Addressing Acceptance and Access to COVID-19 Vaccines

It’s hard to imagine that we’re entering our second winter with COVID-19. A second year in a pandemic is one that brings about new challenges and hard realities. According to the Centers for Disease Control and Prevention (CDC) the United States has seen over 44 million cases of COVID-19, resulting in over 723,205 deaths since the pandemic began. 189.3 million people have been fully vaccinated within the United States, which translates to 57% of the total US population. 66.7% of the US population 12 years and older has been fully vaccinated.

Vaccination is a critical part to controlling COVID-19, especially as we move into the winter months where we are more likely to see transmission spikes due to people moving indoors, more travel, and gatherings. Per the CDC, when breaking down the race/ethnicity aspects of COVID-19 cases within the United States, 52% of cases have been in White people across all age groups, whereas 26.4% have been in Hispanic/Latino and 11.9% in Black, Non-Hispanic individuals.

When it comes to vaccination, White individuals overwhelmingly account for the highest percentage of people fully vaccinated within the United States. Just as COVID-19 has shed light on social and racial inequities deeply rooted within the country, the rollout of a vaccine during a pandemic has also emphasized those disproportionately impacted by the pandemic. A new study in JAMA Network worked to assess the vaccine acceptance and access among Black and Latinx communities.

Utilizing a community-partnered qualitative study via in-depth focus groups from March 17 to March 29 of this year, participants were from New Haven, Connecticut and within 8 focus groups, including 4 in Spanish. Seventy-two participants volunteered information about their access and acceptance to the vaccine: 50% identified as Black and 38% as Latinx, and 11% as Black and Latinx. A majority (78%) identified as women. The authors noted that “Employment backgrounds reflected the diversity of the New Haven community, including teachers, custodial service workers, and health care workers. Vaccination status of participants is noted.

Identified themes centered around trust and addressing barriers to vaccine access. They were categorized into 3 key themes: (1) pervasive mistreatment of Black and Latinx communities and associated distrust; (2) informing trust via trusted messengers and messages, choice, social support, and diversity; and (3) addressing structural barriers to vaccination access.” Some themes and subthemes, as well quotes include—lasting legacy from historical mistreatment, disparate death, increasing confidence through choice, fact-based information, and a need for transparent and continued communication with the community.

In terms of addressing structural barriers to vaccination access, respondents shared hurdles like cutting the line and vaccine supply access, “going in circles” sign-up fatigue, and a need for support in Spanish. As the authors noted, “A key finding of this qualitative study was pervasive mistreatment of Black and Latinx communities, rooted in structural racism, that influenced acceptance of COVID-19 vaccines. Tragedies ranging from the US Public Health Services Syphilis Study at Tuskegee to recently reported disparities in maternal mortality and COVID-19–related mortality fueled untrustworthiness in the COVID-19 vaccine and health care systems. Our participants’ perspectives are supported by systematic reviews providing data exemplifying that systemic racism and health care bias are associated with negative health outcomes and lower quality of care. Discrimination and inequitable treatment of Black and Latinx communities by health care systems further drive untrustworthiness related to COVID-19 vaccinations.”

From a health care perspective, this points to a desperate need to address untrustworthiness and how we can be better allies, advocates, and support systems for Black and Latinx communities.