Critical Insights Into Public Health Interventions: Partnership, Cultural and Racial Tensions, and Vaccine Hesitancy Within Somali Communities in the Upper Midwest, USA, and Western Norway

As the COVID-19 pandemic recedes, SARS-CoV-2 vaccination is crucial for reducing transmission and severity, but vaccine hesitancy remains a challenge. The study explored community actions and initiatives addressing vaccine hesitancy among Somali immigrant communities in cities in the Upper Midwest, USA, and Western Norway, focusing on trust factors and comparing members of the Somali diaspora in two distinct social and cultural contexts. Qualitative collective case studies were conducted, involving 14 semi-structured interviews with key informants from the Upper Midwest and Western Norway knowledgeable about initiatives designed to address SARS-CoV-2 vaccine hesitancy. Data were coded in NVivo 12 and analyzed thematically, guided by the Bergen Model of Collaborative Functioning and the Socioecological Model to identify basic and organizational themes. The findings illustrate critical sociopolitical influences on vaccine hesitancy, like racial tensions following George Floyd’s murder in Minneapolis and mistrust toward the government in Norway. Effective strategies in the Upper Midwest included maintaining long-term community relationships and culturally tailored outreach and communication to reduce hesitancy. Conversely, Western Norway’s less community-centric approach, focusing on translation services without deeper engagement, faced challenges in trust-building. The study highlights the essential role of culturally affirming and community-centric approaches in addressing health challenges in immigrant communities. Trust, fostered through community involvement and understanding sociopolitical contexts, is pivotal in addressing vaccine hesitancy. This research offers insights into designing and implementing effective health promotion strategies tailored to immigrant populations’ unique needs. It emphasizes the necessity of integrating socioecological perspectives and community-specific interventions in health promotion practice and policy.