Examining Predictors of Vaccine Trial Engagement Outcomes among Sexual and Gender Minority LatinX Communities through an Explanatory Mixed Methods Design

The COVID-19 pandemic simultaneously highlights the potential for mRNA vaccines as well as the realities of vaccine hesitancy and health inequity among specific communities such as LatinX populations. LatinX populations were underrepresented in mRNA vaccine trials for COVID-19 much like they have been underrepresented in clinical trials previously. This limits our understanding of vaccine campaign rollout in Latinx communities. To this point LatinX populations were less likely to be vaccinated against COVD-19 and more likely to die from COVID-19 than non-LatinX white populations. LatinX populations are diverse in regard to immigration status, race, primary language, nation of origin, and socio-economic status, yet we have limited understandings of how these factors impact clinical trial participation or vaccine hesitancy in LatinX populations. mRNA vaccine trials are also starting to address viruses that disproportionately impact lesbian, gay, bisexual, and transgender (LGBT) populations such as HIV and herpes. LatinX LGBT populations face greater health disparities among LGBT populations. Yet very little if any research has focused on LatinX LGBT experiences or perceptions of clinical trials such as mRNA vaccine trials. For mRNA technologies to reach their full potential for addressing viruses in LGBT and LatinX communities it is important to examine clinical trial participation at the critical juncture of race/ethnicity, sexuality, and gender. The primary goal of the proposed study is to identify opportunities for improved equity in mRNA vaccine trial participation among LGBT LatinX populations through an explanatory mixed-methods approach. An existing team well-established in LGBT and Latinx health disparities (the Center of Population Sciences for Health Equity in Florida State University's College of Nursing) and a local community partner that serves LGBT LatinX populations in Palm County, Florida (Compass) proposes an explanatory mixed-methods study to address vaccine trial participation, perceptions of mRNA, immigration background, and possible related factors among LGBT LatinX populations. The proposed U01 study will address vaccine trial participation inequities through two phases: (1) identify sub- group characteristics associated with reduced interest in mRNA vaccine clinical trial participation in a sample of LatinX LGBT people in South Florida (N = 600, 300 first generation immigrants, 300 2+ generation), and (2) Understand reasons for reduced interest in clinical trial participation and collect perspectives on possible avenues for increasing participation using qualitative in-depth interviews (N = 60). Findings will be used to identify possible avenues of increasing equity in LGBT LatinX participation in mRNA vaccine trials and clinical trials more broadly.