Barriers to COVID-19 Vaccination and Perceptions Around Vaccination Uptake Strategies Among African Americans Living in the US South: Opportunities for Public Health Program Intervention

Background This study assesses the differences in vaccine hesitancy by vaccination status among African Americans (AAs) living in South Georgia and identifies preferred vaccine uptake strategies by the non-vaccinated AA. Methods Survey data collected as a part of a COVID-19 Health Literacy program from adult (>= 18 years) participants (n = 2058) in Albany, GA, was used (October 2022 to July 2023). We dichotomized COVID-19 vaccination status as "vaccinated" if reported having received at least one dose of vaccine, and "non-vaccinated" otherwise. Perception of vaccine barriers was assessed using 28 questions, and vaccine uptake strategies using 7 questions. All were assessed on a 5-point Likert scale, transformed to a dichotomous response, i.e., agree (merged strongly agree or agree responses) and disagree (merged strongly disagree, or disagree responses); neutral responses were dropped. Descriptive analysis and chi-square tests were used to identify the most prominent barriers to vaccination and the preferred uptake strategies among the non-vaccinated. Result sNearly 1500 participants provided a non-neutral response to vaccine hesitancy questions, where the majority (90.7%) were vaccinated. Medical concerns and myth-related barriers were significantly associated with being vaccinated or non-vaccinated: for example, only 71.3% of non-vaccinated agreed that blood clots from the vaccine are of concern (a myth) compared to 40.5% of vaccinated (p-value < 0.001). Receiving additional information on the COVID-19 vaccine was selected as the most preferred strategy by the nonvaccinated. ConclusionMedical concerns and myth-related barriers were the most common reasons for vaccine hesitancy, which could potentially be addressed by providing additional information on COVID-19 vaccination.