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. 2021 Nov 1;16(11):e0248542.
doi: 10.1371/journal.pone.0248542. eCollection 2021.

COVID-19 vaccine hesitancy in underserved communities of North Carolina

Irene A Doherty  1 , William Pilkington  1 , Laurin Brown  1 , Victoria Billings  1 , Undi Hoffler  2 , Lisa Paulin  3 , K Sean Kimbro  1 , Brittany Baker  4 , Tianduo Zhang  3 , Tracie Locklear  5 , Seronda Robinson  6 , Deepak Kumar  1   5
Affiliations

COVID-19 vaccine hesitancy in underserved communities of North Carolina

Irene A Doherty et al. PLoS One. .

Abstract

Background: In the United States, underserved communities including Blacks and Latinx are disproportionately affected by COVID-19. This study sought to estimate the prevalence of COVID-19 vaccine hesitancy, describe attitudes related to vaccination, and identify correlates among historically marginalized populations across 9 counties in North Carolina.

Methods: We conducted a cross-sectional survey distributed at free COVID-19 testing events in underserved rural and urban communities from August 27 -December 15, 2020. Vaccine hesitancy was defined as the response of "no" or "don't know/not sure" to whether the participant would get the COVID-19 vaccine as soon as it became available.

Results: The sample comprised 948 participants including 27.7% Whites, 59.6% Blacks, 12.7% Latinx, and 63% female. 32% earned <$20K annually, 60% owned a computer and ~80% had internet access at home. The prevalence of vaccine hesitancy was 68.9% including 62.7%, 74%, and 59.5% among Whites, Blacks, and Latinx, respectively. Between September and December, the largest decline in vaccine hesitancy occurred among Whites (27.5 percentage points), followed by Latinx (17.6) and only 12.0 points among Blacks. 51.2% of respondents reported vaccine safety concerns, 23.7% wanted others to get vaccinated first, and 63.1% would trust health care providers about the COVID-19 vaccine. Factors associated with hesitancy in multivariable logistic regression included being female (OR = 1.90 95%CI [1.36, 2.64]), being Black (OR = 1.68 1.16, 2.45]), calendar month (OR = 0.76 [0.63, 0.92]), safety concerns (OR = 4.28 [3.06, 5.97]), and government distrust (OR = 3.57 [2.26, 5.63]).

Conclusions: This study engaged the community to directly reach underserved minority populations at highest risk of COVID-19 that permitted assessment of vaccine hesitancy (which was much higher than national estimates), driven in part by distrust, and safety concerns.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Distribution of reasons to prevent or delay vaccination stratified by participants’ response to getting vaccinated as soon as it became available.
Fig 2
Fig 2. Distribution of vaccine hesitancy over time stratified by race/ethnicity and calendar time.
See this image and copyright information in PMC

Update of

References

    1. Webb Hooper M, Nápoles AM, Pérez-Stable EJ. COVID-19 and Racial/Ethnic Disparities. JAMA. 2020;323(24):2466–2467. doi: 10.1001/jama.2020.8598 - DOI - PMC - PubMed
    1. Clouston SAP, Natale G, Link BG. Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities. Soc Sci Med. 2021;268:113554. doi: 10.1016/j.socscimed.2020.113554 - DOI - PMC - PubMed
    1. Woolf SH, Chapman DA, Lee JH. COVID-19 as the Leading Cause of Death in the United States. JAMA. Published online December 17, 2020. doi: 10.1001/jama.2020.24865 - DOI - PMC - PubMed
    1. Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L, Taylor DDH. Excess Deaths From COVID-19 and Other Causes, March-July 2020. JAMA. 2020;324(15):1562. doi: 10.1001/jama.2020.19545 - DOI - PMC - PubMed
    1. CDC. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. Published February 11, 2020. Accessed December 23, 2020. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-disc...

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