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In the U.S., Covid-19 has hit communities of color especially hard. In a recent national survey, Black Americans expressed strong concerns about the health threat of Covid-19.
Protecting minority communities with Covid-19 vaccination is critical. This requires understanding systemic barriers to healthcare access and sources of vaccine hesitancy. Many surveys and articles have documented concerns about vaccine development, safety, and effectiveness. Our African American, Latinx, and Native American populations express strong concerns. These may arise from health care mistreatment or inequities they have personally experienced. Past abuses of medical research and care can reduce their trust in vaccination. The Tuskegee syphilis study and the Flint, Michigan water crisis are notable examples. The forced sterilization of Native American and Latina women is another. People with disabilities, sexual and gender minorities may share similar concerns.
Misinformation – often passed on by family and peers – can reinforce fears about the Covid-19 vaccine. These strong community and family ties also present opportunities. Messaging connected to caring for others and community wellbeing is often effective.
KEEP IN MIND
Understand why employees from different communities may be hesitant to get Covid-19 vaccines.
Listen respectfully without judging or minimizing their concerns. People of color and those from immigrant communities may have personally experienced bias and discrimination in health care. They may face ongoing healthcare inequities. They may also have concerns based on documented historical abuses. Employees from other groups that have faced bias and stigma can have similar issues. These include people with disabilities, people in the LGBTQ community, and people who are living in poverty. Acknowledge that these concerns are real and can impact the trust they have in the safety and effectiveness of Covid-19 vaccines. Political beliefs can also shape vaccine hesitancy or acceptance. These often center on the appropriate role or trustworthiness of government.
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Attend to different language and accessibility needs.
Make sure everyone can understand and access the information you provide. Use many formats, such as posters, fliers, presentations, and web-based resources. Offering both print and digital materials will reach people with limited electronic access. You may need to translate and caption materials in different languages. Captioning presentations also meets American with Disability Act (ADA) requirements. Consider archiving live presentations to allow people with different schedules to view them. This also allows family members to watch or help translate the material.
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Communicating Across Cultures
Be sensitive to the cultural concerns of your employees. These may differ by race, ethnicity, religion, national origin, political ideology, and ability. Also pay attention to different levels in vaccine access and different information and language needs.
Recommendations
Engage diverse employees and/or community members in the communication process if possible.
Co-design and/or test materials with people from your different audiences. This makes the messages clearer and more welcoming. It also increases the chance that the messages will be understood accurately. Employee engagement can also increase buy-in. You might consider getting feedback through “think-aloud interviews.” These are when you ask people from your target audiences to read drafts and describe what they mean.
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Provide objective information that addresses the concerns of people from minority communities.
The U.S.-approved vaccines proved to be safe and effective across race, ethnicity, national origin, and disabilities. The Pfizer-BioNTech, Moderna, and Johnson & Johnson / Janssen vaccines were tested in clinical trials. Only three hospitalizations from Covid-19 were reported in the U.S. among those vaccinated.
Importantly, these vaccine clinical trials enrolled some of the largest proportions of people of color to date. People who are Black, Latinx/Hispanic, Asian, Pacific Islander, Native American, and other/mixed race accounted for between 14% and 38% of participants in the U.S. clinical trials, including those for children aged 5 years or older. People with at least one high-risk condition (e.g., severe obesity, diabetes, HIV infection) were also represented at significant levels (between 22% and 46% of participants). Highlighting the diversity of people involved in clinical testing could help calm fears that “people like me” might react badly to the vaccine.
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Don’t underestimate vaccine access issues and concerns.
Do not assume that an employee who hasn't been vaccinated is reckless or opposed to vaccination. They may face structural or logistical obstacles. Common barriers include language, internet access, work or school schedules, childcare, and transportation. Employees without a regular doctor may lack access to health professionals who can answer their questions. Those without health insurance may not know that vaccination is free. People who may worry about exposure to immigration officers need to know that vaccination sites are off limits to ICE.
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Trust in the message is tied to trust in the messenger, so engage diverse messengers.
Consider partnering with community, religious, or medical leaders who are highly trusted. Reach out to those who reflect the diversity of your organization. You can also engage visible and trusted employees who come from different communities. They can be influential pro-vaccine role models and spokespeople. Use testimonials or videos and photos of trusted leaders being vaccinated to show that the vaccine is safe and effective.
In a diverse society, convincing people to be vaccinated often requires different messages for communities that are marginalized. These communities are looking for their concerns to be acknowledged and addressed with objective information. Engaging these communities – and their leaders – can help develop effective messaging. Leaders can play a powerful role as health advocates. Across the U.S., pastors, priests, monks, imams, and rabbis have promoted vaccination in their communities.
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