COVID-19 vaccination readiness among multiple racial and ethnic groups in the San Francisco Bay Area: A qualitative analysis

• Published in: PloS one Vol. 17; no. 5; p. e0266397
• Main Authors: Butler, Jonathan Z, Carson, Mariam, Rios-Fetchko, Francine, Vargas, Roberto, Cabrera, Abby, Gallegos-Castillo, Angela, LeSarre, Monique, Liao, Michael, Woo, Kent, Ellis, Randi, Liu, Kirsten, Burra, Arun, Ramirez, Mario, Doyle, Brittney, Leung, Lydia, Fernandez, Alicia, Grumbach, Kevin
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 12-05-2022; Public Library of Science (PLoS)
• Subjects: Access; Adult; African Americans; Asian Americans; Asian cultural groups; Barriers; Biology and Life Sciences; Charities; Chinese Americans; Community involvement; Community organizations; Community participation; Community research; Computer and Information Sciences; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines; Demographic aspects; Discrimination; Ethnic factors; Ethnic groups; Ethnicity; Female; Field theory; Focus groups; Government; Humans; Immunization; Linguistics; Management; Marginality; Medicine and Health Sciences; Minority & ethnic groups; Morbidity; Nonprofit organizations; Organizations; People and places; Populations; Public health; Qualitative analysis; Qualitative research; Racial differences; Racial discrimination; Racism; Religious behavior; Religious beliefs; San Francisco - epidemiology; Social Sciences; Systemic racism; Vaccination; Vaccines; San Francisco; United States; United States > US; San Francisco California; San Francisco Bay
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0266397

COVID-19 vaccination rates are lower among historically marginalized populations, including Black/African American and Latinx populations, threatening to contribute to already high COVID-19 morbidity and mortality disparities for these groups. We conducted a community-based participatory research study using qualitative methods to explore knowledge and beliefs about COVID-19 vaccination among Black/African American, Latinx, and Chinese American residents of the San Francisco Bay Area and assess their views on vaccination outreach and delivery strategies.
Data were collected from January 14, 2021, to February 24, 2021, with adult residents (N = 109 [Female: N = 76; 70%]) in San Francisco. Focus groups (N = 10) and in-depth interviews (N = 25) were conducted among Black/African Americans (N = 35), Latinx (N = 40), and Chinese Americans (n = 34) in English, Spanish, Cantonese, or Mandarin. Themes were identified using grounded field theory, and included misinformation, mistrust of government and health institutions, and linguistic and other barriers to vaccine access. All three racial/ethnic groups had experiences with vaccine misinformation and information overload. Many African American and Latinx participants cited structural and interpersonal racism, and anti-immigrant discrimination, as factors reducing their trust in government and public health disseminated information and their willingness to be vaccinated. Participants expressed trust in community-based organizations, including faith-based organizations and community-run clinics. Participants often experienced barriers to vaccine access, such as transportation to drive-in sites, with Latinx and Chinese American groups also frequently citing language barriers.
Vaccine outreach strategies must acknowledge how longstanding systemic, institutional, and structural racism contributes to mistrust in government and health institutions and engage with and support trusted messengers from the community to eliminate cultural, linguistic, and other barriers to vaccine access.