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. 2023;3(1):56-66.
doi: 10.1007/s43477-023-00071-w. Epub 2023 Jan 11.

Barriers and Enablers to COVID-19 Vaccination in San Francisco's Spanish-Speaking Population

Lucía Abascal Miguel  1 , Canice Christian  1   2 , Erin C Accurso  3 , Adriana Najmabadi  4 , Priyanka Athavale  5 , Jody A Diala  1 , Darpun Sachdev  6 , Susan Philip  6 , Michael J Reid  1   4   2 , Margaret A Handley  5   7
Affiliations

Barriers and Enablers to COVID-19 Vaccination in San Francisco's Spanish-Speaking Population

Lucía Abascal Miguel et al. Glob Implement Res Appl. 2023.

Abstract

Populations at high risk for COVID-19- including Spanish speakers-may face additional barriers to obtaining COVID-19 vaccinations; by understanding their challenges, we can create more equitable vaccine interventions. In this study, we used interviews to identify barriers and enablers to COVID-19 vaccine uptake among participants in the San Francisco Department of Public Health contact tracing program. Data analysis employed Capability, Opportunity, Motivation Behavior model (COM-B) and the Behavior Change Wheel framework as guides to target barriers with interventions and supporting policies. This paper presents data from interviews focused on COVID-19 vaccine uptake that was part of a project to improve COVID-19 preventive behaviors in San Francisco. We completed seventeen interviews between February and May 2021; six (35%) were completed in English and 11 (65%) in Spanish. Barriers to vaccine uptake included an unprepared health system, fear of side effects, limited knowledge, and conflicting information. Behavioral factors influencing vaccine uptake were mainly related to physical opportunity, automatic motivation, and psychological capability. Interventions that could address the most significant number of barriers included education, enablement, and environmental restructuring. Finally, communication and marketing policies that use diverse multi-lingual social media and environmental planning that includes accessible vaccine sites for people with disabilities, literacy barriers, and limited English proficiency could significantly increase vaccination. Public health departments should tailor interventions to high-risk populations by understanding the specific barriers they face. This exploratory study suggests how implementation science can provide frameworks to achieve this.

Keywords: Access; Barriers; COVID-19; Implementation science; Public health; Spanish speakers; Vaccination.

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Conflict of interest statement

Conflict of interestNone of the authors have any financial or non-financial interest related to this work to disclose.

Figures

Fig. 1
Fig. 1
Alluvial chart linking main barriers for COVID-19 vaccine uptake to recommended intervention and policies
See this image and copyright information in PMC

References

    1. Acosta AM, Garg S, Pham H, Whitaker M, Anglin O, O’Halloran A, Milucky J, Patel K, Taylor C, Wortham J, Chai SJ, Kirley PD, Alden NB, Kawasaki B, Meek J, Yousey-Hindes K, Anderson EJ, Openo KP, Weigel A, Monroe ML, Havers FP. Racial and ethnic disparities in rates of COVID-19–associated hospitalization, intensive care unit admission, and in-hospital death in the United States from March 2020 to February 2021. JAMA Network Open. 2021;4(10):e2130479–e2130479. doi: 10.1001/jamanetworkopen.2021.30479. - DOI - PMC - PubMed
    1. Alismail S, Chipidza W. Accessibility evaluation of COVID-19 vaccine registration websites across the United States. Journal of the American Medical Informatics Association. 2021;28(9):1990–1995. doi: 10.1093/jamia/ocab105. - DOI - PMC - PubMed
    1. Carson SL, Casillas A, Castellon-Lopez Y, Mansfield LN, Morris D, Barron J, Ntekume E, Landovitz R, Vassar SD, Norris KC, Dubinett SM, Garrison NA, Brown AF. COVID-19 vaccine decision-making factors in racial and ethnic minority communities in Los Angeles, California. JAMA Network Open. 2021;4(9):e2127582. doi: 10.1001/jamanetworkopen.2021.27582. - DOI - PMC - PubMed
    1. Cassidy C, Langley J, Steenbeek A, Taylor B, Kennie-Kaulbach N, Grantmyre H, Stratton L, Isenor J. A behavioral analysis of nurses' and pharmacists' role in addressing vaccine hesitancy: Scoping review. Human Vaccine Immunotherapy. 2021;17(11):4487–4504. doi: 10.1080/21645515.2021.1954444. - DOI - PMC - PubMed
    1. Castillo, G., Ndumbe-Eyoh, S., Crawshaw, J., Smith, M., Trehan, N., Gauvin, F. P., Betker, C., Grimshaw, J. M., & Presseau, J. (2021). Factors affecting COVID-19 vaccination in Black communities in Canada: a behavioural analysis (COVID-19 Evidence Network to support Decision-making in Canada, Issue. Retrieved, from https://www.mcmasterforum.org/docs/default-source/product-documents/livi...