Understanding Hesitant Adopters

ABSTRACT COVID-19 has become one of the leading causes of death in the United States (US), and racial and ethnic minority groups experience higher risks of exposure, hospitalization, and death due to COVID-19. Population immunity through the uptake of a vaccine is critical to stopping the spread of COVID-19; however, racial and ethnic disparities in vaccine hesitancy raise concerns about whether vaccination programs will further widen COVID-19 disparities. Minority populations have reported greater hesitancy to get the COVID-19 vaccine, with some communities of color half as likely to get the COVID-19 vaccine compared to Whites. To reduce disparities in COVID-19-related morbidity and mortality, we must understand and address racial disparities in vaccine behavior. The proposed study will utilize a mixed-methods nested-study approach including two steps of data collection. Data will be collected using random digit dialing to conduct a cell and landline phone survey of adult Arkansans (N=1800). Then, we will utilize a purposeful/random sample (N=50) drawn from the phone survey participants who are hesitant adopters (i.e., expressing both hesitancy and having received the COVID- 19 vaccination) for qualitative data collection. The purposeful sample for the qualitative portion will provide rich qualitative data on hesitant adopters. Both sampling methods will oversample Black/African American and Hispanic/Latino participants. Our specific aims are: Aim 1. Examine characteristics associated with vaccine hesitancy/willingness and vaccine behavior (e.g., vaccinated or not) between and within racial/ethnic groups using quantitative methods (random sample of N=1800) informed by the Increasing Vaccination Model. Aim 2. Examine the characteristics that distinguish hesitant adopters from hesitant non-adopters using quantitative methods (random sample of N=1800) informed by the Increasing Vaccination Model. Aim 3. Examine the role of thoughts and feelings, social processes, motivations and practical issues in the process of becoming compliant among those who are hesitant and get vaccinated using qualitative methods (purposeful random sample N= 50) in a nested design informed by the Increasing Vaccination Model. Although there is much research documenting the problem of vaccine hesitancy and differences in hesitancy based on race and ethnicity, almost no studies provide information about what might be done about it. Examining those who are hesitant but are vaccinated is key to better understanding factors which might increase uptake despite hesitancy. This study will provide new and actionable information that researchers and healthcare providers can use to create interventions to increase vaccination uptake among the hesitant.