Socioeconomic Inequities in Vaccine Hesitancy Among Native Hawaiians and Pacific Islanders

Abstract

Purpose: COVID-19 vaccine hesitancy exists in communities of color who are disproportionately impacted by COVID-19. In many states, Native Hawaiians and Pacific Islanders (NHs/PIs) experience the highest rates of COVID-19 confirmed cases and mortality among U.S. ethnic/racial groups. National trends regarding vaccine hesitancy among NHs/PIs are currently lacking. Methods: Data were derived from the Asian American and NH/PI COVID-19 Needs Assessment Project, a national survey conducted during January–April 2021. The final analytic sample included 868 NH/PI adults. Logistic regression analyses were conducted to estimate odds ratios for vaccine hesitancy. Results: Vaccine hesitancy ranged from 23% among Other PIs to 56.3% among Tongan adults. Younger adults (18–24 and 25–44 years), those with lower educational attainment, and those with lower income were more vaccine hesitant. Overall, education and income showed a strong association with vaccine hesitancy in bivariate logistic models. However, the associations between vaccine hesitancy and education and income varied by NH/PI groups. NHs, Samoans, and Multiethnic NHs/PIs showed the most consistent associations between the socioeconomic position variables and vaccine hesitancy. Conclusions: The examination of vaccine hesitancy among NHs/PIs follows the socioeconomic gradient for some ethnic groups but not others. More studies are needed to determine what other socioeconomic indicators may be associated with health among specific NH/PI ethnic groups. Policy Implications: Reforms are needed to overcome structural racism underlying NH/PI evidence production, which currently renders NHs/PIs invisible. Innovative solutions based on successful community efforts can help deconstruct racist data inequities experienced by NHs/PIs.

Associations between the Self-Reported Likelihood of Receiving the COVID-19 Vaccine, Likelihood of Contracting COVID-19, Discrimination, and Anxiety/Depression by Sexual Orientation

“…The present study elucidated interesting trends across sexual orientation for the perceived likelihood of receiving the COVID-19 vaccine. Our multivariate logistic regression analysis yielded similar findings to previous literature as individuals who reported lower income (heterosexual respondents) and education levels (heterosexual and sexual minority respondents) were less likely to report being likely to receive the COVID-19 vaccine [ 29 , 30 , 31 , 32 , 33 ]. This illustrates an important area of concern and intervention for vaccine education and promotion, given individuals of lower socioeconomic status have the highest risk for poor respiratory health [ 34 ].…”

Community Resilience and Cultural Responses in Crisis: Lessons Learned from Pacific Islander Responses to the COVID-19 Pandemic in the USA

“…In contrast, other Pacific Islanders, who make up only 4% of the population, comprised 25% of the COVID-19 cases in this same period and 14% of deaths overall [ 5 ]. Similarly, national research has shown that vaccine hesitance varies widely by ethnicity, from 56.3% among Tongans in the USA to 23.6% among Native Hawaiians [ 6 ].…”

Editorial: Community Engagement Is Key to Promoting Asian American, Native Hawaiian, and Pacific Islander Health

“…24 Samoa et al used data from the AA and NH/PI COVID-19 Needs Assessment Project and found that vaccine hesitancy ranged from 23% among NH/PIs to 57% among Tongans, with consistent associations between socioeconomic status and vaccine hesitancy among Native Hawaiians, Samoans, and Multi-ethnic NH/PIs. 25 …”