Across the global community, COVID-19 has disproportionately impacted members of marginalized communities. Members of marginalized communities experience higher levels of physical and mental health conditions due to economic and social factors that increase stress and limit access to health resources such as poverty, stress, and health inequity. The same inequities that contribute to higher levels of infection, morbidity, and mortality can also impact trust in healthcare systems, as well as public health authorities and government officials. This in turn impacts attitudes toward vaccinations. Members of marginalized communities have historically shown mistrust in vaccines due to experiences of healthcare inequities, unethical medical experimentation, and underrepresentation in vaccine trials. Essentially, the same factors that increase risk of infection, morbidity, and mortality from COVID-19 also contribute to vaccine hesitancy.
Thus, it might seem illogical for mistrust to fuel vaccine hesitancy among highly privileged populations, who benefit greatly from healthcare inequity. However, the modern “anti-vax” movement gains its strongest support from predominantly wealthier, liberal, white individuals. Across industrialized countries, pockets of low vaccination rates are often found in more economically privileged communities. The mistrust that fuels vaccine hesitancy among these populations is based on an inflated sense of agency in making medical decisions without doctors or public health officials, and a preference for “natural” methods of healthcare. Further, privileged communities are less directly exposed to the negative impact of the COVID-19 pandemic, due to the largest effects manifesting in marginalized communities.
Because previous research has typically focused on either marginalized or privileged populations separately, the underlying role of inequity has yet to be fully quantified. To this aim we are collecting global data to better understand how factors like income, race, access to health care, and perceptions of marginalizaiton contribute to vaccine hesitancy.