Vaccine Hesitancy in Black Versus White Americans

The COVID-19 vaccine rollout shed light on vaccine hesitancy, including the so-called “anti-vaxxers,” in the US. One study, published in the Journal of the American Medical Association (JAMA), sought to examine how COVID-19 vaccine hesitancy is stratified by race.

Prior research has found Black Americans typically have high levels of vaccine hesitancy, despite being disproportionally affected by COVID-19 infection and illness. However, few studies have tracked changes in vaccine hesitancy over time. This study, led by researchers from The Ohio State University, compared changes in vaccine hesitancy between Black and White Americans and examined factors that could account for observed differences.

The survey study used a panel design to collect 7 waves of data. It included 1200 English-speaking US adults, recruited from an online nonprobability panel. The investigators followed up with participants every month from December 9, 2020-June 16, 2021.

The primary outcome of interest was self-reported vaccination intention, measured on a scale from 1 (extremely unlikely) to 6 (extremely likely). Opinions on the safety, efficacy, and necessity of COVID-19 vaccination were measured on a 5-point Likert scale.

“As availability of the vaccine approached, and then as it became available, we were hearing as part of the national conversation this assumption that Black Americans would be less likely to seek vaccines because of well-earned distrust shaped by racism,” said Tasleem Padamsee, one of the study’s lead authors. “But we also know that Black Americans are highly motivated to take care of themselves and their communities.”

At the beginning of the study, 38% of Black respondents and 28% of White respondents indicated hesitancy, before COVID-19 vaccines were widely available. By June 2021, 26% of Black participants and 27% of White Participants were hesitant.

Black individuals had significantly higher increases in vaccine intention on the March, April, May, and June 2021 checkpoints. The belief that vaccines are necessary for protection also increased more among Black Americans.

The investigators concluded that the vaccination intentions of Black Americans were initially comparable to White Americans, but increased more steadily and rapidly. Vaccination rates are still lower among Black individuals, but the results suggest this may be due to factors outside of vaccine hesitancy.

“The data suggest that Black communities were particularly focused on ways to protect themselves and their communities as more evidence emerged that vaccines were effective and safe,” said study co-author Kelly Garrett, a communication professor at OSU. “While Black Americans’ intention to get vaccinated has gone up, their actual vaccination rates haven’t gone up as quickly. That suggests that there are other obstacles to vaccination. We have good reason to think that has to do with access, something we must continue to work on,” Garrett said.