key: cord-0686411-rqwbhut5
authors: Peng, James; Marquez, Carina; Rubio, Luis; Chamie, Gabriel; Jones, Diane; Jacobo, Jon; Rojas, Susana; Rojas, Susy; Tulier-Laiwa, Valerie; Black, Douglas; Martinez, Jackie; Pilarowski, Genay; Cox, Chesa; Derisi, Joe; Havlir, Diane; Petersen, Maya
title: High likelihood of accepting COVID-19 vaccine in a Latinx community at high SARS-CoV2 risk in San Francisco
date: 2021-04-20
journal: Open Forum Infect Dis
DOI: 10.1093/ofid/ofab202
sha: 27a619b8720ebd329ef8d919a5dec0fc8d6aca7e
doc_id: 686411
cord_uid: rqwbhut5

Of 4,133 persons surveyed at a low-barrier COVID-19 test site with high positivity in an urban Latinx community in January 2021, 86% indicated they would accept a COVID-19 vaccination. Top reasons for vaccine hesitancy included concerns around side effects and safety and distrust of healthcare systems.

A c c e p t e d M a n u s c r i p t 2 BACKGROUND Coronavirus disease 2019 (COVID-19) vaccine hesitancy may impede effective epidemic control. Up to 45% of United States residents, and over 50% of Black and Hispanic populations, have been estimated to be reluctant to receive an approved vaccine [1, 2] . As of March 2021, White persons are roughly 2 times more likely to have received a vaccine than Black and Hispanic persons in the United States [3] . We sought to assess vaccine motivation in a low-income urban Latinx community heavily impacted by COVID-19.

Between January 10-24, 2021, we conducted a survey about vaccine attitudes and preferences among adults (aged ≥18) seeking free, no-appointment, BinaxNOW rapid COVID-19 testing [4] in San Francisco's Mission District. Mobilization of the Latinx community in Southeastern San Francisco, a population disparately impacted by the COVID-19 epidemic [5] , was conducted through a community-academic-San Francisco Public Health partnership. Prior to testing, participants completed a short web-based survey (English or Spanish) on demographics, occupation, health-seeking behaviors, and vaccine attitudes, including those of friends and family [2] . We characterized persons as vaccine-hesitant if they indicated that they would -definitely not‖ or -probably not‖ get the vaccine. Predictors of vaccine hesitancy were evaluated using multivariate logistic regression.

A c c e p t e d M a n u s c r i p t 3

Over 14 days, 5,198 adults were tested, of whom 4,133 (79.5%) completed the questionnaire; weather and website outages contributed to non-completion. Of surveyed participants (2, 190 (Table 1) . However, among vaccine-hesitant respondents, 57.1% (330/578) indicated a great or fair deal of trust in doctors, higher than trust reported in local/state government (27.0%, 156/578) or newspapers/TV/radio (19.9%, 115/578).

Effective vaccination strategies for COVID-19 epidemic control must reach persons at highest risk of infection. In a community-based low-barrier testing setting, we reached highrisk persons, including low income, Latinx frontline essential workers and their families. In this priority group, we found that 86% of all respondents and 87% of frontline essential workers indicated they would accept vaccination.

Eighty-four percent of Latinx persons surveyed indicated that they would get a vaccine, substantially higher than prior reports [1] . However, opportunities remain to further increase vaccine motivation in this priority population by addressing concerns around safety and side effects. The relatively high trust in doctors reported by vaccine-hesitant persons also suggests an important role for clinicians in increasing vaccine uptake. Leveraging community leaders and trusted influencers in the social networks of intergenerational households may also be an effective strategy to provide education and information on vaccines.

Because we selected for a population seeking COVID-19 testing, our survey may overestimate vaccine motivation in the general population. However, vaccine acceptance in the general population is of less immediate relevance for epidemic control than acceptance among persons at highest risk of infections. Our mobilization strategy, which by design 

National Trends in the US Public's Likelihood of Getting a COVID-19 Vaccine

Epub ahead of print

KFF Covid-19 vaccine monitor

Latest Data on COVID-19 Vaccinations Race/Ethnicity

Field performance and public health response using the BinaxNOW TM Rapid SARS-CoV-2 antigen detection assay during community-based testing

SARS-CoV-2 Community Transmission disproportionately affects Latinx population during Shelter-in-Place

Epub ahead of print

Centers for Disease Control: When Vaccine is Limited, Who Should Get Vaccinated First? Available at

San Francisco Department of Public Health: COVID-19 Data and Reports

None of the authors have reported conflicts of interests.

The UCSF Human Research Protection Program Institutional Review Board determined that the study met the criteria for public health surveillance.

We obtained verbal and written consent in the participant's preferred language prior to study participation.

A c c e p t e d M a n u s c r i p t M a n u s c r i p t A c c e p t e d M a n u s c r i p t