A Qualitative Study of COVID-19 Vaccination Among Latinx Communities in South Texas

Background and Purpose: Predominantly Latinx communities live along the Texas/Mexico border. These communities have been disproportionately impacted by structural and environmental determinants and conditions that have increased vulnerability during the COVID-19 pandemic (e.g., rural, poverty, lack of transportation or access to health care). Community members also tend to work in industries largely impacted by COVID-19 (e.g., healthcare, retail/hospitality, and education). These border communities have been COVID-19 hotspots, and continue to account for most of Texas infections, hospitalizations, and deaths. These conditions also leave our communities more vulnerable to mistrust and misinformation that may hinder acceptance, confidence in, and uptake of COVID-19 vaccination. Hence, the purpose of our qualitative study was to: (1) explore what factors influence the Latinx border community’s uptake of the COVID-19 vaccine, and (2) identify how can these factors influence current public health messaging among this population.

Methods: Participants were recruited through partnerships with various community organizations in South Texas. Data were collected in Spanish and English through eight semi-structured focus groups in 2021 and 2022. A total of 80 Latinx participants from a variety of ages and genders were part of the focus groups. The interview facilitators were bilingual and bicultural. The interviews were transcribed verbatim by bilingual and bicultural members of the research team. Three researchers individually coded the interview with the largest number of participants (n=15) and compared codes. The rest of the interviews were coded individually by at least two of the three authors. Data was analyzed following the six-step thematic analysis delineated by Braun and Clarke (2006): (1) read the transcripts and conduct line-by-line coding, (2) created a hierarchy of themes and subthemes, (3) examined similarities across participants’ responses, (4) conceptualized themes them until all coders agree with the final themes, (5) developed the final names for each theme, and (6) selected representative verbatim quotations and excerpts. Member-checking was utilized to ensure trustworthiness.

Results: Four themes were constructed to answer research question #1 “What factors influence the community’s uptake of the COVID-19 vaccine?” These themes were: (1) fear of the vaccine, (2) mistrust of the government, (3) lack of education about COVID-19 and the vaccine, and (4) perceived risk of exposure and infection of loved ones. Four themes were constructed to answer research question #2 “How can these factors influence current public health messaging?” These themes were: (1) inconsistent and inaccurate messaging, (2) learning about others’ stories served as motivation to get the vaccine, (3) need for messaging from local trusted community members and healthcare providers, and (4) social media is a critical medium to disseminate information.

Conclusions and Implications: Culturally-relevant public health messaging is necessary for the education of Latinx communities along the Texas/Mexico border. The misinformation that permeates these communities often leads to mistrust, fear, and anxiety of the COVID-19 vaccine. However, motivation lies on wanting to protect loved ones and the community-at-large. Community-informed public health messaging should include local trusted stakeholders and must be disseminated on social media.