Access, not hesitancy, may account for race-based differences in vaccination rates: study

Black Americans’ lower rates of COVID-19 vaccination compared to whites is generally attributed to historical and institutional racism. But results of a recent study point to disparities in vaccine access, rather than vaccine hesitancy, as the explanation for race-based differences in vaccination rates.

A team of researchers surveyed 1,200 adults monthly between December of 2020 and June 2021 to gauge their vaccination intentions, along with their beliefs about the safety, effectiveness and necessity of COVID-19 vaccines. They found that Black and white respondents had roughly the same intentions to get vaccinated at the start of the survey, intentions increased faster among Black respondents than whites.

The survey also showed that the belief that COVID-19 vaccines are necessary for protection increased faster among Blacks than whites, along with a positive association between vaccination intention and belief that the vaccines are safe and effective. The survey found no race-based difference in association of the vaccines’ safety and effectiveness with intent to get vaccinated.

The authors note that instances of historical racism, such as the Tuskegee syphilis study, along with present-day institutional racism are significant drivers of vaccine distrust among Black Americans. At the same time, Black individuals want protection from discrimination and to avoid community-wide health disparities. So while Blacks’ desire to protect themselves from poor outcomes might initially be associated with suspicion of new or experimental vaccines, “the same desire can motivate Black community members to get vaccinated once vaccines are believed to be safe, effective and necessary,” the authors write.

But even with vaccine hestiancy declining faster among Black individuals than whites, the authors note, government data indicates that vaccine uptake among Blacks still trails that of whites, a disparity that may be due to the greater barriers to vaccination faced by many Blacks and members of other marginalized communities.

As examples, they cite Kaiser Family Foundation surveys showing that 55% of Black individuals worry about missing work if they get sick from the vaccine, versus 41% of whites, and that 17% of Black respondents, but only 9% of whites worry about finding transportation to a vaccination site. “These figures, along with our own findings, underscore the need to ensure that research and practical efforts focus on the access barriers faced by those willing to be vaccinated,” they write.

The study, “Changes in COVID-19 Vaccine Hesitancy Among Black and White Individuals in the US,” was published January 21 on JAMA Network Open.