Addressing COVID-19 Vaccination Barriers Among Hispanic, Latino Individuals

In this interview, Dr Razel Bacuetes Milo, affiliated with the University of San Diego, shares barriers against COVID-19 vaccination in Hispanic and Latino populations. In light of her team’s study findings, Dr Milo also provides recommendations to improve ongoing and future efforts aimed at reducing vaccination disparities.

What prompted your research into COVID-19 vaccine barriers in Hispanic and Latino individuals?

I have been a practicing nurse practitioner since 2011, and I primarily work in the community. I have experience working with communities of color and have witnessed health inequality in the Hispanic and Latino population. 

During the pandemic in 2021, communities of color, specifically Hispanic and Latino individuals, had lower vaccination rates compared to the general population. Data shows Hispanic and Latino populations have a higher burden-of-poverty rate, as well as the highest uninsured rate, compared to non-Hispanic White individuals. We also see that a lot of these individuals are less likely to use preventive care and primary care services.

We thought this might contribute to why Hispanic and Latino individuals are deciding to not get the vaccine, but we also wanted to explore other barriers. When we conducted our study, there was limited information on the barriers to COVID-19 vaccination in this population.

How was your study designed, and can you walk through the major findings?

After receiving approval from the University of San Diego’s Institutional Review Board, we recruited participants from 4 different sites and 3 different cities in Southern California. Participants were recruited from an urban setting, primarily from diverse backgrounds. About 34.8% of the population was Hispanic.

The design was a cross-sectional study using convenience sampling. We collected data over 10 months from March 2021 to December 2021. We recruited 200 participants. We asked them to complete a 14-item survey questionnaire that has sociodemographic questions, and the surveys were available in both Spanish and English. We asked questions about their knowledge about COVID-19; their health maintenance; and the barriers to COVID-19 vaccination.

We analyzed the correlation between sociodemographic data and barriers to COVID-19. We found that the desire to get vaccinated was not affected by whether participants knew about COVID-19 and how to protect themselves against COVID-19.

Participants who saw their medical providers in the past 12 months were more likely to get vaccinated, which is very interesting information. We also used logistic regression to create a model to predict their likelihood of getting vaccinated, and we found that participants who had family or household members who had COVID-19 in the past 3 months and saw their medical provider were more likely to get vaccinated than participants who had barriers. About 83.8% of these cases predicted the likelihood of being vaccinated.

As for barriers, participants said they do not have enough information about the vaccine. One reason is misinformation from social media, family members, friends, and even health care providers. There were also some religious reasons behind why people did not want to be vaccinated.

Thank you, Dr Milo. How do you think findings like these can inform future vaccination efforts for this population?

Right now, we see in our community that there are people who were vaccinated at the beginning but refuse to get their boosters. Based on the collected data from the setting of our study, we recommend continuing with community outreach programs to promote vaccine awareness and education in Hispanic communities, so we can reduce vaccine hesitancy and barriers.

We also recommend vaccination sites have bilingual, Spanish-speaking health care professionals or volunteers that can provide vaccine-related education and dispel misinformation about the vaccine. Social media can be used to spread evidence-based information about the vaccine, as well as provide information about vaccine sites. We also should focus on undocumented residents to make them aware that getting vaccinated would not affect their immigration status.

Thank you. Do you intend to expand on this research moving forward?

Yes. We plan to have a similar study designed for future research. We plan to reach more communities of color about the benefits of receiving the vaccine and dispel misinformation. 

During this study, we had coinvestigators who were fluent in Spanish and understood the culture. We plan to work with researchers and volunteers who are bilingual and have cultural awareness.

Is there anything else that you would like to add before we wrap up today?

So many communities of color experience the effects of health inequality and social determinants of health. Some organizations continue with their efforts to reach these communities to provide vaccination and education. My goal, and my team's goal, is to encourage community health leaders and elected officials to support these organizations to reduce the gap in vaccination rates in this population.

About Dr Milo

Razel Bacuetes Milo, PhD, MSN, DNP, graduated from the University of San Diego School of Nursing PhD program and the University of Alabama at Birmingham Doctor of Nursing Practice and Master Science FNP programs. She also holds a BSN from California State University Sacramento, and a BS of Business Administration in Management Information Systems from California State University San Marcos.

Dr Milo has been an associate professor at the University of San Diego School of Nursing for 5 years. She is a nurse practitioner with clinical expertise in family medicine. She founded Direct Care Home Health, based in San Diego, California. She participates in outreach programs in the community, including promoting COVID-19 vaccine education to the underserved population and volunteering with medical providers for health screening and consultation.

Dr Milo has published original research in peer-reviewed academic research journals. She is a reviewer for American Diabetes Association Journals, Journal of Primary Care & Community Health, Health Education Research, the American Journal of Nursing, the Advanced Emergency Nursing Journal, and the Western Institute of Nursing. She has presented at both national and regional professional conferences.

Her current research includes COVID-19 vaccination hesitancy among the Hispanic and Latino community, dermatological conditions among people of color, and the COVID-19 experience of health care workers.