Objective: We sought to examine reasons for vaccine hesitancy among online communities of US-based Black and Latinx communities to understand the role of historical racism, present-day structural racism, medical mistrust and individual concerns about vaccine safety and efficacy.
Design: A qualitative study using narrative and interpretive phenomenological analysis of online bulletin board focus groups.
Setting: Bulletin boards with a focus-group-like setting in an online, private, chat-room-like environment.
Participants: Self-described vaccine hesitant participants from US-based Black (30) and Latinx (30) communities designed to reflect various axes of diversity within these respective communities in the US context.
Results: Bulletin board discussions covered a range of topics related to COVID-19 vaccination. COVID-19 vaccine hesitant participants expressed fears about vaccine safety and doubts about vaccine efficacy. Elements of structural racism were cited in both groups as affecting populations but not playing a role in individual vaccine decisions. Historical racism was infrequently cited as a reason for vaccine hesitancy. Individualised fears and doubts about COVID-19 (short-term and long-term) safety and efficacy dominated these bulletin board discussions. Community benefits of vaccination were not commonly raised among participants.
Conclusions: While this suggests that addressing individually focused fear and doubts are central to overcoming COVID-19 vaccine hesitancy in Black and Latinx groups, addressing the effects of present-day structural racism through a focus on community protection may also be important.
Keywords: COVID-19; anthropology; patient participation; preventive medicine.
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.