Racial differences in vaccine acceptance in a rural southern US state

IntroductionTo assess vaccine acceptance among adults living in a largely rural Southern state. MethodsData were collected between October 3 and October 17, 2020 using random digit dialing. Participants included residents aged 18+, able to understand English or Spanish, and provide informed consent. The primary outcome was a multi-dimensional COVID-19 vaccine acceptance measure. Scores varied between -3 to +3. ResultsThe sample (n=1,164) was weighted to be representative of the states population. Black participants had the lowest overall vaccine acceptance (0.5) compared to White participants (1.2). Hispanic participants had the highest scores (1.4). In adjusted models, Black participants had 0.81 points lower acceptance than White participants, and Hispanic participants had 0.35 points higher acceptance. Hispanic participants had the highest scores for all five vaccine acceptance dimensions, relatively equivalent to White participants. Black participants had consistently lower scores, especially perceived vaccine safety (mean -0.2, SD 0.1). ConclusionsThe lowest vaccine acceptance rates were among Black participants particularly on perceived vaccine safety. While Black participants had the lowest acceptance scores, Hispanic participants had the highest. This variability shows the value of a multi-dimensional vaccine acceptance measure to inform COVID-19 vaccination campaign strategies.