OBJECTIVES: Minorities have been disproportionately affected by the coronavirus disease 2019 (COVID-19) yet have the lowest COVID-19 vaccine rate. Vaccine hesitancy has been reported at higher rates in African Americans (AAs) and young adults. This study aimed to assess COVID-19 vaccine hesitancy, determine the rationale for receiving or declining the COVID-19 vaccine, and propose strategies to address confidence in faculty, staff, and students at a rural historically black college and university (HBCU). METHODS: A study was conducted using an electronic survey administered to a convenient sample of 210 faculty, students, and staff at the University of Maryland Eastern Shore, an HBCU in a rural community. RESULTS: Most participants were 18 to 24 years old (69%), college students (73.89%), AA (70%), and identified as a woman (70%). Notably, 87% of participants were nonhesitant (received one dose or intended to be vaccinated). Approximately 54% had already received at least one dose of a COVID-19 vaccine. Only 13% of participants were hesitant and did not plan to receive the COVID-19 vaccine. The most common rationale for vaccine hesitancy was mistrust of the health care system or government toward AAs. CONCLUSION: The results show that vaccine hesitancy was low in the predominantly young-adult AA population at a rural HBCU. However, opportunities exist for pharmacists and other accessible health care professionals to contribute to efforts aimed at decreasing vaccine hesitancy and improving vaccine confidence.