Are People Hesitating—Or Just Postponing—to Get the Covid-19 Vaccine? Vaccine Outreach in Marginalized Urban Communities

Abstract

Across Philadelphia, approximately 80% of adults are fully vaccinated against Covid-19. However, many zip codes in the city remain far below the city-wide vaccination rate. These zip codes correspond to marginalized sections of the city and to neighborhoods with a high proportion of residents of color and high levels of poverty. In-depth interviews were conducted with representatives from 15 community-based organizations (CBOs) that serve such communities in the city to (1) learn why people are not yet vaccinated and (2) evaluate methods for encouraging vaccination. A qualitative thematic analysis of interview transcripts was conducted to evaluate why people are not getting vaccinated. Together, the findings suggest that distrust toward the vaccine, the government, and the healthcare system, combined with a host of matters considered by residents to be more urgent—such as missing work, cost concerns, and concerns around presenting identification—result in what might be better described as vaccine postponement rather than vaccine refusal. For many, vaccination is simply not a priority. The findings from this analysis illuminate some of the lesser discussed reasons for vaccination delay and provide insights into how to promote vaccinations both for the current Covid pandemic and for future vaccination efforts.