlanta, GA that were selected from an address-based sampling frame. We purposively approached households, from February 6 to June 27, 2021, that declined participation in a national COVID-19 serosurvey to gain perspectives of people who are often under-represented in research. Interviews were conducted in-person or over phone calls for participants with that preference. Thematic analysis was used to identify barriers and facilitators of COVID-19 vaccination, and to contextualize drivers of vaccine hesitancy. RESULTS Decision-making about vaccination was described as dynamic, and was compared to the feeling of being on a roller coaster. The predominant reported sources of information were mass media and social media. Facilitators of vaccination included altruism, positive communication from trusted community members and workplace colleagues, and local vaccine provision sites. Driving reasons for vaccine hesitancy included limited trust in the government and concerns about COVID-19 vaccine safety, which one participant compared to jumping off a cliff without a tested rope. Among a subset of participants, beliefs regarding perceived intent to harm the Black community were prevalent. Opportunities to optimally address vaccine hesitancy included countering negative social media messages with positive messaging that matches the community's vivid ways of discussing vaccines, collaborating with community stakeholders on vaccine promotion efforts, and offering workplace-based vaccine promotion efforts. CONCLUSIONS This study presents data that indicate it may be optimal to more broadly define 'community' in COVID-19 vaccine promotion efforts to include social media and workplace venues. To optimize vaccine and vaccine booster uptake and equity, public health must address historic racism and other concerns by using outreach that is grounded in communities.
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Affiliation(s)
- Wenting Huang
- grid.189967.80000 0001 0941 6502Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Emily Dove-Medows
- grid.214458.e0000000086837370Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Jalissa Shealey
- grid.256304.60000 0004 1936 7400Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Katia Sanchez
- grid.256304.60000 0004 1936 7400Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Lauren Benson
- grid.256304.60000 0004 1936 7400Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - DawnSheska D. Seymore
- grid.256304.60000 0004 1936 7400Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Patrick S. Sullivan
- grid.189967.80000 0001 0941 6502Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Heather M. Bradley
- grid.256304.60000 0004 1936 7400Department of Epidemiology, Georgia State University, Atlanta, GA USA
| | - Aaron J. Siegler
- grid.189967.80000 0001 0941 6502Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
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