Strategies That Promote Equity in COVID-19 Vaccine Uptake for Black Communities: a Review

Abstract

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.

Listening to Voices from African American Communities in the Southern States about COVID-19 Vaccine Information and Communication: A Qualitative Study

“…Disparities in vaccine uptake are attributed to multiple dimensions of structural inequality. Given historical and contemporary health care injustices, the African American (AA) population may not readily accept the COVID-19 vaccine as efficacious, safe, or accessible [ 6 , 7 ]. Moreover, recent studies have shown that misconceptions about the vaccine, mistrust in the health care system, and a lack of access to health services may discourage people from getting vaccinated, especially in communities of color [ 5 , 8 , 9 , 10 , 11 ].…”

Characteristics and Procedures Among Adults Discharged to Hospice After Gastrointestinal Tract Surgery in California

“… 40 Innovative approaches to engaging historically underserved groups in COVID-19 vaccination programs have emphasized that community-level engagement with religious groups, primary care facilities, and trusted community members can be more effective than physician-led efforts. 41 , 42 , 43 , 44 To understand next steps for patients who undergo gastrointestinal tract surgery and are discharged to hospice but are readmitted to the hospital, deeper review of clinical documentation to evaluate whether goals of care or advance care planning were attempted or not and even interviews with patients and/or their loved ones to understand positive and negative experiences around discussions will be essential. Importantly, our study uniquely identifies patients from communities with higher DCI as more likely to be readmitted to an acute care hospital after enrollment in hospice.…”

Leveraging infodemiologists to counteract online misinformation: Experience with COVID-19 vaccines

“…For in situations of scientific uncertainty, values guide us, and an infodemiologist who shares the values of the target audience can not only provide factual information where it exists but help guide the audience through the uncertainty according to the shared values of the group. In our cases, intervening in Black and Latinx communities, this often takes the form of advocating for obtaining vaccines as a powerful way to empower communities and address a long history of medical racism and as a community-focused way to show one's love for their neighbor and their community (Carson et al, 2021;Dada et al, 2022).…”