Covid-19 Vaccine Decision-making Factors in Racial and Ethnic Minority Communities in Los Angeles, California

Datos Bibliográficos

ID23345142
AutoresSavanna L Carson (0000-0001-9940-538X, University of California, Los Angeles, autor de correspondencia), Alejandra Casillas (0000-0003-4229-7466, University of California, Los Angeles), Yelba Castellon-Lopez (Department of Family Medicine, UCLA David Geffen School of Medicine, University of California, Los Angeles), Yelba Castellon‐Lopez (0000-0002-4886-7792, University of California, Los Angeles), Lisa N Mansfield (0000-0002-4617-2663, University of California, Los Angeles), D’Ann Morris (University of California, Los Angeles), Juan Barron (University of California, Los Angeles), Ejiro Ntekume (0000-0002-3352-7728, University of California, Los Angeles), Raphael J Landovitz (0000-0002-1442-714X, University of California, Los Angeles), Raphael Landovitz (Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles), Stefanie D Vassar (0000-0003-4922-6062, University of California, Los Angeles), Keith C Norris (0000-0003-3071-0700, University of California, Los Angeles), Steven M Dubinett (0000-0003-3656-8039, University of California, Los Angeles), Nanibaa’ A Garrison (0000-0002-6228-3216, University of California, Los Angeles), Arleen F Brown (0000-0001-9948-8955, University of California, Los Angeles)
Año2021
Volumen4
Número9
Páginase2127582
Fecha de publicación2021-09-30
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaJAMA Network Open (JOURNAL)
Identificadores de la revistaISSN: 2574-3805 • E-ISSN: 2574-3805
EditorialAmerican Medical Association (AMA) (PUBLISHER)
DOI10.1001/jamanetworkopen.2021.27582
PMID34591103
OpenAlexW3204102380
IdiomaEN
Citas recibidas59
Referencias citadas52

Importance The COVID-19 pandemic has had disproportionate effects on racial and ethnic minority communities, where preexisting clinical and social conditions amplify health and social disparities. Many of these communities report lower vaccine confidence and lower receipt of the COVID-19 vaccine. Understanding factors that influence the multifaceted decision-making process for vaccine uptake is critical for narrowing COVID-19–related disparities. Objective To examine factors that members of multiethnic communities at high risk for COVID-19 infection and morbidity report as contributing to vaccine decision-making. Design, Setting, and Participants This qualitative study used community-engaged methods to conduct virtual focus groups from November 16, 2020, to January 28, 2021, with Los Angeles County residents. Potential participants were recruited through email, video, and telephone outreach to community partner networks. Focus groups were stratified by self-identified race and ethnicity as well as age. Transcripts were analyzed using reflexive thematic analysis. Main Outcomes and Measures Themes were categorized by contextual, individual, and vaccine-specific influences using the World Health Organization’s Vaccine Hesitancy Matrix categories. Results A total of 13 focus groups were conducted with 70 participants (50 [71.4%] female) who self-identified as American Indian (n = 17 [24.3%]), Black/African American (n = 17 [24.3%]), Filipino/Filipina (n = 11 [15.7%]), Latino/Latina (n = 15 [21.4%]), or Pacific Islander (n = 10 [14.3%]). A total of 39 participants (55.7%) were residents from high-poverty zip codes, and 34 (48.6%) were essential workers. The resulting themes included policy implications for equitable vaccine distribution: contextual influences (unclear and unreliable information, concern for inequitable access or differential treatment, references to mistrust from unethical research studies, accessibility and accommodation barriers, eligibility uncertainty, and fears of politicization or pharmaceutical industry influence); social and group influences (inadequate exposure to trusted messengers or information, altruistic motivations, medical mistrust, and desire for autonomy); and vaccination-specific influences (need for vaccine evidence by subpopulation, misconceptions on vaccine development, allocation ambiguity, vaccination safety preferences, the importance of perceiving vaccine equity, burden of vaccine scheduling, cost uncertainty, and desire for practitioner recommendation). Conclusions and Relevance In this qualitative study, participants reported a number of factors that affected their vaccine decision-making, including concern for inequitable vaccine access. Participants endorsed policy recommendations and strategies to promote vaccine confidence. These results suggest that support of informed deliberation and attainment of vaccine equity will require multifaceted, multilevel policy approaches that improve COVID-19 vaccine knowledge, enhance trust, and address the complex interplay of sociocultural and structural barriers to vaccination.

2019-20 coronavirus outbreak · Coronavirus disease 2019 (COVID-19) · Ethnic group · Infectious disease (medical specialty) · Outbreak · Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) · Sociology · Anthropology · COVID-19 and Mental Health · Medicine · SARS-CoV-2 and COVID-19 Research · Vaccine Coverage and Hesitancy · Virology · Gerontology