“Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative study
ABSTRACTHigh levels of COVID-19 vaccine hesitancy have been reported among Black and Latinx populations, with lower vaccination coverage among racialized versus White sexual and gender minorities. We examined multilevel contexts that influence COVID-19 vaccine uptake, barriers to vaccination, and va...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2024-12-01
|
| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/21645515.2023.2301189 |
| _version_ | 1827352859338866688 |
|---|---|
| author | Peter A. Newman Duy Anh Dinh Notisha Massaquoi Charmaine C. Williams Ashley Lacombe-Duncan Suchon Tepjan Thabani Nyoni |
| author_facet | Peter A. Newman Duy Anh Dinh Notisha Massaquoi Charmaine C. Williams Ashley Lacombe-Duncan Suchon Tepjan Thabani Nyoni |
| author_sort | Peter A. Newman |
| collection | DOAJ |
| description | ABSTRACTHigh levels of COVID-19 vaccine hesitancy have been reported among Black and Latinx populations, with lower vaccination coverage among racialized versus White sexual and gender minorities. We examined multilevel contexts that influence COVID-19 vaccine uptake, barriers to vaccination, and vaccine hesitancy among predominantly racialized sexual and gender minority individuals. Semi-structured online interviews explored perspectives and experiences around COVID-19 vaccination. Interviews were recorded, transcribed, uploaded into ATLAS.ti, and reviewed using thematic analysis. Among 40 participants (mean age, 29.0 years [SD, 9.6]), all identified as sexual and/or gender minority, 82.5% of whom were racialized. COVID-19 vaccination experiences were dominated by structural barriers: systemic racism, transphobia and homophobia in healthcare and government/public health institutions; limited availability of vaccination/appointments in vulnerable neighborhoods; absence of culturally-tailored and multi-language information; lack of digital/internet access; and prohibitive indirect costs of vaccination. Vaccine hesitancy reflected in uncertainties about a novel vaccine amid conflicting information and institutional mistrust was integrally linked to structural factors. Findings suggest that the uncritical application of “vaccine hesitancy” to unilaterally explain undervaccination among marginalized populations risks conflating structural and institutional barriers with individual-level psychological factors, in effect placing the onus on those most disenfranchised to overcome societal and institutional processes of marginalization. Rather, disaggregating structural determinants of vaccination availability, access, and institutional stigma and mistrust from individual attitudes and decision-making that reflect vaccine hesitancy, may support 1) evidence-informed interventions to mitigate structural barriers in access to vaccination, and 2) culturally-informed approaches to address decisional ambivalence in the context of structural homophobia, transphobia, and racism. |
| first_indexed | 2024-03-08T03:13:09Z |
| format | Article |
| id | doaj.art-cf79670754be4a49b0706c9d73394d87 |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-08T03:13:09Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-cf79670754be4a49b0706c9d73394d872024-02-13T02:56:48ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2024-12-0120110.1080/21645515.2023.2301189“Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative studyPeter A. Newman0Duy Anh Dinh1Notisha Massaquoi2Charmaine C. Williams3Ashley Lacombe-Duncan4Suchon Tepjan5Thabani Nyoni6Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, CanadaFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, CanadaFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, CanadaFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, CanadaSchool of Social Work, University of Michigan, Ann Arbor, MI, USAVOICES-Thailand Foundation, Chiang Mai, ThailandFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, CanadaABSTRACTHigh levels of COVID-19 vaccine hesitancy have been reported among Black and Latinx populations, with lower vaccination coverage among racialized versus White sexual and gender minorities. We examined multilevel contexts that influence COVID-19 vaccine uptake, barriers to vaccination, and vaccine hesitancy among predominantly racialized sexual and gender minority individuals. Semi-structured online interviews explored perspectives and experiences around COVID-19 vaccination. Interviews were recorded, transcribed, uploaded into ATLAS.ti, and reviewed using thematic analysis. Among 40 participants (mean age, 29.0 years [SD, 9.6]), all identified as sexual and/or gender minority, 82.5% of whom were racialized. COVID-19 vaccination experiences were dominated by structural barriers: systemic racism, transphobia and homophobia in healthcare and government/public health institutions; limited availability of vaccination/appointments in vulnerable neighborhoods; absence of culturally-tailored and multi-language information; lack of digital/internet access; and prohibitive indirect costs of vaccination. Vaccine hesitancy reflected in uncertainties about a novel vaccine amid conflicting information and institutional mistrust was integrally linked to structural factors. Findings suggest that the uncritical application of “vaccine hesitancy” to unilaterally explain undervaccination among marginalized populations risks conflating structural and institutional barriers with individual-level psychological factors, in effect placing the onus on those most disenfranchised to overcome societal and institutional processes of marginalization. Rather, disaggregating structural determinants of vaccination availability, access, and institutional stigma and mistrust from individual attitudes and decision-making that reflect vaccine hesitancy, may support 1) evidence-informed interventions to mitigate structural barriers in access to vaccination, and 2) culturally-informed approaches to address decisional ambivalence in the context of structural homophobia, transphobia, and racism.https://www.tandfonline.com/doi/10.1080/21645515.2023.2301189COVID-19vaccinationvaccine hesitancyvaccine acceptancevaccine equitystructural determinants of health |
| spellingShingle | Peter A. Newman Duy Anh Dinh Notisha Massaquoi Charmaine C. Williams Ashley Lacombe-Duncan Suchon Tepjan Thabani Nyoni “Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative study Human Vaccines & Immunotherapeutics COVID-19 vaccination vaccine hesitancy vaccine acceptance vaccine equity structural determinants of health |
| title | “Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative study |
| title_full | “Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative study |
| title_fullStr | “Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative study |
| title_full_unstemmed | “Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative study |
| title_short | “Going vaccine hunting”: Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults—a qualitative study |
| title_sort | going vaccine hunting multilevel influences on covid 19 vaccination among racialized sexual and gender minority adults a qualitative study |
| topic | COVID-19 vaccination vaccine hesitancy vaccine acceptance vaccine equity structural determinants of health |
| url | https://www.tandfonline.com/doi/10.1080/21645515.2023.2301189 |
| work_keys_str_mv | AT peteranewman goingvaccinehuntingmultilevelinfluencesoncovid19vaccinationamongracializedsexualandgenderminorityadultsaqualitativestudy AT duyanhdinh goingvaccinehuntingmultilevelinfluencesoncovid19vaccinationamongracializedsexualandgenderminorityadultsaqualitativestudy AT notishamassaquoi goingvaccinehuntingmultilevelinfluencesoncovid19vaccinationamongracializedsexualandgenderminorityadultsaqualitativestudy AT charmainecwilliams goingvaccinehuntingmultilevelinfluencesoncovid19vaccinationamongracializedsexualandgenderminorityadultsaqualitativestudy AT ashleylacombeduncan goingvaccinehuntingmultilevelinfluencesoncovid19vaccinationamongracializedsexualandgenderminorityadultsaqualitativestudy AT suchontepjan goingvaccinehuntingmultilevelinfluencesoncovid19vaccinationamongracializedsexualandgenderminorityadultsaqualitativestudy AT thabaninyoni goingvaccinehuntingmultilevelinfluencesoncovid19vaccinationamongracializedsexualandgenderminorityadultsaqualitativestudy |