Critical Dynamics in Black and Latino Parents’ Perceptions of Childhood COVID-19 Vaccination: How the “Middle” Moves

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Abstract

National and state data show low adoption of childhood COVID-19 vaccinations, despite emergency use authorizations and availability. We conducted 24 in-depth, semi-structured interviews with Black and Latino parents in New York City (15 in English, 9 in Spanish), who were undecided or somewhat likely to vaccinate their 5 to 11-year-old children in early 2022. The interviews explored the evolution of parental perceptions on childhood COVID-19 vaccines, and were analyzed using a matrix-driven rapid approach to thematic analysis. We present our findings as themes oriented around trust at three levels of the social ecological model. In summary, we found that structural positionality and historical traumas of participants seeded mistrust in institutions and government. This led to parental reliance on personal observations, conversations, and norms within social groups for vaccine decision-making. Our findings also describe key features of trust-building, supportive conversations that shaped the thinking of undecided parents. This study demonstrates how relational trust becomes a key factor in parental vaccine decision-making, and suggests the potential power of community ambassador models of vaccination promotion for increasing success and rebuilding trust with members of the “movable middle.”

Acknowledgments

The authors are grateful to the CUNY Graduate School of Public Health and Health Policy’s NY VLC and HHI and their networks of community partners for supporting recruitment for this project. In particular, we thank Hannah Stuart Lathan, Karen Ortiz, and Deborah Levine. We also benefitted immensely from input and insights from Lauren Rauh, Hannah Stuart Lathan, Dr. Karen Flórez, and Dr. Chloe Teasdale. Finally, we deeply thank our 24 participants for generously sharing their perspectives and experiences.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Centers for Disease Control and Prevention under Grant U48DP006396 (TH, principal investigator).