Racial/ethnic disparities in COVID-19 morbidity and mortality are serious in the United States, particularly among African American/Black and Latine (AABL) populations. Staying up-to-date on COVID-19 vaccination is essential for mitigating risk, but AABL vaccination rates are low. The present qualitative study explores perspectives on COVID-19 among AABL persons at high-risk for exposure to the SARS-CoV- 2 virus: frontline essential workers engaged in public-facing professions (e.g., retail). From a larger study of AABL frontline essential workers not up-to-date on COVID-19 vaccination, N = 50 participants were purposively sampled for maximum variability. Participants engaged in semi-structured qualitative interviews in English or Spanish that were audio-recorded, professionally transcribed, and translated into English as needed. Data were analyzed using a directed content analysis approach that was both inductive and theory-driven. Participants were 37 years old, on average, and most (65%) were men. Approximately half (56%) were Latine/Hispanic and 44% were African American/Black. Occupations included food preparation (40%), retail (28%), construction (12%), in-home health care (8%), and building maintenance and personal services (12%). Approximately a third (38%) had received ≥ 1 COVID-19 vaccine dose. We found COVID-19 vaccination perspectives were grounded in a larger context of medical and institutional distrust and past/ongoing systemic racism. In this context, results were organized into the following themes: general perspectives on COVID-19; barriers/facilitators related to race/ethnicity, social class, and community; specific aspects of the COVID-19 vaccine as barriers; mandates, incentives, and pressures to be vaccinated; and mixed effects of public health initiatives. Overall, participants were knowledgeable about COVID-19. Social norms reduced vaccine intentions but altruism and community/family concern could motivate it. Aspects of the public health response (e.g., advertisement campaigns targeting AABL populations) increased distrust and reduced vaccination willingness. However, at least some ambivalence about vaccination was common (participants would consider it). Yet there was a large gap between considering and receiving vaccination. Thus, barriers to COVID-19 vaccination for AABL frontline essential workers operate at multiple levels of influence, but are addressable. The present study yields recommendations to improve vaccination, including increasing the trustworthiness of systems and institutions, reducing systemic/structural barriers, harnessing social forces, and engaging AABL communities in program planning.

This study centers on familismo as a relevant cultural construct that adds a U.S. Latina/o/x perspective to the Health Belief Model. Employing a qualitative lens, we use in-depth semi-structured focus groups and interviews with participants living, working, and attending school in a mid-size city on the U.S./Mexico border on the decision to take the COVID-19 vaccine. We find that, for many members of these communities, getting vaccinated is seen as a way to protect not only oneself but also one's family, especially those with chronic health conditions, reflecting an obligation to prioritize the collective over the individual. We highlight various approaches that families take to discuss COVID-19 vaccines, ranging from women coordinating vaccination to a non-confrontational approach to the unvaccinated. The borderlands as a place also showcase the diversity of the U.S. Latina/o/x experience during the pandemic, since the perceived disparities of vaccine access in Mexico also seemed to cue the decision to get vaccinated. We propose this helps explain the exceptionally high vaccination rate in the city under study and seen in several other border communities. By illuminating how familial ties impact health communication surrounding this important issue, this study adds an expanded Latina/o/x cultural context for aspects of the Health Belief Model such as perceived severity and susceptibility.

To investigate the association between nativity and COVID-19 vaccine acceptance and its interaction with race/ethnicity, education, and English proficiency.

Differences in vaccine acceptance among propensity-score matched foreign- and US-born persons using 2021 California Health Interview Survey Data were measured using a survey-weighted multivariable logistic regression model with interaction terms and average predicted probabilities between nativity and: race/ethnicity, education, English proficiency.

A total of 4,234,655 survey-weighted persons (8504 unweighted) met inclusion criteria; 2251,279 (53 %) were foreign-born (1,983,376 US-born), and 55 % of all persons were Hispanic/Latino, 22 % were Non-Hispanic White, 17 % were Non-Hispanic Asian/Pacific Islander, 3.6 % were Non-Hispanic Black/African American, and 2.5 % were categorized as 'Other'. Foreign-born status was significantly associated with greater odds of acceptance (adjusted odds ratio [aOR], 2.81 [95 %CI, 1.16-6.83]). Foreign-born Hispanic persons had a significantly greater probability of acceptance compared to their US-born counterparts (average probability difference, +0.11 [95 %CI, +0.023, +0.20]). Foreign-born persons with poor English proficiency had a lower probability of acceptance versus US-born persons (APD, -0.081, [95 %CI, -0.43, 0.27]).

Nativity was significantly associated with COVID-19 vaccine acceptance, and this relationship varied by race/ethnicity and English proficiency. These findings may be used to direct future interventions aimed at improving COVID-19 vaccination rates.

25.6 Million people in the United States have Limited English Proficiency (LEP), defined as insufficient ability to read, write, or understand English. We will (1) Delineate the merits of approaching language as a social determinant of health, (2) highlight pertinent public health values and guidelines which are most relevant to the plight of populations with LEP and (3) Use the COVID-19 pandemic as an example of how a breakdown in public health ethics values created harm for populations and patients with LEP. We define a framework to tease out public health responsibilities given some populations' limited proficiency in a society's predominant language. The American Public Health Association (APHA) public health ethics core values serve as a framework to interrogate current practices. We use the COVID-19 case to illustrate gaps between health policy and healthcare disparities experienced by populations with LEP.

This study assesses the relationship between trust in sources of information in regard to the Coronavirus Disease 2019 (COVID-19) pandemic and self-rated health (SRH) in a sample of Latino Day Laborers (LDLs) and explores whether these associations were mediated by mental health measures.

A rapid needs assessment survey was conducted with 300 LDLs, recruited at randomly selected hiring locations in Houston, Texas, during November and December 2021. Two measures of trust were developed, and SRH was measured by a single item. Depression, anxiety, and stress were measured by previously validated scales. We applied the product of coefficients approach to assess our mediation model. Using Hayes' PROCESS version 4.2 in SPSS, linear regression models were generated simultaneously to assess the total effect of trust on SRH, effect of trust on the mental health mediator, and effect of the mediator on SRH, controlling for trust. Demographic characteristics were entered as covariates.

Greater trust in formal sources of information (such as Spanish-speaking television networks) as well as greater levels of anxiety and depression were associated with lower SRH. There were no significant associations between formal trust and mental health measures. As such, the association between formal trust and decreased SRH was not mediated by mental health. Trust in informal sources of information (conversations with friends, family, and coworkers) was not significantly associated with SRH or mental health. Higher levels of depression and anxiety, however, were associated with lower SRH.

LDLs' perception of their health was inversely associated with their level of trust in formal sources of information and with greater levels of depression and anxiety. Nevertheless, these pathways were independent of each other. The results indicate the direct impact of COVID-19 public information on subjective well-being, a relationship that merits further exploration.

The COVID-19 pandemic disproportionately impacted intersectionally marginalised migrants, revealing systemic disparities in health outcomes and vaccine uptake. Understanding the underlying social and structural factors influencing health behaviours is necessary to develop tailored interventions for migrants, but these factors have been seldom explored. This qualitative study aimed to explore contextual factors shaping COVID-19 vaccination decision-making among Congolese migrants in the UK.A community-based participatory research study was designed and led by a community-academic partnership in London, UK (2021-2022). Peer-led, semi-structured interviews were conducted in Lingala with 32 adult Congolese migrants and explored beliefs, perceptions and lived experiences of migration, healthcare, vaccination and the COVID-19 pandemic. Reflexive thematic analysis generated two themes and a model conceptualising the vaccination decision-making process. Participants and community partners were financially compensated; ethics was granted by the University of London ethics committee (REC: 2021.0128).Participants highlighted the incompatibility of lockdown restrictions with their communal culture, which intensified feelings of exclusion and alienation. Concerns about COVID-19 vaccination were attributed to safety and effectiveness, partly informed by experiences and legacies of racial discrimination and exploitation. Inequality in the pandemic response and COVID-19 outcomes heightened participants' sense that their views and needs were being overlooked, and government sources and information were perceived as coercive. Our model depicts the interplay between institutional trust, belonging, and message perception, which shaped participants' vaccination decisions and led to (non-)engagement with COVID-19 vaccination. This research enhances understanding of how social and contextual factors may influence migrants' engagement with health interventions. It underscores the importance of partnering with migrant communities to understand their needs in context and co-design tailored interventions and inclusive messaging strategies that promote trust and belonging. Implementing systemic changes to address structural inequalities will be crucial to create an environment that supports engagement with health-protective behaviours and enhances health outcomes among migrant communities.

To analyze community experiences involving COVID-19 vaccination access and equity in Black and Latina/o/x communities within South Los Angeles, using a socioecological framework.

We conducted four virtual focus groups (n = 33 total participants) in 2021, with Black and Latina/o/x community members, community leaders, and community-based providers in South Los Angeles, a region highly impacted by the COVID-19 pandemic. We used a grounded theory approach to guide the analysis and generate data shaped by participant perspectives.

Participants across groups consistently emphasized medical mistrust, fear/skepticism, misinformation, accessibility, and feelings of pressure and blame as factors influencing COVID-19 vaccination decisions. The need to address pandemic-related socioeconomic hardships in underresourced communities was equally highlighted.

Findings show that building trust, providing tailored information, and continued investment into diversity and equity initiatives can support Black and Latino/a/x communities in making informed health decisions. Community-centered support services should address the economic, social, and structural impact of the pandemic on vulnerable communities. Furthermore, public health and policy efforts must prioritize funding to equip social and health care systems with infrastructure investment in racial and ethnic minority communities.

Challenges with SARS-CoV-2 vaccine prioritization, access, and hesitancy have influenced vaccination uptake.

Was the impact of SARS-CoV-2 vaccine rollout on COVID-19 monthly admission and mortality trends different between Hispanic and non-Hispanic populations?

We used interrupted time series analysis to conduct an ancillary study of the Viral Infection and Respiratory Illness Universal Study registry supplemented by electronic health record data from five participating Mayo Clinic sites in Florida, Arizona, Minnesota, and Wisconsin. We included hospitalized patients with COVID-19 admitted between April 2020 and December 2021. Our primary outcome was the impact of vaccine rollout on admission trends. Our secondary outcome was the impact of vaccine rollout on mortality trends.

This interrupted time series analysis includes 6,442 patients. Vaccine rollout was associated with improved monthly hospital admission trends among both Hispanic and non-Hispanic patients. Among Hispanic patients, pre-vaccine rollout, monthly admissions increased by 12.9% (95% CI, 8.1%-17.9%). Immediately after vaccine rollout, patient admissions declined by -66.3% (95% CI, -75.6% to -53.9%). Post-vaccine rollout, monthly admissions increased by 3.7% (95% CI, 0.2%-7.3%). Among non-Hispanic patients, pre-vaccine rollout, monthly admissions increased by 35.8% (95% CI, 33.4%-38.1%). Immediately after vaccine rollout, patient admissions declined by -75.2% (95% CI, -77.6% to -72.7%). Post-vaccine rollout, monthly admissions increased by 5.6% (95% CI, 4.5%-6.7%). These pre-vaccine rollout admission trends were significantly different (P < .001). Post-vaccine rollout, the change in admission trend was significantly different (P < .001). The associated beneficial impact from vaccine rollout on monthly hospital admission trends among Hispanic patients was significantly lower. The trend in monthly mortality rate was fourfold greater (worse) among Hispanic patients (8.3%; 95% CI, 3.6%-13.4%) vs non-Hispanic patients (2.2%; 95% CI, 0.6%-3.8%), but this was not shown to be related to vaccine rollout.

SARS-CoV-2 vaccine rollout was associated with improved COVID-19 admission trends among non-Hispanic vs Hispanic patients. Vaccine rollout was not shown to influence mortality trends in either group, which were four times higher among Hispanic patients. Improved vaccine rollout may have reduced disparities in admission trends for Hispanic patients, but other factors influenced their mortality trends.

We developed and tested MivacunaLA/MyshotLA, a community-informed mobile phone intervention, to increase COVID-19 vaccination among Latino parents/caretakers of minors in under-resourced areas of Los Angeles by addressing misinformation and building trust. We recruited Latino parents/caregivers with at least one unvaccinated child in East and South Los Angeles in the summer of 2021 and evaluated MivacunaLA as a randomized controlled trial with a wait-list control group. A difference-in-difference analysis showed Latino parents/caregivers that participated in MivacunaLA (n = 246), in comparison to the control group, were 15 percentage points more likely (p = 0.04) to report vaccination of minors aged 12-17 years, and 12 percentage points more likely (p = 0.03) to report a positive intention to vaccinate minors aged 2-11 years (when COVID-19 vaccines became available). Mobile phone-delivered digital interventions using videos and culturally tailored educational material to promote COVID-19 vaccine confidence can be an effective way to combat misinformation and deliver timely information to marginalized communities. Community-based participatory research approaches are crucial to advance health equity among minority communities, especially immigrant Spanish-speaking underserved communities.

The coronavirus disease 2019 (COVID-19) pandemic affected all social systems, but healthcare services were particularly disrupted. The pandemic also had a disproportionate impact on populations made socially vulnerable. In this study, we documented the experiences of Latinx sexual and gender minority (SGM) individuals with access to care during COVID-19 stay-at-home orders.

Semistructured qualitative interviews assessing experiences during the stay-at-home orders in response to the COVID-19 pandemic and patients' experiences accessing healthcare during this period were conducted with 21 Latinx SGM individuals from the Washington, DC, area. Data were analyzed using rapid qualitative analysis (RQA), and salient themes were identified.

The RQA revealed 3 themes reflecting participants' experiences with pharmaceutical care during COVID-19 stay-at-home orders: (1) challenges in accessing HIV services; (2) community engagement; and (3) providers supporting access to care. Participants experienced problems with adherence to medication, transportation, and technology, as well as delays in care and miscommunication with providers. Latinx SGM individuals demonstrated engagement in response to this emergency as a community and valued their providers and their efforts to facilitate access to care.

The COVID-19 pandemic strained healthcare services. Findings from this study show that the impact of the pandemic on the provision of care increased the vulnerability of Latinx SGM people. Future research should explore the impact of public health emergencies on the health of populations historically made socially vulnerable, and innovative solutions should be identified to eliminate these barriers to health equity.

Misinformation is known to affect norms, attitudes, and intentions to engage with healthy behaviors. Evidence strongly supports that Spanish speakers may be particularly affected by misinformation and its outcomes, yet current insights into the scope and scale of misinformation is primarily ethnocentric, with greater emphasis on English-language design.

This study applies Natural Language Processing (NLP) to analyze a corpus of English/Spanish tweets about vaccines, broadly defined, for misinformation indicators.

We analyzed NEnglish = 247,140 and NSpanish = 104,445 tweets using Latent Dirichlet Allocation (LDA) topic models with Coherence score calculation (model fit) with a Mallet adjustment (topic optimization). We used informal coding to name computer-identified topics and compare misinformation scope and scale between languages.

The LDA analysis yielded a 12-topic solution for English and a 14-topic solution for Spanish. Both corpora contained overlapping misinformation, including uncertainty of research guiding policy recommendations or standing in support of antivax movements. However, the Spanish data were positioned in a global context, where misinformation was directed at government equity and disparate vaccine distribution.

Our findings support that misinformation is a global issue. However, misinformation may vary depending on culture and language. As such, tailored strategies to combat misinformation in digital planes are strongly encouraged.

Since the beginning of the COVID-19 pandemic, certain U.S. population groups have suffered higher rates of infection and mortality than whites, including Latinx. Public health officials blamed these outcomes on overcrowded housing and work in essential industries prior to the vaccine's availability. We sought to illuminate the lived experience of these factors through a qualitative study of undocumented Latinx immigrant workers in the secondary economy (n ​= ​34). This study focuses on the intersectionality of social locations for undocumented Latinx immigrants living in a relatively affluent suburb and working in the construction and service sectors prior to the pandemic. Their narratives revealed how the pandemic created financial precarity through prolonged periods of unemployment and food insecurity. Workers described worry over unpaid bills, and potentially catastrophic episodes in which they treated severe COVID-19 with home remedies. Long spells of unemployment, food insecurity, inability to pay bills and lack of access to healthcare emerged because of socio-political contexts including the nature of low-wage labor and lack of a safety net.

Background: Latinx school-aged children are more than twice as likely to be infected with and die from COVID-19 as non-Latinx White children in Los Angeles. Although COVID-19 vaccination has the potential to mitigate health disparities exacerbated by the pandemic, vaccination uptake among Latinx children remains limited. MiVacunaLA (MVLA) is a mobile-phone-delivered digital intervention that improved vaccination rates in 12- to 17-year-old Latinx children and parental intention to vaccinate 2- to 11-year-old children. Since piloting MVLA, the COVID-19 vaccine became available to children aged 5-11. We sought to understand parental experiences with the MVLA intervention and their attitudes and beliefs about vaccinating their young children to improve vaccination confidence in the Latinx community. Methods: We conducted six virtual focus groups with 47 parents/caregivers of children aged 5-11 who participated in the MVLA intervention. We used standard qualitative content analysis methods and rigid and accelerated data reduction to identify and analyze major themes discussed in the sessions. Results: Each salient theme from our focus groups was mapped to one of the 5Cs constructs. The themes included the parents' need for more contemplation about vaccinating their children than about vaccinating themselves; the parents' need for trusted sources of vaccine information; the parents' motivations to vaccinate their children against COVID-19; parental concern about short- and long-term effects of the vaccine in children; digital technology and videos as useful engagement tools; and age and health stratification as an approach to parental vaccination decision-making. Conclusions: The results of this study clarify the key factors that influence the decision of Latinx parents and caregivers to vaccinate their children against COVID-19. Our findings can inform efforts to increase COVID-19 vaccination rates among children in underserved Latinx communities, especially regarding the use of digital technologies for promoting vaccine confidence.

Although the coronavirus disease 2019 (COVID-19) pandemic has reached all over the world population, it has demonstrated a heterogeneous impact on different populations. The most vulnerable communities which coexist daily with the social inequalities like low access to hygiene and personal protection products, crowded residences, and higher levels of chronic diseases have a higher risk of contact and the spread of infection, beyond unfavorable clinical outcomes. The elevation of the risk of infection exposure can be related to gender due to the presence of a larger contingent of women in essential services, as well as frontline and cleaning professionals who regardless of gender have the greatest exposure to the virus. Such exposures can contribute to the development of fear of contaminating themselves or their family members associated also with the work stress, both of which are related to the emergence of mental disturbances in these populations. Furthermore, conditions of unsanitary living and low socioeconomic status, populations at war, pre-existing social barriers, and ethnicity have contributed to more impact of the pandemic both in the exposure to the virus and access to health services, COVID-19 management, and management of other pathologies. At the same time, factors such as the closing of non-essential services, the loss of jobs, and the increase in household spending aggravated the social vulnerabilities and impacted the family economy. Lastly, the COVID-19 pandemic contributed still more to the impact on women's health since it propitiated a favorable environment for increasing domestic violence rates, through the segregation of women from social life, and increasing the time of the victims with their aggressors.