Evaluating Racial Identity as a Characteristics for use in Tailored Interventions Designed to Reduce Vaccine Hesitancy in Black/African American Adults.

Vaccine hesitancy is a growing concern in public health. Since its introduction, Black/African Americans have been less likely to receive the first dose of the COVID-19 vaccine despite the alarming death rate observed for this community. Past studies on vaccine hesitancy have placed an emphasis on the role of parental decision-making in their child's vaccination. In this study, we explore how the role of racial identity contributes to COVID-19 vaccine hesitancy among Black/African American adults, as a foundational step prior to tailored intervention development. We administered a survey to a convenience sample of 501 Black/African American individuals in Detroit. Random forest models were built to predict vaccine hesitancy using demographics, racial factors, perceived vaccine risk, and perceived risk of contracting COVID-19 (COVID-19 risk). We observed eight important variables predictive of vaccine hesitancy including perceived vaccine risk, trait reactance, age, vaccine actual knowledge score, perceived COVID risk, conspiracy theories, racial consciousness, and racial fairness. The prediction accuracy of these eight variables combined was high, achieving an Area Under the Curve (AUC) of 0.87, a sensitivity of 75%, and a specificity of 89%. In this convenience sample of Black/African Americans, racial variables, among other factors, were associated with vaccine hesitancy. Given that tailored interventions have shown promise in behavior change, results suggest that these variables may be effective in targeting the concerns of Black/African American adults contemplating receipt of the COVID-19 vaccine.