Drs. Ramsey-Goldman and Feldman's work was supported by the NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant R01-AR-080089). Dr. Feldman's work was supported by the Rheumatology Research Foundation (R Bridge award).

Author disclosures and a graphical abstract are available online at https://onlinelibrary.wiley.com/doi/10.1002/acr.25172.

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Abstract

Objective

Disparities in COVID-19 vaccine and booster uptake persist. This study aimed to obtain perspectives from community and physician stakeholders on COVID-19 vaccine and booster hesitancy and strategies to promote vaccine uptake among Black individuals with rheumatic and musculoskeletal conditions.

Methods

We invited community leaders and physicians in greater Boston and Chicago to participate in semi-structured interviews using a moderator guide developed a priori. Participants were queried about how to best address vaccine hesitancy, strategies to target high-risk populations, and factors to identify future community leaders. Interviews were audio recorded, transcribed verbatim, and analyzed thematically using Dedoose.

Results

A total of 8 physicians and 12 community leaders participated in this study between November 2021 and October 2022. Qualitative analyses revealed misinformation/mixed messaging and mistrust, with subthemes including conspiracy theories, concerns regarding vaccine development and function, racism and historical injustices, and general mistrust of health care systems as the top cited reasons for COVID-19 vaccine hesitancy. Participants also shared demographic-specific differences, such as race, ethnicity, age, and gender that influenced the identified themes, with emphasis on COVID-19 vaccine access and apathy. Strategies for community-based vaccine-related information dissemination included personal storytelling with an iterative and empathetic approach, while recognizing the importance of protecting community leader well-being.

Conclusion

To increase vaccine uptake among Black individuals with rheumatic conditions, strategies should acknowledge and respond to racial/ethnic and socioeconomic injustices that engender vaccine hesitancy. Messaging should be compassionate, individually tailored, and recognize heterogeneity in experiences and opinions. Results from these analyses will inform a planned community-based intervention in Boston and Chicago.

Supporting Information

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Citing Literature

Volume75, Issue12

December 2023

Pages 2508-2518

Filename	Description
acr25172-sup-0001-Disclosureform.pdfPDF document, 1.7 MB	Disclosure Form
acr25172-sup-0002-FigureS1.docxWord 2007 document , 23.1 KB	Supplementary Figure 1. Total number of times theme or subtheme was mentioned, stratified by physician and community leader title.
acr25172_sup-0003-Supplementary_Material_1.docxWord 2007 document , 15.1 KB	Supplementary Material 1. Moderator Guide for Interview of Community Leaders
acr25172_sup-0004-Supplementary_Material_2.docxWord 2007 document , 14.4 KB	Supplementary Material 2. Moderator Guide for Interview of Physicians