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Trust-Building and Tailored Interventions Essential to Improving COVID-19 Vaccine Rates, Confidence Among Black Women
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Key Takeaways
- Black communities face disproportionate COVID-19 impacts due to structural racism and health disparities, influencing vaccine hesitancy among Black women.
- Mistrust in healthcare and government, concerns over vaccine safety, and ineffective communication contribute to vaccine hesitancy in Black women.
Engaging with the community, providing transparent information to patients, and using noncoercive methods of encouragement are strategies to reduce COVID-19 vaccine hesitancy.
To address COVID-19 hesitancy and improve vaccine confidence among Black women, treatment providers and public health officials must engage community leaders, prioritize trust-building, and tailor interventions as part of a multifaceted approach that involves providing transparent safety information, according to the authors of a study published in the Journal of the American Health Association.1
Black woman have higher levels of vaccine hesitancy, primarily due to mistrust in health care institutions due to historically racially-motivated medical practices and concerns over long-term complications. | Image Credit: © Prostock-studio | stock.adobe.com
Public health crises tend to exploit existing disparities in society and affect some populations more than others; the COVID-19 pandemic was no different, with Black communities disproportionately affected by the impacts of the virus. Studies have confirmed that Black or African American race and ethnicity play a significant role in contracting COVID-19 and having severe disease due to the existing health disparities rooted in structural racism.1,2
Unfortunately, these disparities have continued since the rollout of the COVID-19 vaccine. Trials have indicated that Black race is independently associated with vaccine hesitancy when compared with their White counterparts, often stemming from medical mistrust due to a history of racial mistreatment. Other concerns among this population include a lack of trust in government institutions promoting the vaccine and concerns regarding a lack of diversity in clinical trials.1,3
Black women have reported being especially hesitant to receive COVID-19 vaccines compared with Black men. This can be influential in multiple facets, as hesitancy in Black women can lead to poor health outcomes in a population that already faces health disparities, while their choice could influence other family members’ decisions and reduce overall uptake. In this current qualitative study, in-depth interviews were used to explore the perspectives of Black women and provide a nuanced understanding of which public health strategies could be effective to improve vaccine uptake.1,4
A total of 54 Black women were included in the study. Interviews with the study participants revealed 3 major themes associated with COVID-19 vaccine hesitancy in this population: mistrust in health care and government, concerns over vaccine safety and long-term effects, and ineffective and coercive vaccine communication and promotion, according to the study investigators.1
Participants expressed deeply rooted mistrust in the health care system, with a sentiment echoing instances throughout history of medical exploitation. In the context of vaccine development, many expressed feelings of being treated as “lab experiments” or “expendable.” This mistrust seemed to be exacerbated by often-changing clinical guidance, especially among health care professionals. Skepticism towards the government’s speed in developing the COVID-19 vaccine was also documented, as patients pondered why other longstanding diseases remained uncured.1
Anxiety regarding the potential adverse events or long-term impacts of the COVID-19 vaccine were also reported, as some participants did not believe in their provider’s ability to accurately associate an adverse reaction with the vaccine; “They’re gonna try and push it off as something else,” one patient reported. The vaccine’s novelty led to significant concerns regarding long-term impacts, emphasized by the rapid development of the vaccine.1
Lastly, concerns surrounding COVID-19 vaccine communication and promotion strategies were documented. Trial participants reported information being unclear and inconsistent, which led to mistrust and confusion. Some promotional tactics, such as celebrity endorsements or financial incentives, were perceived as not only unethically coercive and disrespectful of their communities’ needs, but disrespectful to the intelligence of Black people, according to the study authors.1
To overcome these obstacles to greater vaccine uptake in Black women, pharmacists and public health professions must prioritize building trust, which could mean training to be more culturally competent or skilled in understanding a history of discrimination. Communication strategies should be specially tailored to addressing the specific concerns of Black women, and transparent information should be provided regarding the COVID-19 vaccine’s development, safety, long-term effects, and possible impacts on reproductive health.1
“Health care practitioners can use these findings to improve communication with Black women patients, while public health officials can design more respectful outreach programs addressing specific concerns, which may increase vaccine confidence and uptake,” the study investigators concluded.1
