"My Daughter Is in Med School" : Culturally Relevant Motivations and Trusted Sources Contributing to the Early Adoption of COVID-19 Vaccine Among African Americans

Background and Purpose: COVID-19 has affected African Americans at a disproportionate rate in the United States. Racism, poverty, and medical mistrust are well-supported social determinants of health and impact COVID-19 vaccine uptake among African Americans. Less is known about the motivating factors and trusted sources of information contributing to the early adoption of the COVID-19 vaccine among African Americans. In 2020, the National Institutes of Health launched Community Engagement Alliance (CEAL) Against COVID-19, tasked with improving the vaccination rates among African American, Hispanic/Latino, and Native American communities. CEAL provided new opportunities to assess culturally relevant factors contributing to the vaccine-related decision-making process among African Americans. Early adopters of the Covid-19 vaccine make up about 15% of the population of individuals who get the vaccine at the onset. This study explores the perceptions of African American community members’ motivations and factors among early adopters of the COVID-19 vaccines in two urban cities in the Southwest United States. This study aims to increase knowledge of culturally relevant factors contributing to health decision-making among African Americans.

Methods: This study is part of the Arizona CEAL COVID Consortium (AC3), a statewide effort to address the urgent needs of the rapidly changing course of the COVID-19 pandemic in communities of color. A subset of focus group data was used for this present study. Purposeful sampling was used to recruit African American adults from two urban cities in a Southwest state. Data collection was conducted via zoom with focus groups lasting approximately 90-120 minutes. Sample questions were “What are some reasons why you and/or your family received the vaccine for COVID-19? and “Whom do you trust to learn about COVID-19?” Focus groups were audio-recorded, transcribed, and analyzed for thematic analysis.

Results: Data were collected from 32 (N = 5 focus groups) African American adults ages 20 to 78. The mean age was 53 years (SD = 15.8). Participants were predominantly female (68%). Using grounded theory, motivating factors and culturally relevant sources of trusted information were the two themes that emerged from our analysis. Motivating factors for early vaccine adoption were recent death or illness of loved ones, proximity to a parent or their elders, commitment to work with the community, and having pre-existing conditions. Culturally relevant sources of trusted information contributing to vaccination were “people who look like me,” family members in health care, access to science-based information, and faith. Moreover, faith and science were identified as co-existing facilitators of vaccine uptake among African American participants in this study.

Conclusions and Implications: Findings suggest that despite historical mistrust as a social determinant of health for African American communities, African Americans are deciding to get vaccinated. Specifically, this study highlights family, science, and faith as culturally relevant factors contributing to the motivation and trust of early vaccine adopters. The implications of this study suggest that culturally relevant factors need to be considered to promote vaccine confidence among African Americans and to advance health equity in research, messaging, and community education.