Minority communities are among the hardest hit by the COVID-19 pandemic in the United States, but have lower rates of vaccination than other groups. As of March 11, 2021, the majority of patients who have received at least 1 dose of a COVID-19 vaccine are White (67%); only 9% are Hispanic, 7% are Black, 5% are Asian, 2% are American Indian or Alaska Native, and <1% are Native Hawaiian or Other Pacific Islander.

In a recent webinar hosted by The American Journal of Nursing, nursing experts examined the causes of and strategies to overcome vaccine hesitancy in Black, Hispanic, Orthodox Jewish, and other underserved patient populations.

Vaccine hesitancy often stems from misinformation about vaccine efficacy and safety, lack of trust in the government and pharmaceutical companies, fear of deportation among undocumented immigrants, as well as inaccessible vaccination sites in underserved communities. Some patients wonder if COVID-19 death rates have been inflated for political purposes, if the disease is really that bad, and whether the benefits of the vaccine outweigh the risks of serious adverse effects.


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Kristen Choi, PhD, MS, RN, emphasized the importance of giving the public clear and accurate information and trusting that they can handle, in some cases, complicated information. When administering the COVID-vaccine, clinicians should ask patients about their concerns and take the time to explain how and why the vaccines work, anticipated side effects, and what is happening in the body when side effects occur, she said.

Kristen Choi, PhD, MS, RN
Kristen Choi, PhD, MS, RN

Patients may need to be reassured that none of the COVID-19 vaccines currently in use contain a live virus and cannot cause COVID-19, said Dr Choi, who is an assistant professor of nursing and public health at the University of California, Los Angeles. Also, some patients believe a common conspiracy theory that the mRNA vaccines (Pfizer and Moderna) will alter their DNA, which is not the case.

Facts to counter concerns on vaccine safety were presented by Janell Routh, MD, MHS, of the Centers for Disease Control and Prevention (CDC) and are linked here.

Racism and the COVID-19 Pandemic

In Black communities and other communities of color “we are dealing simultaneously with a pandemic of racism in this country that is rooted in antiblackness and this country’s refusal to reconcile its very racist past,” said Sheldon D. Fields, PhD, RN, CRNP, FNP-BC, AACRN, FAANP, FNAP, FAAN, associate dean for equity and inclusion and research professor at The Pennsylvania State University College of Nursing.  

Sheldon D. Fields, PhD, RN, CRNP,
FNP-BC, AACRN, FAANP, FNAP, FAAN

“The unrest that we all witnessed last summer sparked by the death of George Floyd that led to the rise of the Black Lives Matter movement to the witnessing of the insurrection on January 6, 2021, of our nation’s capital by a white supremacist mob, all feeds into the narrative that tells Black people that their lives matter less,” said Dr Fields, who is also the first vice president of the National Black Nurses Association (NBNA). “So the question then becomes, why should I trust the government?”

In response, the more than 100 chapters of the NBNA “have been meeting with people where they are,” including in rural areas, to offer a trusted voice and to educate patients on facts related to the vaccines, Dr. Fields said.