Exploring the Scope and Dimensions of Vaccine Hesitancy and Resistance to Enhance COVID-19 Vaccination in Black Communities

Olihe Okoro, Janet Kennedy, Glenn Simmons, Elyse Carter Vosen, Kay Allen, Desiré Singer, Desmond Scott, Renee Roberts

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: The long history of distrust that characterizes the relationship between the Black/African-American population and the US Medical community makes COVID-19 vaccine hesitancy of great concern. A needs assessment of the Black/African-American community assessed willingness and explored the perceptions of community members regarding COVID-19 vaccination. Methods: The study used a mixed-methods approach. Respondents (n = 183) were surveyed with a web-based questionnaire. They were asked whether there would get vaccinated for COVID-19 barring any access or cost-related challenges. Perceptions of community members regarding vaccination were explored through one-on-one interviews (n = 30) and eight focus groups (n = 49), with participants drawn from across various demographic characteristics. Survey responses were summarized using frequencies and proportions. A thematic analysis was conducted on the qualitative data. Results: Thirty-four percent of respondents indicated “Yes” (willing to get vaccinated); 26.8% indicated “No”, while 37.1% expressed hesitancy (“Maybe” or “I don’t know”). Themes emerging from the qualitative data are grouped into three broad categories: vaccine accessibility (transportation, information, navigating healthcare system); vaccine hesitancy (with sub-categories of compliance, complacency and confidence); and vaccine “resistance” (conspiracy theories, conflicting beliefs, distrust of Government, trustworthiness of Health care). Conclusion: Findings demonstrate a nuanced expansion of “vaccine hesitancy” to delineate groups with varying issues and perspectives. Interventions to enhance vaccination rates in Black/African-American communities should incorporate components that assure accessibility at the minimum, but also address non-access-related issues. Priority should be given to enhancing vaccine literacy, information-sharing as efficacy and safety data emerge, and addressing specific concerns identified through community-engaged outreach efforts.

Original languageEnglish (US)
JournalJournal of Racial and Ethnic Health Disparities
Early online dateSep 22 2021
StatePublished - Sep 22 2021

Bibliographical note

Funding Information:
This research was supported by funding from the Minnesota Department of Health (MDH) COVID-19 Community Engagement Request for Services.

Publisher Copyright:
© 2021, W. Montague Cobb-NMA Health Institute.


  • Black/African American
  • Community-based
  • COVID-19 vaccination
  • Vaccine hesitancy
  • Vaccine resistance

PubMed: MeSH publication types

  • Journal Article


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