Black and Latinx people intensely sought information on COVID-19 and engaged in public health measures such as mask-wearing and testing due to devastating experiences during the pandemic but are still skeptical about vaccines, according to a Rutgers study.
The findings, which appear in JAMA Network Open, offer insight into what motivates people in Black and Latinx communities - which have been disproportionately affected by the pandemic - to embrace COVID-19 safety precautions but to hesitate about vaccines. The findings may also help to develop appropriate public health messages and strategies.
Researchers interviewed 111 Black and Latinx people from New Jersey low-income counties with high rates of COVID-19 infections and deaths during the initial surge in 2020. They also interviewed health care workers in these communities to understand their views.
"Fear, illness and loss experienced during the pandemic motivated them to intensely seek information and take safety precautions like wearing a mask, social distancing and washing hands to protect themselves and loved ones," said co-author Manuel Jimenez, an assistant professor of pediatrics, family medicine and community health at Rutgers Robert Wood Johnson Medical School. "However, participants did not trust the vaccine development process and wanted clearer information."
The study found that:
- Latinx participants, in particular, reported difficulty finding testing sites, transportation issues and language barriers. This was more pronounced for undocumented people who were told to pay for testing if they are ineligible for unemployment benefits and other assistance programs.
- Some participants did not feel safe inside or outside their homes, and described uncertainty about who among them had the virus. Crowded living conditions resulted in contact with neighbors and housemates who had COVID-19.
- Participants questioned how a vaccine for a new virus could be developed so rapidly when other diseases have been around for decades without successful vaccines. They also expressed concerns that the vaccine development process, including that clinical trials had been "rushed," and worried about the short- and long-term side effects.
- They questioned whether vaccines would work against variants and wanted clear and transparent information on vaccine effectiveness. Many wanted to see how others would respond to vaccination first.
- Black participants mentioned distrust of health care systems and government, citing experience of racism, discriminatory interventions and medical experimentation.
"We need to reduce logistical barriers and improve access to testing within underserved communities, regardless of documentation status," said co-principal investigator Shawna Hudson, professor and research division chief in the Department of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School. "Health care providers should offer convenient testing options, accessible sites within walking distance, translated information and transparency about free testing to address these barriers."
Logistical barriers to testing must be addressed and vaccine skepticism needs to be taken seriously, the report concluded, the researchers said.
"The remaining unknowns about new vaccines need to be acknowledged and described for these communities to make informed decisions," Jimenez said. "Scientists and public officials need to work collaboratively with trusted community leaders and health professionals to provide transparent information, including remaining unknowns, so that these communities can make informed decisions rather than focusing on marketing campaigns to eliminate vaccine hesitancy."
The study was conducted as part of NJ HEROES TOO (New Jersey Healthcare Essential Worker OutReach and Education Study - Testing Overlooked Occupations) in collaboration with 18 community-based organizations and four health care organizations, funded by the NIH Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) Initiative.
Other Rutgers authors include Zorimar Rivera-Núñez, Benjamin F. Crabtree, Diane Hill, Maria B. Pellerano, Donita Devance, Myneka Macenat, Daniel Lima, Emmanuel Martinez Alcaraz, Jeanne M. Ferrante, Emily S. Barrett, Martin J. Blaser and Reynold A. Panettieri Jr.
JAMA Network Open