COVID-19 Vaccine Hesitancy and Uptake among Caribbean, Latino/a, Native American, and Middle Eastern/North African Populations in Detroit and Surrounding Counties: A Qualitative Study

As of December 20, 2022, 2,977,727 confirmed cases and 40,657 deaths were identified in Michigan. COVID-19 vaccine uptake rates have remained below average throughout the state. Vaccine hesitancy has been operationalized to include the constructs of convenience, complacency, and confidence. While vaccine hesitancy is a global concern, vaccine decision-making is integrated within local sociocultural and historical contexts. Qualitative data were collected to identify factors contributing to decisions about vaccine uptake through focus group discussions with Caribbean, Latino/a, Native American, and Middle Eastern groups living in the Detroit tri-county area. Outreach for recruitment of participants was through local community-based organizations. Data were collected in English, Spanish, and Arabic. In relation to convenience, concerns included loss of work time in the event of side effects, transportation issues, and fears of legal ramifications for undocumented residents at vaccination sites. In terms of complacency, most respondents perceived COVID-19 to be a serious disease in terms of risk of long-term effects and death. There were also many concerns about the emotional and social impact of the pandemic including anxiety, social isolation, and inconsistencies in information and adherence to preventive practices (e.g., masking). Vaccine confidence was discussed within historical and extant traumas within respondents’ communities. Overall, participants expressed positive views about information received about COVID-19 and vaccines from healthcare providers but were more skeptical about information from national health resources and the media. Despite multiple concerns, several respondents decided to take the vaccine to protect family members more vulnerable to poor outcomes.