Are People Hesitating-Or Just Postponing-to Get the Covid-19 Vaccine? Vaccine Outreach in Marginalized Urban Communities

Across Philadelphia, approximately 80% of adults are fully vaccinated against Covid-19. However, many zip codes in the city remain far below the city-wide vaccination rate. These zip codes correspond to marginalized sections of the city and to neighborhoods with a high proportion of residents of color and high levels of poverty. In-depth interviews were conducted with representatives from 15 community-based organizations (CBOs) that serve such communities in the city to (1) learn why people are not yet vaccinated and (2) evaluate methods for encouraging vaccination. A qualitative thematic analysis of interview transcripts was conducted to evaluate why people are not getting vaccinated. Together, the findings suggest that distrust toward the vaccine, the government, and the healthcare system, combined with a host of matters considered by residents to be more urgent-such as missing work, cost concerns, and concerns around presenting identification-result in what might be better described as vaccine postponement rather than vaccine refusal. For many, vaccination is simply not a priority. The findings from this analysis illuminate some of the lesser discussed reasons for vaccination delay and provide insights into how to promote vaccinations both for the current Covid pandemic and for future vaccination efforts.

Automated summary

Approximately 80% of adults in Philadelphia are fully vaccinated against Covid-19, but many zip codes in the city have significantly lower vaccination rates, particularly in marginalized communities with residents of color and high poverty levels. In-depth interviews with representatives from 15 community-based organizations were conducted to understand the reasons behind the low vaccination rates and to evaluate strategies for promoting vaccination. The qualitative analysis revealed that vaccine postponement, rather than refusal, is a result of distrust towards the vaccine, government, and healthcare system, as well as more urgent concerns such as work, cost, and identification issues. The findings shed light on lesser discussed reasons for vaccination delays and offer insights for promoting vaccinations during the current pandemic and future efforts.