Contributing factors for low COVID-19 vaccination rates in vulnerable populations

As we celebrate the one-year milestone of the COVID-19 crisis, a gift to all of us has been developing and implementing the COVID-19 vaccine from manufacturers Pfizer, Moderna, and Johnson and Johnson.  While a segment of Americans throughout the country are scheduling appointments and rolling up their sleeves, vaccine hesitancy prevents a portion of the population from receiving their vaccines. 

            The American Journal of Preventive medicine defines vaccines hesitancy as concerns about the decision to vaccinate oneself or one's children due to a broad range of contributing factors such as their compulsory nature, their coincidental temporal relationship to adverse health outcomes, and a lack of trust in the corporation and public health (Daniel Salmon, 2015). Vaccine hesitancy was a concern for public health experts even before the COVID-19 pandemic, as it primarily impacted the influenza vaccination rates in elderly and minority populations. A report from the AARP Public Policy Institute shared that nearly half of adults aged 50 and older are vaccine-hesitant. Another 11 percent of this population never get vaccines, and that the relationship with previous vaccination behaviors is an indicator of what people can expect with the COVID-19 pandemic. The CDC's 2019 Behavioral Risk Factor Surveillance System showed that 53 percent of adults ages 50 and older received a flu shot in the previous year. Still, there were notable differences in the population. For example, Black (47 percent) and Hispanic (43 percent) older adults receive flu vaccines at rates below their White (55 percent) counterparts (McSpadden, 2021).  

            As of February, the Kaiser Family Foundation reports that White individuals are over three times more likely than Hispanic individuals to have received the first dose of the COVID-19 vaccine. The report shows growing gaps between the populations is based primarily on contributing factors such as lack of trust in the development of the vaccine and gaps in access to appointments and information about the vaccine to build the vaccine's trust (Artiga, 2021).When individuals are deciding whether to get a COVID-19 vaccine, older adults ranked factors such as how well it works, their research, and if it was recommended by their physician, public health official, or family and friends, as well as the total cost of the vaccines.  And while the vaccine is free due to being purchased with US taxpayer dollars, often to schedule an appointment, individuals are being asked to provide insurance or Medicaid information, delaying them from scheduling the appointment  (Preeti Malani, 2020). Additionally, many Black and Hispanic Americans are less likely to have reliable internet access to make online appointments or flexible work schedules to take advantage of available openings at vaccination sites.  In January, over a third of Hispanic adults and 43% of Black adults indicated that they planned to wait and see how others fare after vaccinations before they plan to receive it (Amy Schoenfeld Walker, 2021). It's important to note that not all reluctance should be construed as a refusal to get the vaccine entirely, but merely recognizing that individuals have concerns about the new product and its development.  For communities of color, this is understandable regarding the medical system's historical mistreatment, which has factored into their decisions.  Individuals respond better to empathy and patience than to pressure.  Individuals should persuade loved ones by asking them the reason behind their skepticism and addressing them individually. Connecting them to trusted resources such as a trusted healthcare provider or peers who have received the vaccines is another way to build their trust in the process (HealthyWomenEditorts, 2021).    

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References

Amy Schoenfeld Walker, A. S. (2021, March 5). Pandemic’s Racial Disparities Persist in Vaccine Rollout. Retrieved from New York Times: https://www.nytimes.com/interactive/2021/03/05/us/vaccine-racial-disparities.html

Artiga, S. (2021, February 22). Growing Gaps in COVID-19 Vaccinations among Hispanic People. Retrieved from Policy Wath: https://www.kff.org/policy-watch/growing-gaps-covid-19-vaccinations-hispanic-people/

Daniel Salmon, M. D. (2015). Vaccine Hesitancy. American Journal of Preventive Medicine, 391-398.

HealthyWomenEditorts. (2021, February 11). Vaccine Hesitancy vs. Vaccine Refusal: Nursing Home Staffers Say There’s a Difference. Retrieved from Healthy Women: https://www.healthywomen.org/your-health/prevention--screenings/vaccine-hesitancy-vs-vaccine-refusal

McSpadden, J. (2021, February). Vaccine Hesitancy among older adults, with implications for COVID-19 vaccination and beyond. Washington: AARP Public Policy Institute.

Preeti Malani, E. S. (2020, December 23). Older Adults’ Perspectives on a COVID-19 Vaccine. Retrieved from JAMA Health Forum: https://jamanetwork.com/channels/health-forum/fullarticle/2774598