"Life as We Knew It": Continued Challenges in Getting Up-to-Date COVID-19 Vaccinations Amongst Black and Latinx Michigan Residents.

Background: Minority communities are disproportionately impacted by COVID-19. In Michigan in 2024, 59% of Latinx residents, 46% of Black residents, and 57% of White residents have received at least one dose of the vaccine. However, just 7% of Black residents and 6% of Latinx residents report being up-to-date per CDC definition, versus 13% of White residents. Drawing from protection motivation theory, we aimed to identify barriers to COVID-19 vaccination.

Methods: Interviews with 24 Black and 10 Latinx Michigan residents self-reported as not up-to-date (n = 15) or up-to-date (n = 19) on COVID-19 vaccines were conducted in 2022-2023. We used a community-based participatory approach in collaboration with 16 leaders from 15 organizations to develop research questions, interview protocols, and methods for data collection and analysis. Thematic coding of interviews was conducted.

Results: Findings indicate participants' lack of confidence in the COVID-19 vaccine's efficacy, with those not up-to-date expressing greater doubt. Participants were also concerned about vaccine benefits versus risks, safety, and side effects. Distrust in medicine, confusion about public health guidelines, and conspiracy theories were often reported. Younger unvaccinated individuals cited low health risk as reason to remain unvaccinated. Many participants felt that health education, especially through medical professionals, was beneficial.

Conclusion: There is great need for more data to make informed decisions given ongoing lack of understanding of the public health benefits of COVID-19 vaccination. Identifying drivers of vaccine uptake, particularly boosters, in communities of color and developing age-appropriate and culturally responsive interventions to increase vaccination rates are of utmost importance.