The path to vaccine equity? Address 3 fears, study suggests.

As of August 2022, COVID-19 vaccination rates in Black and Hispanic people exceeded those of white Americans nationally, but only for the initial shots. FatCamera/E+ via Getty Images

A new study from Pitt and the Black Equity Coalition provides insights for boosting vaccine uptake in Black communities. Will providers and public health officials heed the advice as they roll out the latest COVID booster?

by Venuri Siriwardane, PublicSource

Kristina Terrell took months to make up her mind before she received a COVID-19 vaccine.  

Terrell, who is immunocompromised, said she needed the time to consult her doctor: Would her health condition keep her from mounting a robust immune response to the vaccine? What side effects might she experience? And how were drugmakers able to bring the vaccines to market so quickly? 

Terrell is Black. Her doctor, who is white, welcomed her questions and patiently answered them. 

“She’ll let me talk through something 100 times until she’s blue in the face answering them,” said the 38-year-old from Garfield, who supports a large family that includes her mother and children. “There’s no barrier in her relationship with me and I’ve always felt that she’s had my best interests [at heart], although she doesn’t look like me.” 

Her doctor’s advice helped her make a decision: She took 10 family members to a mobile vaccine clinic at a community block party last year. They all received a first dose of the Pfizer vaccine and completed their primary vaccine series about a month later. 

A vaccine clinic was held at a community center in Northview Heights, in Pittsburgh, in April 2023. (Photo courtesy of Ruth Howze/Black Equity Coalition)

Terrell said she has friends and family members who refused to be vaccinated. Their hesitancy is part of a problem that advocates have been trying to solve for more than two years: lower uptake of COVID vaccines in Black communities across Allegheny County.  

Vaccine hesitancy was reported by more than half of participants — all of whom were Black — in a recent study by researchers at the University of Pittsburgh and the Black Equity Coalition [BEC]. They surveyed nearly 400 Black adults in the county from September 2021 to January 2022 to understand drivers of that hesitancy, which the World Health Organization defines as a delay or refusal to get vaccinated despite the availability of vaccines. 

The researchers believe unvaccinated participants (about 23%) knew they were at risk because most wore masks to avoid a COVID infection. But they remained unvaccinated due to fear of illness (40%), side effects (26%) and not knowing the long-term effects of the vaccine (33%). Addressing their concerns might boost COVID vaccine uptake in Black and other communities of color, the researchers said in the study.

“We see [those reasons] as actionable,” said Ashley Hill, an assistant professor of epidemiology at Pitt, a BEC member and the lead author of the study. 

Addressing concerns amid ‘horrible rollout’

Less than 20% of Americans got the previous bivalent booster, with lower uptake among Black and Latino people.

The Pitt and BEC study was published last month in the journal Health Equity — just as providers, advocates and public health officials were gearing up for the rollout of the new monovalent COVID booster, which targets the Omicron variant XBB.1.5 and provides protection against EG.5, the dominant variant in the United States.  

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