Acceptability of COVID-19 vaccines among Black immigrants living in the United States

BACKGROUND: Coronavirus disease 2019 (COVID-19) has disproportionately affected the Black community in the United States (U.S.). The emergency authorization of three COVID-19 vaccines in the U.S.—issued between December 2020 and February 2021—will significantly reduce hospitalizations and deaths due to COVID-19. To date, no published study on COVID-19 vaccine acceptability among Black individuals in the U.S. has examined the unique experiences of Black immigrants. METHODS: Between January and February 2021, we conducted an online quantitative survey of first and second generation Black immigrants across the U.S. (n = 388). We fit bivariate and multivariable multinomial logistic regression models to examine acceptability of the COVID-19 vaccines. RESULTS: Overall, 57% of participants reported that they would get the COVID-19 vaccine immediately if it was available to them or had already received at least one dose of the vaccine, 37% would delay getting the vaccine, and 6% indicated that they would never get the vaccine. Compared to participants who reported that they would get the COVID-19 vaccine immediately/had already received at least one dose, participants who indicated that they would never get the vaccine were more likely to have an associate’s degree or lower [adjusted odds ratio (aOR) 9.25; 95% confidence interval (CI): 2.34 to 36.6] and a bachelor’s degree (aOR 3.79; 95% CI: 1.14 to 12.6) compared to having a master’s degree or higher. Additionally, compared to participants who reported that they would get the COVID-19 vaccine immediately/had already received at least one dose, participants who indicated that they would delay getting the COVID-19 vaccine were more likely to: identify as female (aOR 2.62; 95% CI: 1.45 to 4.72), identify as heterosexual (aOR 4.33; 95% CI: 1.46 to 12.9), report having been employed in healthcare operations and care delivery in the previous 6 months (aOR 2.08; 95% CI: 1.02 to 4.25), and history of a laboratory-confirmed COVID-19 diagnosis (aOR 2.44; 95% CI: 1.15 to 5.19). CONCLUSION: Our results suggest that COVID-19 vaccine hesitancy may be high among Black immigrants in the U.S. We found that lower educational attainment, being female, and employment in healthcare setting were associated with vaccine refusal and delay. Culturally-relevant interventions are needed to ensure optimal vaccination rates among this vulnerable population.