Black Americans have a high level of vaccine hesitancy and mistrust of COVID-19 vaccines, including among Black health care workers, according to a new RAND Corporation survey.
Those who expressed vaccine hesitancy also showed high levels of overall mistrust in the vaccine, concerns about potential harm and side effects, and lack of confidence in vaccine effectiveness and safety.
Participants in the RAND survey reported higher trust in COVID-19 information from health care providers and public health officials than from elected local and federal officials.
The findings are based on a survey of 207 Black Americans who are participants in the RAND American Life Panel, a nationally representative internet panel. Participants were surveyed during November and December 2020.
"Public health messages and communication strategies to address vaccine hesitancy should be tailored through authentic community engagement," said Laura M. Bogart, the study's lead author and a senior behavioral scientist at RAND, a nonprofit research organization. "Messaging about COVID-19 vaccines should first acknowledge systemic racism as a justifiable reason for mistrust before providing transparent information about the vaccine, including specific information about efficacy and safety."
The survey found that mistrust of the government's motives and transparency around COVID-19, as well as beliefs about racism in health care, appear to be contributing to mistrust of the vaccine. In addition, the more participants believed that people close to them would want them to get vaccinated, the more likely they were to say that they would get vaccinated themselves.
Black Americans attribute their medical mistrust, in general and specific to COVID-19 vaccines, to systemic racism, including discrimination and mistreatment in health care, as well as by the government.
Overall, more than one-third of all survey participants agreed or strongly agreed that they would not get a COVID-19 vaccine, and an additional 25% said they "don't know" if they would become vaccinated. Only 40% indicated that they planned to get vaccinated.
Participants in health care fields, including health care practitioners and those in technical and support occupations, showed higher vaccine hesitancy. Specifically, 48% of participants in health care fields indicated that they would not get vaccinated, compared with 32% of participants who were not in health care-related occupations.
When asked about which sources they trusted for information about COVID-19, nearly two-thirds of all respondents said that they trusted health care professionals such as doctors and nurses. Health care providers were trusted by higher percentages of participants who said that they would get the vaccine (72%) than those who said that they would not (56%).
Participants said that public health campaigns should involve trusted, known community members and trusted local organizations. Some participants suggested partnerships with Black celebrities such as hip-hop artists to encourage vaccination.
The study, "What Contributes to COVID-19 Vaccine Hesitancy in Black Communities, and How Can It Be Addressed?," is available at http://www.
Other authors of the study are Lu Dong, Priya Gandhi, Samantha Ryan, Terry L. Smith, David J. Klein, Luckie Alexander Fuller and Bisola O. Ojikutu.
RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.