"You're Not Dealing with What We're Dealing with": COVID-19 Hesitancies and Motivations Among Late Vaccinating Black Americans in the Deep South.

INTRODUCTION AND

backgroundThe COVID-19 vaccines have been public for several years and have been shown to mitigate symptoms in recipients. Yet many Americans are still hesitant or late to receive the vaccines for several reasons, especially Black Americans. To better understand how Black Americans who reside in the rural Mississippi Delta understand the COVID-19 virus and vaccines, we conducted a qualitative study focusing on their hesitance toward the vaccine, and how they make decisions or change(d) their minds regarding receiving it at intersecting layers of social disadvantage-race and place-based inequalities.

methodsIn 2021, we conducted 10 in-person, in-depth, semi-structured interviews with Black residents of the Mississippi Delta who were vaccinated months after the vaccines' release. We used an iterative, grounded approach to study design and data analysis, as well as the constant comparative method, until data saturation was achieved.

resultsParticipants reported they were initially hesitant toward the vaccines for the following reasons: an overabundance of misinformation, fear of illness, mistrust of decision-making institutions, and uncertainty of unknown side effects. Participants cited several reasons that motivated them to change their minds and receive the vaccine, including positive results when people in their networks vaccinated, increased feelings of safety, work requirements, and faith in God.

conclusionsOur findings unpack the complications around vaccine hesitance and motivations for vaccine uptake for late vaccinators at the intersections of social and racial inequality. Findings underscore the importance of recognizing the pervasive influence of generalized institutional mistrust and spirituality when providing health advice to Black Mississippians about the COVID-19 vaccines.