UGA researchers identify factors of COVID-19 vaccine hesitancy

Four years after the release of the COVID-19 vaccine, University of Georgia College of Public Health researchers are still exploring what factors contributed to COVID-19 vaccine hesitancy—and how those factors remain at play today.

A new study, published in the Journal of Racial and Ethnic Health Disparities, examines attitudes toward COVID-19 vaccination among African Americans in Albany, Georgia—one of the hardest-hit communities during the early waves of the pandemic.

Identifying hesitancy and health concerns

Researchers surveyed about 1500 African American adults between October 2022 and July 2023, reviewing concerns, trusted information sources, and practical barriers to vaccination. They found that worries about health, safety, and misinformation topped the list of reasons people were hesitant about vaccination.

Concerns included long-term health effects and common myths about vaccines, for example, nearly 3/4 of unvaccinated individuals cited blood clots as a worry, and 60% believed the myth that vaccinations led to miscarriages in pregnant women. By comparison, a lower proportion, about 40% and 30% believed blood clots were a concern and led to miscarriage, respectively.

Providing clear information

When exploring what messages influence opinions on vaccines, researchers found that factual resources were key.

“Providing more fact-based information was identified as a key vaccination promotion strategy, not just in the already vaccinated group, but also among those who had not yet been vaccinated but are willing to get vaccinated,” said Biplav Tiwari, a doctoral student in the College of Public Health.

About 85% of vaccinated respondents said they wanted to learn more about the vaccine and 88% were “willing to get vaccinated if my healthcare provider recommends [it],” compared to 70% and 66%, respectively, of non-vaccinated respondents. Among non-vaccinated respondents who identified themselves as willing to be vaccinated in the future, those numbers increased to nearly 82% and 70%, respectively.

This finding highlights that clear, evidence-driven details about side effects and benefits could persuade hesitant individuals, Tiwari added. Participants pointed to healthcare providers—doctors, nurses, and local health departments—as their most trusted sources, rather than social media or broad public campaigns.

Surprisingly, while faith leaders often play a big role in community health initiatives, this study found that a lower proportion of vaccinated (83%) and unvaccinated (55%) individuals said they were willing to be vaccinated if recommended by a spiritual advisor compared to when recommended by health professionals (88% and 66%, respectively).

Janani Rajbhandari, PhD

“It is a good thing that people want to hear from the health care workforce including health departments and nurses in addition to physicians. This is doable,” said Associate Professor of Health Policy & Management Janani Rajbhandari. “But we must remember that the US South lacks health care access.”

Future interventions and next steps

Ultimately, this study highlights the importance of seeking community input and tailoring vaccination interventions to their needs. Respondents’ desire for clear, factual vaccine information shows that community outreach and intervention is a powerful tool toward reducing hesitancy, researchers said. But these approaches will differ from community to community.

“The one approach fits all does not work because different populations have different hesitancy,” she said. “Identifying where the barriers are coming from before investing in health promotion activities is important. We need to know our population.”

With new variants and updated vaccines on the horizon, these insights will help public health teams tailor their limited resources for maximum impact.

“Regardless of where and when in the timeline we are post-COVID-19, vaccination efforts are always going to be important,” Rajbhandari said. “There is always going to be a subsection of the population that will be hesitant for one reason or another and efforts are needed to identify reasons behind the hesitant and confirm it is not lack of access.”

By Erica Techo