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Alabama CEAL study finds evidence of vaccine hesitation due to mistrust

  • November 19, 2021

The study concluded that participants were hesitant to receive the COVID-19 vaccine due to mistrust, fear and lack of information.

Written by: Anne Heaney
Media contact: Adam Pope


Female doctor wearing a face mask giving vaccine to a mature patient in her clinic. General practitioner giving flu shot to a senior woman in clinic. Informed by these findings, the Alabama CEAL team will continue to provide consistent messages from trusted sources to decrease vaccine hesitancy.Researchers with the Alabama Community Engagement Alliance (CEAL) Against COVID-19 Disparities, which is part of the National Institutes of Health’s CEAL, recently published findings from a study focused on understanding vaccine hesitancy among African American and Latinx communities. 

The American Journal of Health Promotion’s published study, “Exploring COVID-19 Vaccine Hesitancy among Stakeholders in African American and Latinx Communities in the Deep South through the Lens of the Health Belief Model,” concluded that participants were hesitant to receive the COVID-19 vaccine due to mistrust, fear and lack of information. Participants who were African American and Latinx stated that they preferred to wait and see the long-term effects of the vaccine by watching how others react to it first.  

Participants, all from Jefferson, Dallas and Mobile counties in Alabama, were further concerned about what they felt was the rushed development of the vaccine, unknown long-term side effects and the efficiency of the vaccine. All the focus groups mentioned the historical impact of the Tuskegee Syphilis Study as a source of mistrust, and the term “guinea pig” was also used, with several people mentioning they did not want to be part of an experiment.

“We’re listening to what people have to say,” said Mona Fouad, M.D., lead investigator for Alabama CEAL and director of the University of Alabama at Birmingham’s Minority Health and Health Disparities Research Center. “Our goal is to increase Alabama’s number of vaccinated residents, and the best way to accomplish this is to hear what the communities are saying and help them form their own opinions based on the facts.” 

Informed by these findings, the Alabama CEAL team will continue to provide consistent messages from trusted sources to decrease vaccine hesitancy.

“Addressing concerns — which may be mistrust of a system, fear of getting coronavirus and needing more information — falls into an educational model of listening to communities and providing them with truthful, science-based information about strategies to mitigate risk for COVID-19,” said George Mensah, M.D., director of the Center for Translation Research and Implementation Science at the National Heart, Lung, and Blood Institute and co-lead of the NIH CEAL initiative.  

Authors of the publication include Lori Bateman, Ph.D.; Allyson G. Hall, Ph.D.; William A. Anderson, Ph.D.; Andrea L. Cherrington, M.D.; Anna Helova, DrPH; Suzanne Judd, Ph.D.; Robert P. Kimberly, M.D.; Gabriela Oates, Ph.D.; Tiffany Osborne; Corilyn Ott, Ph.D.; Melissa Ryan; Christian Strong; and Mona N. Fouad, M.D.

Alabama Community Engagement Alliance Against COVID-19 Disparities

Ethnic and racial minority communities have been disproportionately affected by the COVID-19 pandemic. The National Institutes of Health funded an effort to provide trustworthy information through active community engagement and outreach to those hardest hit by COVID-19, including African Americans, Hispanics/Latinos, and American Indians. The NIH Community Engagement Alliance Against COVID-19 Disparities, or CEAL, leads efforts in 11 states: Alabama, Arizona, California, Florida, Georgia, Louisiana, Michigan, Mississippi, North Carolina, Tennessee and Texas. By promoting and facilitating the inclusion and participation of underrepresented communities in vaccine and therapeutic clinical trials, CEAL hopes to successfully prevent and treat the disease. 

At UAB, investigators have leveraged the infrastructure and community partnerships of the UAB Minority Health and Health Disparities Research Center, the Center for Clinical and Translational Science, and the schools of Medicine, Public Health and Health Professions. Community engagement efforts have been launched to help reduce the impact of COVID-19 on the most vulnerable populations and to evaluate these efforts through community-engaged research.