RAND Corporation, Santa Monica, CA, United States of America.
UCLA Center for HIV Identification, Prevention, and Treatment Services, Los Angeles, CA, United States of America.
PLoS One. 2022 May 3;17(5):e0268020. doi: 10.1371/journal.pone.0268020. eCollection 2022.
COVID-19 vaccination rates among Black Americans have been lower than White Americans and are disproportionate to their population size and COVID-19 impact. This study examined reasons for low vaccination intentions and preferred strategies to promote COVID-19 vaccination.
Between November 2020 and March 2021, we conducted semi-structured interviews with 24 participants who expressed low vaccination intentions in a RAND American Life Panel survey; we also interviewed five stakeholders who represent organizations or subgroups in Black communities that have been highly affected by COVID-19.
Many interviewees discussed the "wait-and-see" approach, citing that more time and evidence for vaccine side effects and efficacy are needed. Perceived barriers to COVID-19 vaccination included structural barriers to access (e.g., transportation, technology) and medical mistrust (e.g., towards the vaccines themselves, the government, healthcare providers and healthcare systems, and pharmaceutical companies) stemming from historical and contemporary systematic racism against Black communities. Interviewees also discussed strategies to promote COVID-19 vaccines, including acknowledging systemic racism as the root cause for mistrust, preferred messaging content (e.g., transparent messages about side effects), modes, and access points (e.g., a variety of medical and non-medical sites), and trusted information sources (e.g., trusted leaders, Black doctors and researchers).
These insights can inform ways to improve initial and booster vaccination uptake as the COVID-19 pandemic progresses.
美国黑人的 COVID-19 疫苗接种率一直低于美国白人，与他们的人口规模和 COVID-19 影响不成比例。本研究探讨了低疫苗接种意愿的原因以及促进 COVID-19 疫苗接种的首选策略。
在 2020 年 11 月至 2021 年 3 月期间，我们对 24 名在 RAND 美国生活面板调查中表示低疫苗接种意愿的参与者进行了半结构化访谈；我们还采访了五名利益相关者，他们代表受 COVID-19 严重影响的黑人群体中的组织或亚群体。
许多受访者讨论了“观望”的方法，他们认为需要更多的时间和证据来了解疫苗的副作用和疗效。对 COVID-19 疫苗接种的感知障碍包括获取疫苗的结构性障碍（例如交通、技术）和医疗不信任（例如对疫苗本身、政府、医疗保健提供者和医疗保健系统以及制药公司的不信任），这些障碍源于历史上和当代针对黑人群体的系统性种族主义。受访者还讨论了促进 COVID-19 疫苗的策略，包括承认系统性种族主义是不信任的根源、首选的信息内容（例如关于副作用的透明信息）、模式和接入点（例如各种医疗和非医疗场所），以及可信的信息来源（例如可信赖的领导人、黑人医生和研究人员）。
随着 COVID-19 大流行的发展，这些见解可以为提高初始和加强疫苗接种率提供方法。
