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Vaccine Equity: Lessons Learned Exploring Facilitators and Barriers to COVID-19 Vaccination in Urban Black Communities

Journal of Racial and Ethnic Health Disparities (2023)Cite this article

Abstract

COVID-19 vaccines were developed at unparalleled speed, but racial disparities persist in vaccine uptake. This is a cross-sectional survey that was conducted in mid-2021 in ambulatory clinics across Brooklyn, New York. The objectives of the study were to assess: knowledge of COVID-19, healthcare communication and access, attitudes including trust in the process of vaccine development and mistrust due to racial discrimination, and to determine the relationship of the above to vaccine receipt. 58 respondents self-identified as Black non-Hispanic and completed the survey: the majority were women (79%), <50 years old (65%), employed (66%), and had annual household income <$75,000 (59%). The majority reported having some health insurance (97%) and a regular place of healthcare (95%). 60% of respondents reported COVID-19 vaccination receipt. A significant percentage of the vaccinated group compared to the unvaccinated group scored higher on knowledge questions (91% vs. 65%; p = 0.018), felt it was important that others in the community get vaccinated (89% vs. 65%, p = 0.04), and trusted vaccine safety (86% vs. 35%; p < 0.0001) and effectiveness (88% vs. 48%; p < 0.001). The unvaccinated group reported a lower annual household income of <$75,000 (72% vs. 50%; p = 0.0002) and also differed by employment status (p = 0.04). Majority in both groups agreed that racial discrimination interferes with healthcare (78%). In summary, unvaccinated Black non-Hispanic respondents report significant concerns about vaccine safety and efficacy and have greater mistrust in the vaccine development process. The relationship between racial discrimination, mistrust, and vaccine hesitancy needs further study in order to improve vaccine uptake in this population.

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Data Availability

The datasets generated and analyzed during the current study are not publicly available due the fact that they constitute an excerpt of research in progress but are available from the corresponding author on reasonable request.

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Acknowledgements

NYU Langone Vaccine Center- Brooklyn site staff: Akeem Moore, Jasmine Briscoe, Diandra Williams, Heycha Rosado Lebron, Andrew Korman, Thomas Jenkins, Kelsey Smith, Kelly Minus, Grace Lioue, and Stephanie Sterling.

Funding

This work was supported by the National Institutes of Health, including grant AI148574 and contract 75N93021C00014, and by institutional funding provided by NYU Grossman School of Medicine for salary support.

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Author notes

  1. Anna Jaysing and Helen Ding will have equal authorship.

Authors and Affiliations

  1. New York University (NYU) Langone Vaccine Center, New York, NY, USA

    Lalitha Parameswaran, Kesi K. Wilson, Olivia Frank, Ralf Duerr & Mark J. Mulligan

  2. Division of Infectious Diseases and Immunology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA

    Lalitha Parameswaran, Ranekka Dean, Kesi K. Wilson, Ralf Duerr & Mark J. Mulligan

  3. NYU Long Island School of Medicine, New York, NY, USA

    Anna Jaysing & Helen Ding

  4. Division of Occupational/Environmental Medicine, Department of Medicine, NYU Long Island School of Medicine, New York, NY, USA

    Marc Wilkenfeld

  5. Department of Microbiology, NYU Grossman School of Medicine, New York, NY, USA

    Ralf Duerr

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  1. Lalitha Parameswaran
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Contributions

All authors contributed to the study conception and design. The first draft of the manuscript was written by Lalitha Parameswaran, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Dr. Jaysing and Dr. Ding contributed equally and will receive equal authorship.

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Correspondence to Lalitha Parameswaran.

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Ethics Approval and Informed Consent

The study was approved by NYU Grossman School of Medicine Institutional Review Board (IRB) which also provides the ethics approval for the study. All subjects were consented by a verbal script approved by IRB. No Private Health Information was collected in the study.

Competing Interests

Dr. Parameswaran reported potential competing interest: contract funding from Pfizer for an influenza vaccine; Dr. Mulligan reported potential competing interests: laboratory research and clinical trials contract funding for vaccines or monoclonal antibodies for SARS-CoV-2 with Lilly, Pfizer, and Sanofi; personal fees for Scientific Advisory Board service from Merck, Meissa Vaccines Inc., and Pfizer. All authors declare no competing interests.

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Parameswaran, L., Jaysing, A., Ding, H. et al. Vaccine Equity: Lessons Learned Exploring Facilitators and Barriers to COVID-19 Vaccination in Urban Black Communities. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01680-9

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