The Limits of Medical Trust in Mitigating COVID-19 Vaccine Hesitancy among Black Americans

Abstract

A highly anticipated COVID-19 vaccine has the potential to slow the pandemic in 2021. But a preponderance of misinformation, including conspiracy theories spreading through social media, has left much of the American public skeptical of vaccine candidates, and may undermine vaccine adherence. Up to 40% of Americans either do not intend to be vaccinated, or are unsure. Black Americans have borne a particularly disproportionate share of COVID-19 infections, and surveys have revealed higher rates of COVID-19 vaccine hesitancy among Black Americans relative to other racial/ethnic groups. Centuries of medical racism and subsequent medical mistrust among racial/ethnic minorities has left COVID-19 vaccine trials struggling to achieve diverse participation. This casts doubt on many communities’ ability to eventually achieve herd immunity. Efforts to increase trust among Black Americans may help alleviate these problems, but the relationships between race, COVID-19 beliefs, trust, and vaccine hesitancy are complicated. A richer understanding of these dynamics is crucial for diversifying participation in clinical trials and reducing vaccine hesitancy. We used nationally representative survey data from June 2020 to test the hypothesis that Black race would interact with medical trust to undermine COVID19 vaccine willingness.