Social Networks Influence Vaccine Confidence in Rural Black Americans

BACKGROUND: Despite vaccination being one of the most effective ways to mitigate the impact of vaccine-preventable diseases, immunization coverage is low among rural and minoritized populations. Vaccine hesitancy, which increased during the COVID-19 pandemic, contributes to low immunization coverage despite higher prevalence of and increased risk for severe illness due to vaccine-preventable diseases among rural minoritized adults. OBJECTIVE: Public health efforts to reduce vaccine hesitancy among rural Black Americans require understanding the factors that contribute to vaccine confidence and vaccine uptake. This study identifies how multilevel factors influence vaccine confidence and uptake among rural Black American adults in 3 Northeast Florida counties. METHODS: Four focus groups (N = 34) were conducted, audio-recorded, transcribed, and open-coded in MAXQDA 2022. The social ecological model was used to guide analysis and provide insight into contextual factors influencing vaccine knowledge and confidence, and trust in vaccines. RESULTS: Results show that multilevel variables influence vaccine confidence among rural Black Americans. Social factors, specifically social networks, shape an individual's perception of vaccines at all levels of the social ecological model. CONCLUSION: Public health interventions to increase vaccine uptake among rural Black adults should focus on social networks to enhance the credibility of the information provided by experts.