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BackgroundFew studies have focused on attitudes toward COVID-19 vaccination among Black or African American young adults (BYA) in the Southern United States, despite high levels of infection in this population. ObjectiveTo understand this gap, we conducted an online survey to explore beliefs and experiences related to COVID-19 vaccination among BYA (aged 18-29 years) in 3 southern states. MethodsWe recruited 150 BYA to participate in an online survey as formative research for an intervention to address vaccine hesitancy in Alabama, Georgia, and North Carolina from September 22, 2021, to November 18, 2021. Participants were recruited through social media ads on Facebook, Twitter, Instagram, and YouTube. Additionally, we distributed information about the survey through organizations working with BYA in Alabama, Georgia, and North Carolina; our community partners; and network collaborations. We used measures that had been used and were previously validated in prior surveys, adapting them to the context of this study. ResultsRoughly 28 (19%) of the participants had not received any doses of the COVID-19 vaccine. Half of the unvaccinated respondents (n=14, 50%) reported they wanted to wait longer before getting vaccinated. Motivators to get vaccinated were similar between unvaccinated and vaccinated respondents (eg, if required, to protect the health of others), but the main motivator for those vaccinated was to protect one’s own health. Among unvaccinated individuals, reasons for not receiving the COVID-19 vaccine included concern about vaccine side effects (n=15, 54%) and mistrust of vaccine safety (n=13, 46%), of effectiveness (n=12, 43%), and of the government’s involvement with vaccines (n=12, 43%). Experiences of discrimination (n=60, 40%) and mistrust of vaccines (n=54, 36%) were common overall. Among all respondents, those who said they would be motivated to get vaccinated if it was required for school, work, or travel were more likely to endorse negative beliefs about vaccines compared to those motivated for other reasons. ConclusionsMistrust in COVID-19 vaccine safety and efficacy is common among BYA in the Southern United States, irrespective of vaccination status. Other motivators, such as safety of family and community and vaccination requirements, may be able to tip the scales toward a decision to be vaccinated among those who are initially hesitant. However, it is unclear how vaccine requirements among BYA in the South affect trust in the government or health care in the long term. Interventions that include BYA in vaccination messaging and programs may more proactively build feelings of trust and combat misinformation.

BackgroundDespite high rates of novel COVID-19, acceptance of COVID-19 vaccination is low among Black adults. In response, we developed a digital health intervention (Tough Talks-COVID) that includes digital stories created in a workshop we held with young Black adults. ObjectiveOur formative research using digital storytelling workshops asked 3 research questions: (1) What issues did participants have in conceptualizing their stories, and what themes emerged from the stories they created? (2) What issues did participants have related to production techniques, and which techniques were utilized in stories? and (3) Overall, how did participants evaluate their workshop experience? MethodsParticipants were workshop-eligible if they were vaccine-accepting based on a baseline survey fielded in late 2021. Final participants (N=11) completed a consent process, all 3 workshops, and a media release form for their digital story. The first 2 workshops provided background information and hands-on digital storytelling skills from pre- to postproduction. The third workshop served as a screening and feedback session for participants’ final videos. Qualitative and quantitative feedback elements were incorporated into all 3 sessions. ResultsDigital stories addressed one or more of 4 broad themes: (1) COVID-19 vulnerability, (2) community connections, (3) addressing vaccine hesitancy, and (4) countering vaccine misinformation. Participants incorporated an array of technical approaches, including unique creative elements such as cartoon images and instant messaging tools to convey social interactions around COVID-19 decision-making. Most (9/11, 82%) strongly agreed the digital storytelling workshops were delivered as expected; 10 of 11 agreed (n=5) or strongly agreed (n=5) that they had some ideas about what story to tell by the end of the first workshop, and most (8/11, 73%) strongly agreed they had narrowed down their ideas by workshop two. Of the participants, 9 felt they would very likely (n=6) or likely (n=3) use digital storytelling techniques for personal use in the future, and even more were very likely (n=7) to use the techniques for professional use. ConclusionsOur study is one of the first to incorporate digital storytelling as a central component to a digital health intervention and the only one to do so with exclusive focus on young Black adults. Our emphasis on digital storytelling was shown to be highly acceptable. Similar approaches, including careful consideration of the ethical challenges of community-based participatory approaches, are applicable to other populations experiencing both COVID-19 inequities and marginalization, such as other age demographics and people of color.