'Community Leaders Have More Impact on Neighbors Than Celebrities' In COVID-19 Vaccine Trust

The Bottom Line

To truly move the needle around vaccine confidence, healthcare systems and public health entities must work with trusted community groups and leaders. Community-engaged COVID-19 vaccine initiatives and messaging can reflect the nuances of the pandemic and vaccine and address specific, local concerns.

Context

COVID-19 has disproportionately affected Black and Latino/a communities, with data from the Centers for Disease Control and Prevention showing that Black and Latino/a patients both been hospitalized and have died at rates approximately twice that of white patients. While COVID-19 vaccines have been proven to significantly reduce hospitalizations and deaths from the virus, since their rollout, there have been inequities in vaccination rates by race and ethnicity.

To date, data shows 42.3% of Black individuals, 53.7% of Latino/a individuals, and 49% of white individuals are fully vaccinated against COVID-19. The likely reasons for the gaps in vaccination status are multifold: valid distrust of the medical system, structural racism, structural barriers to care, and additional complications among immigrant communities, such as language barriers and fear of deportation.

Study Objective

To overcome mistrust and succeed in both COVID-19 vaccination campaigns and future public health programs by directly asking community members their feelings and perceptions of the COVID-19 vaccine and pandemic.

The Details

Boston Medical Center organized a series of nine community-based conversations between March and September 2021. The events were led by trusted community leaders, including leaders of community organizations, local sports celebrities, and faith leaders, and were held over Zoom and often re-broadcast over other channels.

Six of the nine conversations prioritized specific groups important to the city area: the Haitian Creole community, the Latino/a community, the Cape Verdean community, the Black Christian faith community, guardians caring for children with disabilities, and individuals with lupus. The other three conversations were for the general Greater Boston area public. Often, the conversations were available in several languages commonly spoken by community members of the area.

People who attended these conversations could write in questions or ask them live, and researchers used qualitative methods to identify emerging themes.

Findings

Boston Medical Center researchers identified five common themes from these community conversations.

1. Structural factors are important barriers to COVID-19 vaccination
2. Mistrust due to the negative impact of systemic oppression and perceived motivation of the government
3. Desire to learn more about biological and clinical characteristics of the COVID-19 vaccine as well as practical implication of being vaccinated
4. Community leaders emphasize community engagement for delivering COVID-19 information and education
5. Community leaders believe that the COVID-19 vaccine is a solution to address the pandemic

Pull Quote

“We are trying to reach out because we know that community members have more impact on their neighbors than celebrities or politicians that kind of thing, so I think that people have made an effort, perhaps based on that question, not enough of an effort, so maybe we should double down and try to be better at that and do more at that,” said one community leader during the general public community conversation #2.