Black communities have had a high burden of COVID-19 cases, hospitalizations, and death, yet rates of COVID-19 vaccine uptake among Blacks lag behind other demographic groups. This has been due in part to vaccine hesitancy and multi-level issues around access to COVID-19 vaccines. Effective strategies to promote vaccine uptake among Black communities are needed. To perform a rapid review covering December 2020–August 2021, our search strategy used PubMed, Google, and print media with a prescribed set of definitions and search terms for two reasons: there were limited peer-reviewed studies during the early period of vaccine roll-out and real-time perspectives were crucially needed. Analyses included expert opinion, descriptions of implemented projects, and project outcomes. The strategies described in these reports largely converged into three categories: (a) addressing mistrust, (b) combatting misinformation, and (c) improving access to COVID-19 vaccines. When working to reduce hesitancy, it is important to consider messaging content, messengers, and location. To address mistrust, reports detailed the importance of communicating through trusted channels, validating the real, history- and experience-based reasons why people may be hesitant to establish common ground, and addressing racism embedded within the healthcare system. To combat misinformation, strategies included dispelling myths and answering questions through town halls and culturally intelligent outreach. Black physicians and clinicians are considered trusted messengers and partnering with community leaders such as pastors can help to reach more people. The settings of vaccination sites should be convenient and trusted such as churches, barbershops, and community sites. While a number of individual and combination efforts have been developed and implemented, data that disentangle components that are the most effective are sparse. This rapid review provides a basis for developing strategic implementation to increase COVID-19 vaccine uptake in this ongoing pandemic and planning to promote health equity for future bio-events and health crises.

Black and Hispanic Americans have been hardest hit with COVID-19 infections, hospitalizations, and deaths, yet during the first several months of vaccine roll-out they had the lowest level of vaccine uptake. Primarily, our research on vaccine hesitancy focused on skepticism around the vaccine itself and its roll-out. Our search strategy used PUBMED and Google with a prescribed set of definitions and search terms for two reasons: there were limited peer-reviewed studies during early period of roll-out and real-time perspectives were crucially needed. Literature searches occurred in April 2021and covered September 2020-April 2021. Analyses included expert opinion, survey results and qualitative summaries. Overall, for the general U.S. population, there was considerable hesitancy initially that remained high during the early roll-out. The general population expressed concerns over the speed of vaccine development (“warp speed”), confidence in the competence of government being involved in the development of vaccines and general mistrust of government. Among Black and Hispanic Americans, hesitancy was further expressed as mistrust in the medical establishment that was related to past and current medical mistreatment. Undocumented immigrants worried about access to insurance and possible deportation. These results on confidence in the vaccine early during vaccine roll-out suggest diverse reasons that influence a person’s decision to vaccinate or not. Additional barriers to vaccine uptake include complacency and access. To ensure health equity, particularly to address disparities in morbidity and mortality, vaccine hesitancy needs to be acknowledged and addressed as COVID-19 vaccine roll-out continues, and these observations calls for conscious planning to address these issues early with future health crises.

The challenges of identifying and eliminating racial disparities regarding the exposure, transmission, prevention, and treatment of communicable diseases within the healthcare system have been a mounting concern since the COVID-19 pandemic began. The African, Caribbean, and Black (ACB) populations in Canada represent a fast-expanding and underprivileged community, which have been previously found to have higher susceptibility to communicable diseases and lower sensitivity to intervention measures. Currently, there is insufficient evidence to adequately identify racial patterns in the prevalence and healthcare utilization among the ACB population within the context of the ongoing pandemic. Our proposed study will explore the association between the social determinants of health (SDH) and COVID-19 health outcomes in ACB populations in high-income countries (UK, US, Australia). We will explore the literary evidence through a systematic review (SR) of COVID-19 literature covering the period between December 2019 and October 2020. The objectives include investigating the effect of SDH on the ACB populations’ risk to COVID-19 health outcomes, including COVID-19 infection incidence, severity of disease, hospitalization, mortality and barriers to the treatment and management of COVID-19 for Black people in Canada. In addition, this project aims to investigate the effect of COVID-19 on ACB communities in Ontario by examining the challenges that front-line healthcare workers and administrators have during this pandemic as it pertains to service provisions to ACB communities. A systematic review of original and review studies will be conducted based on the publications on eleven databases (MEDLINE, Web of Science, Cochrane Library, CINAHL, NHS EDD, Global Health, PsychInfo, PubMed, Scopus, Proquest, and Taylor and Francis Online Journals) published between December 2019 to October 2020. Primary outcomes will include the rate of COVID-19 infection. The systematic review will include a meta-analysis of available quantitative data, as well as a narrative synthesis of qualitative studies. This systematic review will be among the first to report racial disparities in COVID-19 infection among the ACB population in Canada. Through synthesizing population data regarding the risk factors on various levels, the findings from this systematic review will provide recommendations for future research and evidence for clinical practitioners and social workers. Overall, a better understanding of the nature and consequences of racial disparities during the pandemic will provide policy directions for effective interventions and resilience-building in the post-pandemic era.

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There has been a dearth of reports that examine the effect of immigration status on COVID-19 vaccine hesitancy. While intention to be vaccinated has been higher among adults in immigrant families than non-immigrant adults, uptake of the vaccine has been lower among immigrants and especially those who are undocumented. Concerns raised by immigrants usually centered on the lack of access to information, language barriers, conflicts between work and clinic hours, and fears over their precarious status in the U.S. To perform a rapid review, our time frame was December 2020 through August 2021. Our search strategy used the PUBMED and Google search engines with a prescribed set of definitions and search terms for two reasons: there were limited peer-reviewed studies during the early period of roll-out and real-time perspectives were crucially needed. Strategies used to promote equity include the use of trusted leaders as well as direct communication styles. Other strategies centered informational messaging from government agencies and the medical community, with a strong emphasis on coalescing broad engagement of the community and being responsive to language and cultural needs. In addition to communication and messaging to educate about COVID-19 vaccines, another important aspect of COVID-19 vaccine uptake was overcoming multiple obstacles that affect ease of access. This report suggests that vaccine uptake, and more generally pandemic response, in vulnerable communities may be better able to launch when they build on existing, trusted, culturally intelligent community-based organizations and local sociocultural processes. These organizations need continued support to contribute to population health equity in emerging health crises.