Understanding COVID-19 Vaccine Hesitancy and Uptake Among a Diverse Group of Hispanic/Latinx Community Members in Arizona

Background: Although scientific evidence strongly supports uptake of COVID-19 vaccine and boosters to prevent hospitalizations and mortality, Hispanic/Latinx people in the U.S. continue to experience lower vaccination rates. In Arizona (AZ), a state with a large proportion of Hispanic/Latinx people, ranks fourth in the nation in percent of Latinx deaths due to COVID-19 (29%) and fourth for states with the lowest Latinx vaccination rates (Arizona Department of Health Services, 2022). Given these disparities, it is essential to understand more closely how Hispanic/Latinx populations in AZ make sense of the disease and related vaccines. Focus group data from AZ Community Engagement Alliance Against COVID-19 Disparities (AZ CEAL) study is examined to further identify factors beyond religious values and beliefs that contribute to vaccine hesitancy and to understand the beliefs and meanings AZ Hispanic/Latinx populations attribute to COVID-19 and vaccines.

Methods: Mixed-method data were analyzed from an NIH community-engaged research study to increase COVID-19 awareness and education in AZ. Fourteen focus groups were conducted virtually on Zoom with 71 participants who identified as Hispanic/Latinx across southern, central and northern regions of AZ. Focus group participants completed an online survey prior to focus group participation to collect demographic information and vaccination status. Participants were 18 years of age or older, identified as a member of the Hispanic/Latinx community, resided in AZ, and had an email address to receive Zoom link, online survey, and $45.00 e-gift card incentive. Individuals were screened for their language preference (i.e., English or Spanish). In total, nine focus groups were conducted in English and 5 were conducted in Spanish between February and June 2021. The research team expanded the use of snowball sampling with a “family or friends” recruitment strategy to increase participation for members of intergenerational households. Two Latinx researchers facilitated focus groups in English or Spanish using semi-structured questions. Participants were asked about their experiences during the COVID-19 pandemic including the effects of the pandemic on their families and their community. Audio recordings of focus groups were transcribed, Spanish focus groups were transcribed in Spanish, then translated to English by certified translators. Thematic coding centered on vaccine hesitancy, vaccine confidence, and trusted sources of health information. These codes were then categorized into subthemes and inter-rater reliability was assessed via team discussions and any discrepancies were resolved by a third researcher.

Results: Using an explanatory model of health framework, Hispanic/Latinx participants described vaccine hesitancy as a result of not having enough relevant information (i.e., vaccines’ side effects) and having negative feelings and attitudes about the vaccine. In contrast, vaccine confidence was attributed to protecting one’s family, fear of getting sick, one’s civic duty, a desire for normalcy, and placing trust in science.

Conclusions and Implications: Ultimately this information is significant to develop targeted public health messaging to increase vaccination acceptance and uptake across diverse Hispanic/Latin communities in AZ and potentially in other states where there is a large population of Hispanic/Latinx residents.

References

Arizona Department of Health Services. (2022). Arizona Covid-19 Dashboard. Retrieved January 14, 2022, from https://www.azdhs.gov/covid19/data/index.php