Study: Vaccine Hesitancy Among Some African Americans Due to Young Age, Housing Insecurity

A survey of mostly African American adults living in and around a large Georgia city found the highest rates of COVID-19 vaccine hesitancy among individuals between 18 and 29 years of age.

The results showed that the strongest reason for vaccine hesitancy among younger individuals is the belief that their risk of developing severe COVID-19 is low because of their younger age and not having any serious chronic medical conditions. Housing insecurity during COVID-19, which is defined as difficulty making rent or mortgage payments and eviction, increased the odds of vaccine resistance and was the second strongest association the researchers found.

The study, conducted by Augusta University, was among the first to examine factors related to vaccine hesitancy among a large African American community sample, according to the authors.

“These findings highlight an important issue and necessity for innovative and proactive approaches in reaching two vulnerable populations: the younger (African American) population that may believe that their risk of severe COVID-19 and mortality are low due to their youth and little to no chronic medical conditions, and participants with housing insecurity due to COVID-19 who may have limited or no reliable interactions with health care systems,” the investigators said in a press release.

The researchers surveyed 257 adults living in Augusta and the surrounding communities of Hephzibah, Georgia, and North Augusta, and Aiken, South Carolina, during 6 events from December 5, 2020, until April 17, 2021. The team asked a variety of demographic and health behavior questions, in addition to COVID-19-specific questions. Responders were classified as resistant, hesitant, or acceptant of receiving the new COVID-19 vaccines.

The survey found that 31.9% were hesitant or resistant to receiving a vaccine, and those who were hesitant were more likely to be younger, at a median age of 31 years. Conversely, 57.1% of those who were considered resistant were female and more likely to be employed full time but less likely to have health insurance. This group had fewer comorbidities than vaccine-acceptant individuals, but were more likely to be smokers than those in the other 2 categories and less likely to receive a flu shot, according to the survey.

Among those who are resistant, 33.3% reported housing insecurity, compared with 10% and 6.9% for hesitant and acceptant participants, respectively. Further, approximately half of the participants had not been tested for COVID-19 when they were surveyed. The study authors feel that this is more evidence that “public health prevention strategies and infrastructures have largely failed to protect communities of color, low-income neighborhoods, essential workers and those with variable employment status.”

A lack of trust resulting from medical exploitation and abuse is connected to ethnicity, in addition to racial inequities, as a part of the COVID-19 disease burden on African American individuals, according to the study authors.

Dr. Justin Xavier Moore, epidemiologist at the Medical College of Georgia at Augusta University, noted that both Black men and women have a higher allostatic load at a younger age compared to their non-Hispanic white counterparts.

“Allostatic load is the wear and tear on the body due to external stressors that happen within your environment over a life course,” Moore said in a press release. “If one group is under elevated stress simply because of their complexion, compared to their counterparts, their reaction to everything is going to be different. It’s going to explain some of the environment-gene interactions we are seeing.”

The investigators are hoping to continue having targeted conversations to find the reasons behind them after learning about the key factors of hesitancy.

“To maximize the efficacy of a vaccine, you want nine out of 10 people saying they will get it,” Moore said in a press release. “We had more than 30%, about one-third, saying they are not going to get vaccinated. We wouldn’t be here if we would have had a larger uptake of the vaccine within the first three or four months of it being available. We wouldn’t have the issues we’re seeing regarding increasing rates of COVID-19 infection.”

REFERENCE

Young age, housing insecurity primary factors in vaccine hesitancy among African Americans. Augusta University. August 23, 2021. Accessed August 23, 2021. https://jagwire.augusta.edu/young-age-housing-insecurity-primary-factors-in-vaccine-hesitancy-among-african-americans/