| Bateman LB, 2022 [42] |
8 focus groups; n = 67 |
6 AA focus groups + 2 Latinx |
19 years old and older |
Alabama and Texas Counties: Jefferson (urban), Mobile County (urban), and Dallas (rural) |
Mistrust, Fear, Information Needs |
The primary themes driving COVID-19 vaccine hesitancy/acceptance—ordered from most to least discussed—included mistrust, fear, and lack of information. Additionally, they suggest that interventions to decrease vaccine hesitancy should be multi-modal and community-engaged, and they should provide consistent, comprehensive messages delivered by trusted sources. |
8 |
| Budhwani H, 2021 [46] |
Interviews; n = 28 |
All AA |
Age 15–17 |
Alabama (rural areas) |
Mistrust, Fear, Misinformation,
Elder Influence |
The primary themes driving COVID-19 vaccine hesitancy/acceptance included the influence of community leaders and elders, fear of side effects and misinformation, and institutional mistrust. The findings suggest that the sentiments and behaviors of older family members and Church leaders may influence AAB adolescents’ vaccine acceptance, particularly in rural communities. |
7 |
| Carson S, 2021 [45] |
13 focus groups;
n = 70, of whom 17 are AA |
3 Black/AA focus groups (n = 17);
3 Latino (n = 15);
3 American Indian (n = 17);
2 Filipino (n = 11);
2 Pacific Islander (n = 10) |
50 Females |
California (LA County) |
Mistrust,
Misinformation,
Concern about Accessibility of the Vaccine, Unclear Information |
The primary themes driving vaccine hesitancy/acceptance included misinformation/unclear information, medical mistrust, concern about inequitable access, and accessibility barriers. |
8 |
| Ignacio M, 2023 [10] |
34 focus groups;
n = 153 |
10 AA groups;
10 Native American; 14 Hispanic |
>18 years of age |
Arizona |
Mistrust, Uncertainty due to Disinformation |
The primary themes driving vaccine hesitancy/acceptance included mistrust due to historical and contemporary experiences with racism and uncertainty created by disinformation and the speed of vaccine development. The findings across all three racial/ethnic groups strongly suggest that an effective way of promoting trust in science and increasing COVID-19 vaccine confidence is through the use of community-based testimonials or narratives from local leaders, local elected officials, local elders, and other community members who have received the COVID-19 vaccine and who are able to encourage others in their community to do the same. |
9 |
| Jimenez ME, 2021 [47] |
13 focus groups;
n = 111 |
4 AAB (n = 34);
3 Latinx (n = 24);
4 Mixed Groups (n = 36);
2 Healthcare Worker Groups (n = 9);
Total Black Participants across Groups (n = 68) |
Median age 43 years;
87 women (78.4%); Age 18–93 years |
New Jersey counties |
Mistrust |
Mistrust among Black participants was the main reason for vaccine skepticism. |
8 |
| Kerrigan D, 2023 [39] |
5 focus groups (n = 36);
40 interview participants + crowdsourcing contest (n = 208) |
2 AA (n = 16);
2 Latinx (n = 16); 1 African Immigrant (n = 5).
Interviews: AA (n = 19); Latinx (n = 13);
African Immigrant (n = 7) |
19–92 years old |
D.C. |
Medical Mistreatment,
Mistrust in Government, Information Needs |
The prominent themes among AA participants included mistrust in government and the medical establishment, lack of information, and misinformation. Trusted channels were listed for grassroots’ mobilization and working with religious leaders. |
9 |
| Majee W, 2023 [43] |
21 individual interviews (16 phone, 5 in person) |
20 AAB interviewees, 1 White |
14.29% (n = 3) 30–40 years old; 85.71% (n = 18) 60+ years old. Lifestyle coaches, Church leaders, and program participants |
Central Missouri |
Mistrust |
Most participants expressed a lack of trust in the government concerning their health and felt unsafe/lacked confidence in government. Continued acts of injustice influence AAs’ perceptions of the healthcare system. |
9 |
| Momplaisir F, 2019 [41] |
4 focus groups; n = 24 |
All Black, 1 Mixed Race |
20–63 years old, avg 46 years old.
17 Non-Hispanic Black; 1 Black Hispanic; 1 Mixed Race. Black barbershop and salon owners. |
West Philadelphia |
Mistrust in Government, Information Needs |
The primary reasons for vaccine hesitancy were mistrust in government, hesitancy based on unethical historical practices in research toward the Black community, and skepticism, which was not effectively addressed. |
9 |
| Okoro O, 2022 [15] |
8 focus groups (n = 49) + 30 interviews
+ surveys (n = 183, of whom 120 are AA, 40 are African, 23 are Biracial) + One-on-one interviews (n = 30) |
32 AA, 12 African/Jamaican, 4 Bi/Multi-racial in focus groups;
All AAB in interviews and surveys |
>18 years old, 18–81; 47% male |
Minnesota and Wisconsin |
Information Needs, Mistrust |
The primary reasons included mistrust in government and misinformation, lack of information, and vaccine literacy. The recommendations included use of community spaces as vaccination sites, engagement of community members as outreach coordinators, and timely provision of information in multiple formats. |
9 |
| Osakwe ZT, 2022 [44] |
One-on-one semi-structured interviews; n = 50 |
Black individuals (n = 34);
Hispanic (n = 9); Black/Hispanic (n = 3); White/Hispanic (n = 4) |
64% women, avg age 42;
44% had high-school-level education or less |
New York |
Information Needs |
The primary reasons included the influence of social networks, lack of information and communication. This qualitative study found that among Black and Hispanic participants, the receipt of reliable vaccine-related information, social networks, seeing people like themselves receive the vaccination, and trusted doctors were the key drivers of vaccine acceptance. |
8 |
| Rios-Fetchko F, 2022 [48] |
6 focus groups (n = 45);
One of the six focus groups was of mixed race. |
AAB (n = 13); Latinx (n = 20); AAPI (n = 12) |
18–30 years of age |
San Francisco Bay Area |
Mistrust,
Information Needs |
The primary reasons among all three racial–ethnic groups included mistrust in medical and government institutions, strong conviction about self-agency in health decision making, and exposure to contradictory information and misinformation on social media. Social benefit and a sense of familial and societal responsibility were often mentioned as reasons to get vaccinated. |
7 |
| Sekimitsu S, 2022 [17] |
Individual interviews;
n = 18 |
n = 18 Black individuals |
20–79 years old,
Black, identified as “vaccine-hesitant” |
Boston, MA |
Mistrust,
Fear, Information Needs |
The primary reasons for vaccine hesitancy included a lack of trust in the government, healthcare, and pharmaceutical companies, concerns about the rushed development of the vaccine, fear of side effects, history of medical mistreatment, and a perception of low risk of disease.
The motivators likely to increase COVID-19
vaccine uptake included more data on vaccine safety, friends and family getting vaccinated (not celebrities), and increased
opportunities, which come with being vaccinated. |
9 |
| Zhang R, 2022 [18] |
2 focus groups; n = 18 |
All AA |
18–30 (n = 12); 31–49 (n = 4); 50+ (n = 2)
Participants primarily worked in colleges, Churches, and health agencies; 72% female |
Three counties in South Carolina |
Information Needs, Mistrust |
The primary reasons included challenges in accessing reliable vaccine information. In AA communities, the challenges primarily included structural barriers, information barriers, and a lack of trust. Community stakeholders recommended recruiting trusted messengers, using social events to reach target populations, and conducting health communication campaigns through open dialog among stakeholders. Health communication interventions directed at COVID-19 vaccine uptake should be grounded in ongoing community engagement, trust-building activities, and transparent communication about vaccine development. |
8 |
| Zhou S, 2022 [40] |
Interviews; n = 18 |
5 Latinx;
8 AAs;
5 AI/ANs |
21–54 |
Denver Metropolitan Area |
Fear,
Information Needs,
Mistrust |
Negative perceptions of the COVID-19 vaccine were driven by concerns about vaccine safety due to the rapid development process and side effects. AA participants identified seeing others—especially government officials—get the vaccine first as a facilitator for accepting the vaccine, and low trust in the government and healthcare system as barriers to vaccine acceptance.
To address the barriers, campaigns should increase credibility of the information and reduce inconsistencies, build trust with communities, and frame messages in a positive manner. |
9 |
