Audience Insights & Messaging Guidance for Black, Hispanic, American Indian and Alaska Native Communities

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Updated: October 11, 2021

COVID-19 disproportionately affects Black, Hispanic, American Indian and Alaska Native communities at every stage—they experience higher risk of exposure through jobs and living situations, higher rates of illness and death and greater economic losses. Throughout the pandemic, Black, Hispanic, American Indian and Alaska Native people have died from COVID-19 at more than twice the rate of white Americans while receiving vaccinations at dramatically lower rates.

This is the result of long-standing inequities in physical, economic, cultural and social environments that put many people from these and other racial and ethnic groups at increased risk of getting sick and dying from COVID-19, restrict availability of paid time off and healthcare, and limit access to vaccines.

This plays out in personal ways for your employees and workers. Consider this: a Pew Research study in September 2021 found that 82% of Black Americans are likely to say they know someone who has been hospitalized or died as a result of COVID-19, compared with 78% of Hispanic, 70% of White and 64% of Asian-American adults.

At the same time, concern about COVID-19 vaccines continues to remain higher among many Black and Hispanic people for reasons detailed below. That level of concern has decreased and the intention among these groups to get vaccinated has increased—but closing racial gaps in the pandemic will require a continuous effort to earn trust in and ensure access to vaccines.

Conversations and stories matter. This document shares audience insights to help you better understand some of the key issues and concerns among Black, Hispanic, American Indian and Alaska Native populations, recognizing that no population shares all of the same beliefs, perceptions and concerns. It also includes considerations for your messaging and outreach.

NOW AVAILABLE! We offer a Vaccine Education Program for Employee Resource Groups (ERGs) and Diversity, Equity and Inclusion (DEI) leaders. This interactive workshop will prepare you to powerfully engage members of your community who may have unique concerns about vaccines or need extra support.

Register for a free upcoming workshop

Audience Insights

Common concerns across Black, Hispanic and American Indian and Alaska Native populations:

  • Mistrust in the speed and safety of the vaccine development process.
  • Questions about vaccine safety and efficacy.
  • Distrust of government and corporate motives.
  • Concerns about the vaccines’ potential side effects—leading many to say they will “wait and see” how a COVID-19 vaccine works for others before they would get it.
  • Current experience with medical abuse and disrespect from the healthcare industry.
  • A history of discrimination in health care, and a history of unethical and devastating practices in medicine and science. 
  • Lack of equitable access to the vaccines for some people who want them. 

Specific concerns among some Black Americans:

  • According to research conducted by the Ad Council and the COVID Collaborative, Black Americans initially reported higher levels of hesitancy to COVID-19 vaccines in part due to both personal experience of medical abuse and a history of unethical practices in medical research (e.g., the Tuskegee experiments), as well as systemic healthcare inequities, especially laid bare by the pandemic.
  • Black Americans tend to question just how open, diverse and transparent vaccine conversations will be, as they often feel excluded from other health-related discussions. More than one-third of Black Americans say they have experienced racial discrimination when going to a doctor, hospital or health clinic. 
  • About half of Black women (53%) and men (45%) say that they trust the health care system to do what is right for them and their community “only some” or “almost none” of the time. 
  • While Black Americans were more likely than other groups to want to “wait and see” how the COVID-19 vaccine works for others before getting it themselves (24%),vaccine hesitancy has decreased, in part because stories shared by peers who have received the vaccine helped to normalize vaccination and ease fears.
  • Providing accurate information about side effects may be key to communicating with this group. Research conducted in February 2021 showed that among those not yet vaccinated, large shares of Black women (87%) and men (61%) said they were worried they might experience serious side effects from a COVID-19 vaccine. Many Black women (69%) and men (65%) who had not yet gotten vaccinated also said they did not have enough information about vaccine side effects.
  • About one in five (19%) Black women say they “definitely will not” get vaccinated for COVID-19, larger than the share of Black men (7%) who say the same. This greater reluctance may be related to Black women’s higher levels of concerns about side effects. In addition, among those not yet vaccinated, many more Black women (68%) than men (38%) say they worry about contracting COVID-19 from a vaccine, underscoring the importance of vaccine education. 

Specific concerns among some Hispanic Americans: 

  • Research from the Ad Council and COVID Collaborative shows that vaccine hesitancy among Hispanics is primarily driven by a lack of confidence in the information they’ve received.
  • Lack of clear, consistent and culturally relevant information about vaccines and the virus—in appropriate languages and cultural contexts and aligning with health literacy best practices—fuels mistrust. In addition, 20% of Hispanics say they have experienced racial discrimination when going to a doctor, hospital or health clinic.
  • Some Hispanic people who are undocumented or who have family members who are undocumented have unique concerns around vaccine accessibility and the safety of using a government program. Note that the U.S. Department of Homeland Security (DHS) has committed to ensuring that every individual who needs a vaccine can get one, regardless of their immigration status.
  • Hispanic Americans who wanted to “wait and see” had similar feelings to Black Americans, as detailed above, according to research conducted in February 2021. And while disparities across race remain, data from October 2021 shows that those disparities are narrowing, particularly for Hispanic people. There continue to be opportunities to correct misperceptions about how the vaccine works and to share stories from others in the community who have had the vaccine.

Specific concerns among some American Indians and Alaska Natives:

  • According to the Indigenous Futures Survey, 81% of Native peoples feel their experiences with COVID-19 are overlooked in mainstream media, in addition to being invisible in most mainstream contexts.
  • Lack of trust in vaccines and the government has historical roots, from failure to deliver on treaties and other agreements to the weaponization of disease. For example, in the 18th century, colonists intentionally gave smallpox-contaminated blankets to Native Americans, killing at least 30% of the Native population on the Northwest coast.
  • The federal government has underfunded healthcare for American Indian and Alaska Native people for centuries and COVID-19 deaths of American Indians have been linked to limited access to resources and healthcare. Twenty-three percent of American Indians and Alaska Natives have experienced racial discrimination when visiting a non-Tribal doctor, hospital or health clinic. 

Messaging Considerations

  1. Conversations should focus on the agency of individuals and their freedom to make decisions that are best for themselves and their families, with the help of fact-based, trusted information about vaccine safety and efficacy.
  2. Lead with empathy and acknowledge that it’s normal to have questions about vaccines. It’s also OK to want more information before making a decision.
  3. Acknowledge the deep historical traumas and inequities that have created increased risk of infection and death from COVID-19, concerns and questions about COVID-19 vaccines and distrust in government and healthcare systems generally.
  4. Transparency is key to trust building; according to research, greater information about how vaccines work and how they were developed and tested leads to greater willingness to take the vaccine.
  5. Offer facts to help answer questions and ease concerns, but take care not to continually reinforce higher rates of hesitancy (which may create the perception that “no one trusts it”) or imply blame for lower rates of vaccination. In fact, as hesitancy decreases, noting improved vaccination rates across demographic groups can help build confidence in the vaccines.
  6. Avoid language that diminishes concerns or tries to convince. Instead, focus on providing facts about vaccine safety and efficacy. Listen for what’s holding people back and help them find their own reason to get vaccinated. Andand encourage individuals with additional questions to speak with their doctor or healthcare provider.

Our Communications Guidance and Key Messages for Employees offer a good starting point. The most important thing is to deliver consistent, fact-based information about vaccine safety and efficacy.

In addition, you might emphasize these messages: 

  • It’s OK to have questions and concerns about vaccines. We want you to have the best information from trusted experts to help you make the decision you believe is best for you and your family. 
  • Access our vaccine fact sheet, FAQ and conversation guide. We also offer several resources in Spanish.)
  • Access our guidance for responding to myths and sensitive questions.
  • This video, from the nonprofit National Alliance of Healthcare Purchaser Coalitions, features healthcare professionals and other speakers from a diversity of racial and ethnic communities.
  • The vaccines available today are authorized by FDA after meeting the agency’s rigorous requirements for safety and efficacy, as shown in clinical testing. They have been studied in clinical trials in large and diverse groups of people, of various ages, gender identities, races and ethnicities.
  • The vaccine development process is heavily regulated and transparent. For COVID-19, a diverse group of doctors and public health practitioners were assembled to ensure that the vaccine was safe and effective across racial groups. 
  • Dr. Kizzmekia Corbett, who is a Black woman, is credited as one of the lead scientists at the National Institutes of Health (NIH) who helped develop the Moderna vaccine.
  • DHS and its federal government partners fully support equal access to COVID-19 vaccines and vaccine distribution sites for undocumented immigrants.
  • U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection will not conduct enforcement operations at or near vaccine distribution sites or clinics. 
  • Consistent with ICE’s long-standing sensitive locations policy, ICE does not and will not carry out enforcement operations at or near healthcare facilities, such as hospitals, doctors' offices, accredited health clinics, and emergent or urgent care facilities, except in the most extraordinary of circumstances.
  • Hundreds of millions of people around the world, from every racial and ethnic group, have been vaccinated safely.

Considerations for Trusted, Open Communication 

Listen to your employees and your community. 

Discussing COVID-19 and vaccines with population groups who have greater concerns requires listening with empathy and responding with accurate information that addresses their concerns. 

  1. Engage employee resource groups—or even supervisors or informal leaders from the population groups within your workforce—to understand specific concerns, identify unique needs and share information in a way that speaks to any questions they have about vaccines.
  2. Pay attention to discussions on company message boards and other communication channels, and in interpersonal communications between managers and their teams. Listen for questions, concerns and rumors and quickly provide facts.
  3. Outside your company, many organizations, public health departments, cities and states are hosting events and launching initiatives to reach Black, Hispanic and American Indian and Alaska Native people. Share information about these events with your employees, and participate as a company if you can. 

Offer information and understanding, not a directive.

  • Respect people’s independence and their need to learn more. 
  • Be welcoming, clear, compassionate, empathetic and understandable. 
  • Respect people’s Accept their reluctance. Communicate with empathy, honesty and kindness, providing facts to help overcome myths and misconceptions. and their need to learn more. 

Commit to integrity.

The Trust for America’s Health recommends four principles for building trust in and access to COVID-19 vaccines among people of color and Tribal Nations. Committing to these across all communications can help businesses convey information that is trusted:

  1. Agency: Black, Hispanic and American Indian and Alaska Native employees must have the opportunity to participate in decision-making and communication. 
  2. Transparency: Fight misinformation by using data to show what we know about COVID-19 vaccines. Be clear and honest about company motives for encouraging (or mandating) vaccination. 
  3. Relevancy: There is no one-size-fits-all approach. Data and information must be specific to the community. Historical context and current lived experience must be acknowledged and respected.
  4. Accountability: Businesses must hold themselves to the highest standards of ethics, transparency and integrity. We must honor our commitments. When we make mistakes, we must promptly acknowledge and correct them.

Be thoughtful about the messenger.

  1. Medical experts, personal doctors and other health care providers are generally the most trusted sources of information for COVID-19 vaccination information and advice. Research shows that over half of Black Americans and the overwhelming majority of Hispanics who are hesitant will be more likely to get the vaccine if they receive a strong recommendation from their doctor.
  2. Work to cultivate trusted messengers who reflect a diversity of communities and can speak to the unique concerns of different groups. Trusted messengers might include any existing employee resource groups or informal networks, and other formal and informal leaders in your organization, as well as health providers or public health professionals outside your workplace.
  3. Equip your messengers with information from CDC, FDA, your state/local health department and other trusted health sources.
  4. See our tip sheet on recruiting medical professionals and others to speak with your employees. 
  5. Informal messengers can be just as—or even more—powerful as positional experts. Focus groups in some Hispanic communities found that neighborhood matriarchs, pastors and soccer coaches are trusted figures who can effectively encourage vaccination and be enlisted to distribute reliable information. Hearing from people in the community who have been vaccinated can help ease concerns, especially if the person can share why they chose to get vaccinated and how it has positively impacted them. Invite opportunities for informal sharing in ways that protect privacy and ensure voluntary participation.

Respect and reflect your employee population.

  1. Provide information in English and Spanish. Many of our resources are available in both languages, with additional resources to come. CDC offers Spanish-language COVID-19 resources and vaccine facts in multiple other languages.
  2. If you are relaying experiences of people who have been vaccinated, sharing photos of vaccination clinics or otherwise telling stories, as with all your communication, be sure to reflect the diversity of the country and of your employee population. And, always be sure to respect privacy and confidentiality.  
  3. Consider making a donation of time and/or resources to organizations in your community that are expanding vaccine access to Black, Hispanic, American Indian and Alaska Native people.

Additional Resources

Black Americans Communication Insights

Hispanic Americans Communication Insights

Hispanic Americans Communication Insights

The Morehouse School of Medicine: National COVID-19 Resiliency Network is a consortium of organizations representing multiple populations groups and offering insights and communication tools