Public Perceptions and Responses on the Covid-19 and Covid Vaccination in Rural Alabama

Background: As of April 2021, the U.S. has been more greatly affected by the global Covid-19 pandemic than any other country. Since the emergence of the pandemic in the U.S. around March 2020, we have observed significant shifts in public perceptions of and response toward the pandemic and modern medicine. Vaccinations have long been a polarizing health issue. We are interested in assessing how the Covid -19 pandemic has influenced people’s attitudes toward and perceptions of immunizations living in rural Alabama and their knowledge, attitudes, perceptions, and prevention practices related to the virus.

Methods: Focus group interviews were conducted in designated local communities in the rural areas of Alabama in September 2020. Focus group participants were recruited from a pool of individuals living in a local community and voluntarily participated in this study after informed consent was given. Interested participants were enrolled in one focus group discussion lasting 40 to 60 minutes. All focus group participants were asked to keep any content shared in the groups confidential. A semi-structured interview was conducted revolving around the following topics: (1) the impact of Covid -19 on participants’ health and healthcare access; (2) self-care activities during the Covid -19 pandemic; and (3) opinions on Covid vaccination. All participants were informed that they might choose not to answer questions that make them feel uncomfortable. The focus group discussion was recorded and then uploaded to a secured cloud service for analyses. In appreciation of participation, participants were compensated $20 e-gift cards for completing the focus group discussion. A verbatim transcript of all focus group discussions was exported and analyzed by three research team members using NVivo. Thematic analysis using an inductive approach was performed to identify themes and subthemes within the data. Results were discussed among all members until consensus was achieved and a final set of themes and subthemes was secured.

Results: Three major themes and corresponding subthemes were identified: (1) Applied coping strategies in the pandemic with subthemes like physical health care, relationships with others, maintain hygiene, and keeping informed; (2) Impacts of the pandemic with subthemes like negative mental health and doing online services and activities; (3) Perspectives on Covid vaccine with subthemes like perceived challenges and suggestions about accessibility, and willingness-related concerns.

Conclusion: Our findings press for joint actions and efforts from policymakers and health care practitioners to make strategic intervention mapping to promote positive health behaviors to ultimately reduce Covid -19 transmission, number of cases, and adverse outcomes. For example, providing professional education or information to facilitate people to raise awareness of self-care and vaccination. Other examples include leveraging resources to increase vaccine accessibility, such as providing public transportation, mobile vaccine services, easy-to-find location, administrative support, and mutual community support.