Changing the Narrative: Structural Barriers and Racial and Ethnic Inequities in COVID-19 Vaccination

Njoku, Anuli; Joseph, Marcelin; Felix, Rochelle

doi:10.3390/ijerph18189904

Cited by 109 publications

(107 citation statements)

References 61 publications

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“…However, among younger adults, Blacks, Native Americans, and Multi-racial groups continued to be the most hesitant. Experts continue to recommend targeted campaigns to overcome structural barriers on racial and ethnic disparities in COVID-19 vaccine uptake [ 36 ]. Our study indicates that in May, 2021, Black and Hispanic adults were more likely to be concerned about safety compared to White adults, while White adults were more likely to report not trusting the government and not needing the vaccine than Black and Hispanic adults.…”

Section: Discussionmentioning

confidence: 99%

Time trends, factors associated with, and reasons for COVID-19 vaccine hesitancy: A massive online survey of US adults from January-May 2021

et al. 2021

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Importance COVID-19 vaccine hesitancy has become a leading barrier to increasing the US vaccination rate. Objective To evaluate time trends in COVID-19 vaccine intent during the US vaccine rollout, and identify key factors related to and self-reported reasons for COVID-19 vaccine hesitancy in May 2021. Design, participants and setting A COVID-19 survey was offered to US adult Facebook users in several languages yielding 5,088,772 qualifying responses from January 6 to May 31, 2021. Data was aggregated by month. Survey weights matched the sample to the age, gender, and state profile of the US population. Exposure Demographics, geographic factors, political/COVID-19 environment, health status, beliefs, and behaviors. Main outcome measures “If a vaccine to prevent COVID-19 were offered to you today, would you choose to get vaccinated.” Hesitant was defined as responding probably or definitely would not choose to get vaccinated (versus probably or definitely would, or already vaccinated). Results COVID-19 vaccine hesitancy decreased by one-third from 25.4% (95%CI, 25.3, 25.5) in January to 16.6% (95% CI, 16.4, 16.7) in May, with relatively large decreases among participants with Black, Pacific Islander or Hispanic race/ethnicity and ≤high school education. Independent risk factors for vaccine hesitancy in May (N = 525,644) included younger age, non-Asian race, < 4 year college degree, living in a more rural county, living in a county with higher Trump vote share in the 2020 election, lack of worry about COVID-19, working outside the home, never intentionally avoiding contact with others, and no past-year flu vaccine. Differences in hesitancy by race/ethnicity varied by age (e.g., Black adults more hesitant than White adults <35 years old, but less hesitant among adults ≥45 years old). Differences in hesitancy by age varied by race/ethnicity. Almost half of vaccine hesitant respondents reported fear of side effects (49.2% [95%CI, 48.7, 49.7]) and not trusting the COVID-19 vaccine (48.4% [95%CI, 48.0, 48.9]); over one-third reported not trusting the government, not needing the vaccine, and waiting to see if safe. Reasons differed by degree of vaccine intent and by race/ethnicity. Conclusion COVID-19 vaccine hesitancy varied by demographics, geography, beliefs, and behaviors, indicating a need for a range of messaging and policy options to target high-hesitancy groups.

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Section: Discussionmentioning

confidence: 99%

Time trends, factors associated with, and reasons for COVID-19 vaccine hesitancy: A massive online survey of US adults from January-May 2021

et al. 2021

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“…poor internet access, shorter life expectancy, geographical distance from vaccination sites, living in more deprived areas) and attitudinal (i.e. beliefs or perceptions that impact the willingness to be vaccinated) (7,10,22,34). Overall our results suggest that structural barriers rather than individual barriers might explain the lower vaccination rates in individuals with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Attitudes towards vaccines, intent to vaccinate and the relationship with COVID-19 vaccination rates in individuals with schizophrenia

Raffard¹

2022

Preprint

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Background: People with schizophrenia are at high risk for developing severe COVID-19 outcomes but recent evidence suggests that this population have lower vaccination rates than the general population. This gap in vaccination rates could be explained by attitudinal and structural barriers. Aims: This study explored the role of potential attitudinal barriers by comparing schizophrenia patients with participants from the general population regarding COVID-19 vaccination rates, general attitudes towards vaccines, and willingness to take a COVID-19 vaccine. Method: We conducted a cross-sectional study between April 2021 and October 2021. 100 schizophrenia patients and 72 controls were recruited. Attitudes towards vaccines were assessed with the Vaccination Attitudes Examination Scale. COVID-19 vaccination rates, sociodemographic, clinical and health-related variables were also assessed. Results: In our study, the proportion of individuals with schizophrenia were under-vaccinated despite similar general attitudes towards vaccination and higher willingness to be vaccinated against COVID-19 compared to the participants from the general population. In patients, negative attitudes toward vaccines was related to higher level of negative psychotic symptoms and higher level of paranoid ideation. As a whole, participants with more negative attitudes towards vaccines were less likely to be vaccinated against COVID-19 and had lower levels of trust in institutions. Conclusions: Vaccine hesitancy does not appear to be a major barrier for COVID-19 vaccine uptake amongst people with schizophrenia. This study suggests that disparities in COVID-19 vaccination rates in schizophrenia do not seem related to attitudinal but rather structural barriers.

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“…Racial and ethnic minorities have carried the brunt of disease burden and mortality in the U.S. for the most acute and chronic conditions, as seen in the data [ 5 ]. COVID-19 infections have doubled and tripled the historical suffering in racial and ethnic minority communities in the U.S. due to pervasive structural barriers and racism [ 18 ]. The current public health, racial, and economic crises brought on by the COVID-19 pandemic has had a disproportionately negative impact on historically underserved individuals and communities of color.…”

Section: Covid-19 Disparities As a Public Health Crisismentioning

confidence: 99%

“…The public health field has improved at tracking, counting, and monitoring (surveillance) but not at undoing or eliminating disparities due to the root cause of racism. People with lower socioeconomic status in the U.S. suffer more death, higher morbidity, hospitalizations, and mortality in most chronic conditions as well as COVID-19 [ 18 ]. Because Black Americans are twice as likely as Whites to know someone who has been hospitalized with or has died from COVID-19 [ 19 ], this can also produce a second-hand trauma that exists when they repeatedly witness the pain and suffering of people who look like them [ 20 ].…”

Section: Covid-19 Disparities As a Public Health Crisismentioning

confidence: 99%

“…Black Americans have been disproportionately impacted by police brutality, both before and during the COVID-19 pandemic [ 18 , 22 , 23 ]. Police brutality has been brought to the forefront as a systematic injustice that Black Americans face due to the horrific killing of George Floyd on Memorial Day, 25 May 2020, (as well as those of other Black people within that period), and the ensuing international anti-racism protests against police brutality [ 10 ].…”

Section: Police Brutality Social Unrest and Political Turmoilmentioning

confidence: 99%

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Black Women Faculty and Administrators Navigating COVID-19, Social Unrest, and Academia: Challenges and Strategies

Njoku

Evans

2022

IJERPH

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Black women faculty and administrators in the United States are tackling a force of socioeconomic and racial disparities, emotional tolls and invisible burdens within academia, political turmoil, social unrest, and public health crises. COVID-19 has added an additional layer related to work responsibilities, the overall well-being of Black women faculty and administrators and the diverse students they encounter, and management of work and home responsibilities. This paper discusses perspectives and evidence-based strategies regarding Black women faculty and administrators who navigate academia and teach during times of COVID-19 and social unrest. We also outline strategies for university leaders to mitigate cultural and racial gaps in the classroom or workplace and foster diversity and inclusion in academia.

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Changing the Narrative: Structural Barriers and Racial and Ethnic Inequities in COVID-19 Vaccination

Cited by 109 publications

References 61 publications

Time trends, factors associated with, and reasons for COVID-19 vaccine hesitancy: A massive online survey of US adults from January-May 2021

Time trends, factors associated with, and reasons for COVID-19 vaccine hesitancy: A massive online survey of US adults from January-May 2021

Attitudes towards vaccines, intent to vaccinate and the relationship with COVID-19 vaccination rates in individuals with schizophrenia

Black Women Faculty and Administrators Navigating COVID-19, Social Unrest, and Academia: Challenges and Strategies

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