Faculty, Staff and Student Publications
Publication Date
1-2-2025
Journal
JAMA Network Open
Abstract
IMPORTANCE: COVID-19 vaccine hesitancy among Black women is a critical public health concern, potentially exacerbating existing health disparities and impacting community-wide vaccination efforts.
OBJECTIVE: To explore the factors associated with COVID-19 vaccine hesitancy among Black women in the US and identify the specific concerns and experiences shaping hesitant attitudes toward vaccination.
DESIGN, SETTING, AND PARTICIPANTS: Qualitative study using in-depth, semistructured interviews conducted virtually between June and November 2021. Thematic analysis was used to identify key themes from the interview data. Participants were recruited through social media platforms and word-of-mouth referrals from various regions of the US. Interviews were conducted remotely via Zoom. Data were analyzed from June to October 2023.
MAIN OUTCOMES AND MEASURES: Identification of key themes associated with COVID-19 vaccine hesitancy, identified through thematic analysis of interview data.
RESULTS: Fifty-four Black women aged 21 to 66 years participated in the study. Most participants (41 [75.9%]) resided in the South. The sample was predominantly well-educated, with 41 (75.9%) holding a bachelor's degree or higher. Income levels varied, with 16 (29.6%) earning between $40 000 and $59 999 annually. Regarding family structure, 32 participants (59.3%) reported having no children, while 22 (40.7%) had 1 or more children. Three primary themes emerged as being associated with vaccine hesitancy: (1) mistrust in health care and government, rooted in past medical exploitation; (2) concerns over vaccine safety and long-term effects, particularly regarding reproductive health; and (3) ineffective and coercive vaccine communication and promotion. Participants expressed deep-rooted skepticism about being treated as "expendable" in medical research, fears about the rapid vaccine development process, and frustration with coercive vaccine advertisements. Many women desired more comprehensive education about vaccine mechanisms and criticized the use of coercive financial incentives and celebrity endorsements in vaccine promotion.
CONCLUSIONS AND RELEVANCE: Addressing COVID-19 vaccine hesitancy among Black women requires a multifaceted approach that acknowledges historical traumas, provides clear and transparent safety information, and avoids coercive vaccine promotion strategies. These findings emphasize the need for health care practitioners and public health officials to prioritize trust-building, engage community leaders, and tailor interventions to address the unique concerns of Black women to improve vaccine confidence and uptake.
Keywords
Adult, Aged, Female, Humans, Middle Aged, Young Adult, Black or African American, COVID-19, COVID-19 Vaccines, Health Knowledge, Attitudes, Practice, Patient Acceptance of Health Care, Qualitative Research, Trust, United States, Vaccination Hesitancy
DOI
10.1001/jamanetworkopen.2024.53511
PMID
39786776
PMCID
PMC11718551
PubMedCentral® Posted Date
1-9-2025
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Included in
COVID-19 Commons, Influenza Humans Commons, Influenza Virus Vaccines Commons, Race and Ethnicity Commons