by Min Matson

Skepticism stemming from a variety of historical factors is a primary reason for vaccine hesitancy – here are steps to help shore up trust.

As the U.S. rolls out the COVID-19 vaccine, approximately a quarter of all unvaccinated adults have indicated they will probably not, or will definitely not, receive the vaccine once one is available to them, and over 1/3 of Black, Indigenous and people of color (BIPOC) probably, or definitely will not, receive the vaccine (U.S. Census Bureau Survey).  A survey by Langer Research Associates reveals the reasons for hesitancy include safety and trust concerns, criticisms of the process, politics, the previous administration and institutional racism.

Additional key findings from the Langer survey found that:

  • Just 14% of Black adults completely or mostly trust that a vaccine will be safe, compared with 34% of Latinx people.
  • 18% of Black people expressed that level of trust in its effectiveness, compared with 40 percent in the Latinx community.
  • Black adults are nearly 20 percentage points more skeptical than Latinx people that a vaccine will be adequately tested for safety and effectiveness specifically in their own racial or ethnic group.
  • Views of vulnerability differ among the two groups, with just 33% of Black adults believing they will catch the virus, compared with 52% of Latinx adults.

Underscoring the enduring injustices, including the history of mistreatment of Black patients, the survey revealed that 2/3 of Black adults believe the government can be rarely or never trusted to look out for the interests of the Black community, with just four in 10 Black adults stating they would get the vaccine. Among the Latinx community, 43% believe the government can be rarely or never trusted to look out for the best interests of Latinx people, with six in 10 Latinx community members saying they would get the vaccine.

Indigenous people, who over the years have been subjected to federal programs for relocation, reservation, assimilation, and termination, require reassurances about the vaccine’s safety from trusted, culturally relevant communication from the voices of their community elders.

Given these findings, the medical community faces an uphill battle to foster trust in the vaccine. What can be done to help shore up trust among the BIPOC community?

  • Connect with trusted community advisers. Of the study respondents, there is a correlation that shows community plays a key role in their decision making. Partner with religious leaders, community activists, cultural leaders and influencers, and other trusted community advisers. Equip them with the information they need in a culturally relevant context to help you gain traction in communities of color.
  • Understand your community’s fears. For communities where there is a lack of trust in the science and/or the vaccination development process, there may be little you can do to overcome hesitancy in the short term.  However, for communities that fear side effects or efficacy, address those concerns by setting clear expectations and providing easy access to reliable and well-known contacts for support.
  • Remove barriers to access. For some communities, the greatest barrier is access to a vaccine site. In some cities, long drive-thru lines and few “walk-up” options inherently limit access for individuals and communities with fewer resources. These barriers can be eliminated with targeted, mobile efforts or partnerships with community providers. Flexible hours that accommodate schedules for working parents, single parents, and shift workers will help to address timing barriers.
  • Proactively plan for expiration dates. We see reports every day that vaccines are being given to those outside of the target groups to avoid wasting expiring doses. Planning for utilization of expiring doses should include a proactive supply management plan that details doses and expiration dates, then builds mobilization efforts such as extending clinic hours or planning pop-up clinics that use doses about to expire to push vaccines at critical times.
  • Engage workplaces in the process. BIPOC individuals are disproportionately placed at-risk due to their jobs as essential workers. Partnering with employers to provide information about the vaccinations and to identify vaccination sites that are convenient for their employees may assist in removing barriers to access and driving greater uptake of the vaccination.

The Bottom Line

We are at a critical time in our ability to fight this global pandemic and build trust in our healthcare system with communities that have been most harmed by an inequitable system. Any hesitance will be detrimental to not only the health of individuals and communities, but also to healing the deep wounds of healthcare disparities that have haunted BIPOC communities for centuries. It is incumbent upon our healthcare system to put all available resources into this effort, for the sake of our communities’ health and for future generations’ trust in the healthcare ecosystem.