State of Vaccine Hesitancy in the United States

Glen J. Nowak and Michael A. Cacciatore, “State of Vaccine Hesitancy in the United States,” forthcoming, in an upcoming issue of Pediatric Clinics of North America, a journal that provides the latest clinical information on health issues for children and adolescents. Each bimonthly issue (February, April, June, August, October, and December) focuses on a single topic and is presented under the direction of an experienced editor.

Abstract:  The term “vaccine hesitancy” has achieved great prominence in recent years, but the current state of pediatric vaccine hesitancy among parents in the United States is unknown. Some findings from recent national surveys of parent compliance and intentions suggest that the current state of childhood and adolescent vaccine hesitancy in the United States is relatively stable and mostly positive. Other national survey findings, in concert with information from other sources, suggest a more worrisome picture of the state of parent vaccine hesitancy in the U.S. Three years into a COVID-19 pandemic which has featured multiple new vaccines, disruptions in the administration of routinely recommended childhood and adolescent vaccines, and debates about COVID-19 vaccination recommendations for children, assessments of the state of vaccine hesitancy in the U.S. are especially needed to sustain or achieve needed pediatric immunization uptake. The assessment here does this by 1) overviewing concepts and considerations that help identify evidence or indications of vaccine hesitancy among parents and 2) using the overview as the foundation for surfacing insights into the current state of parent vaccine hesitancy in the U.S. This assessment illustrates the overall state of vaccine hesitancy among parents in the U.S. is not easy to quantify or characterize, including because systematic and significant investments in measuring and monitoring do not exist. Also notable, investments in research that includes sufficient numbers of racial/ethnic groups reflective of the diversity of U.S. parents and caregivers is lacking.

Contextual Pathways Linking Cumulative Experiences of Racial Discrimination to Black American Men’s COVID Vaccine Hesitancy

Curtis, M.G., Whalen, C.C., Ivanka Pjesivac, & Kogan, S. M. (2022) “Contextual Pathways Linking Cumulative Experiences of Racial Discrimination to Black American Men’s COVID Vaccine Hesitancy.” Journal Racial and Ethnic Health Disparities. doi: 10.1007/s40615-022-01471-8

Abstract: The COVID-19 pandemic has revealed and widened racialized health disparities, underscoring the impact of structural inequities and racial discrimination on COVID-19 vaccination uptake. A sizable proportion of Black American men report that they either do not plan to or are unsure about becoming vaccinated against COVID-19. The present study investigated hypotheses regarding the mechanisms by which experiences of racial discrimination are associated with Black American men’s COVID-19 vaccine hesitancy. Hypotheses were tested using structural equation modeling with 4 waves of data from 242 Black American men (aged ~ 27) living in resource-poor communities in the rural South. Study findings revealed that racial discrimination was indirectly associated with COVID-19 vaccine hesitancy via increased endorsement of COVID-19 conspiratorial beliefs. Findings also demonstrated that increased levels of ethnic identity strengthen the association between experiences of racial discrimination and COVID-19 conspiratorial beliefs. In contrast, increased levels of social support weakened the association between cumulative experiences of racial discrimination and COVID conspiratorial beliefs. Taken together, these results suggest that racial discrimination may promote conspiratorial beliefs which undermine Black American men’s willingness to be vaccinated. Future interventions aimed towards promoting vaccine uptake among Black American men may benefit from the inclusion of targeted efforts to rebuild cultural trust and increase social support