Building Trust: The Perspectives of COVID-19 Vaccination Efforts among African American Community Health Workers in HHS Region 4.

Introduction: Viral outbreaks such as COVID-19 have historically and disproportionately impacted low SES communities and communities of color. African Americans were disproportionately impacted by COVID-19 compared to others. At the height of the pandemic, vaccination was critical to mitigating the impact of the highly transmissible SARS-CoV2 virus. Despite this, hesitancy contributed to poor vaccination rates among adults in the United States. African Americans were more likely to report hesitancy and hesitancy associated with medical mistrust and structural barriers. Since vaccination is multifaceted and context specific, factors influencing vaccination should be considered within the appropriate context.

Study purpose: The current study examines perspectives of COVID-19 vaccination efforts among African American Community Health Workers (CHWs) in HHS Region 4 through Critical Discourse Analysis (CDA) using an ecological framework.

Results: Findings indicate equitable vaccination efforts empowered underserved communities. Moreover, findings imply equitable vaccination efforts improved trustworthiness of government and public health officials despite political tensions. Findings also revealed CHWs tend to trust COVID-related information provided by the CDC which is associated with acceptance. Despite religious tensions around vaccination, "The Church" emerged as a trustworthy location to receive COVID-19 information and vaccination.

Conclusion: This research highlights the importance of community-centered public health interventions and trustworthiness. Community Health Workers (CHWs) hold established trust within marginalized communities. "The Church" is a trusted and uniquely positioned institution able to facilitate health interventions and deliver essential health-related services.