The Limits of Medical Trust in Mitigating COVID-19 Vaccine Hesitancy among Black Americans

Objective This state of the art review focuses on bioethical questions and considerations from research findings and methodological issues, including design and recruitment of participants, in studies related to COVID-19 vaccine hesitation in Black individuals. Ethical concerns identified were applied to otolaryngology with recommendations for improving health inequities within subspecialties. Data Sources An internet search through PubMed, CINAHL, and socINDEX was conducted to identify articles on COVID-19 vaccine hesitation among the Black population between 2020 and 2021. Review Methods A systematic review approach was taken to search and analyze the research on this topic, which was coupled with expert analysis in identifying and classifying vital ethical considerations. Conclusions The most common COVID-19 vaccine hesitation factors were related to the development of the vaccine, mistrust toward government agencies, and misconceptions about safety and side effects. These findings raised bioethical concerns around mistrust of information, low health literacy, insufficient numbers of Black participants in medical research, and the unique positions of health professionals as trusted sources. These bioethical considerations can be applied in otolaryngology and other health-related areas to aid the public in making informed medical decisions regarding treatments, which may reduce health inequalities among Black Americans and other racial and ethnic minority groups. Implications for Practice Addressing ethical questions by decreasing mistrust, tailoring information for specific populations, increasing minority representation in research, and using health professionals as primary sources for communicating health information and recommendations may improve relationships with Black communities and increase acceptance of new knowledge and therapies such as COVID-19 vaccination.

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Intragroup differences in COVID-19 vaccine attitudes among Black Americans

10.31234/osf.io/r3vem ◽

2021 ◽

Author(s):

Charles R. Senteio ◽

Christie Newton ◽

Gordon Pennycook ◽

David Gertler Rand

Keyword(s):

African American ◽

Healthcare System ◽

Black Americans ◽

Vaccine Hesitancy ◽

African American Culture ◽

Negative Attitudes ◽

Gender Education ◽

Variation Explained ◽

The Relationship ◽

Level Of Acculturation

COVID-19 vaccine hesitancy among Black Americans threatens to further magnify racial inequities in COVID-19 related health outcomes that emerged in the earliest stages of the pandemic. Here we shed new light on attitudes towards COVID-19 vaccines by considering intragroup variation. Rather than analyzing Blacks as a homogenous group, we examine the relationship between COVID-19 vaccine attitudes and the extent to which participants are aligned with African American versus White culture (i.e., level of “acculturation”). In a sample of N=997 Black Americans, we find that stronger alignment with African American culture predicts substantially more negative attitudes towards COVID-19 vaccination, above and beyond variation explained by age, gender, education, and socioeconomic status. This relationship was substantially attenuated when controlling for suspicion of the healthcare system, but not perceptions that healthcare system treats Blacks unfairly, science knowledge, or cognitive reflection. The intragroup differences among Blacks in COVID-19 vaccine perceptions uncovered here provide insights into designing interventions that provide health information that targets the relevant factors for vaccine hesitancy in differing subgroups.

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Beyond Tuskegee, To Middlesboro: How Perspectives of Policing Shape Vaccine Attitudes for Black Americans

10.31235/osf.io/wjq4a ◽

2021 ◽

Author(s):

Aaron Rosenthal ◽

Matt Motta ◽

Christina E. Farhart

Keyword(s):

Healthcare System ◽

Causal Effect ◽

Black Americans ◽

Past Research ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Police Attitudes ◽

History Of ◽

Nationally Representative

Attempts to explain the higher levels of vaccine skepticism among Black Americans frequentlyfocus on the history of racial discrimination within the American healthcare system. Whilestudying this discrimination is important, we argue that past research overlooks the role of law enforcement actors outside the healthcare system; both in their history of supporting medical discrimination, and in its contemporary function as a coercive face of the state that may influence Black American’s concerns about vaccines. Using cross-sectional and longitudinal nationally representative surveys, we demonstrate that police attitudes have a strong and causal effect on vaccine skepticism and opposition to pro-vaccine policies among Black Americans. These findings point to the importance of reforming areas outside of the medical field, such as policing, in order to promote lasting declines in vaccine hesitancy.

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