The Biggest Barriers to COVID-19 Vaccination—and How to Break Them Down

No child care, no transportation, no trust: Parents of color and older adults are still facing obstacles when it comes to getting vaccinated. So how do we fix a broken system and get to that coveted herd immunity?

Many Americans have been fully vaccinated against COVID-19, but we still have a long way to go. Everyone 6 months and up is now eligible for a vaccine, but that doesn't mean that they'll easily be able to get to a vaccine distribution center or even trust the health care system or vaccination process to begin with.

Every eligible person who wants to get a vaccine should be able to get one, but that's not always the case. And even those who are eligible may have lost all faith in a system that's consistently worked against them. To keep Americans healthy and achieve herd immunity, a substantial portion of the population needs to get vaccinated for their family's sake, but also for the sake of other families in their communities and the country as a whole.

An image of a women's hands reaching for a vaccine vial on a colorful background.
Getty Images (5). Art: Jillian Sellers.

What Aren't People Getting Vaccinated?

Natasha Williams, Ed.D., MPH, MSW, an assistant professor in the department of population health at the NYU Grossman School of Medicine in New York, says some of the main barriers to vaccination have included "access, understanding eligibility, and convenience."

In fact, a survey released in early 2021 showed about 3 in 10 Americans said they did not know whether they were eligible in their state. Now the question of initial eligibility has turned into questions about boosters and which vaccine to get.

Experts also cite widespread vaccine hesitancy as a huge problem. The issue partly stems from misinformation circulating online. Plus, some people expressed concern that the vaccines were initially only approved for emergency use by the Food and Drug Administration (FDA).

Sonia Sroka, head of multicultural communications at Meta, which is running a worldwide campaign to promote COVID-19 vaccine information and help stop the spread of misinformation on its platforms, says the vaccines felt like a light at the end of the tunnel. But even within her own family, she said there were some people who were skeptical or scared—despite her being around to quell their fears. "Add in factors like not being near testing sites, work schedules, family responsibilities, language barriers, and even fear of not having immigration status, it really worried me," she says.

Vaccine hesitancy and obstacles to getting shots in arms existed long before COVID-19. During the pandemic, Black people, the Latinx people, and even Trump supporters in rural areas (like Mississippi, Tennessee, Arkansas, Alabama, and Georgia) are less likely to be vaccinated. A March 2021 poll by the Kaiser Family Foundation found that while some Americans are coming around to the idea of getting vaccinated as they see others do the same, 13 percent of respondents still said they would "definitely not" get a vaccine.

We broke down these four main roadblocks to parents and their families getting vaccinated—and what still needs to happen to tackle the vaccination barriers that could jeopardize the pandemic coming to an end.

1. Lack of access for marginalized communities

According to the Centers for Disease Control and Prevention (CDC), Black and Hispanic people are at a greater risk of hospitalization and death from COVID-19 but are less likely to get vaccinated than their white or Asian counterparts. They're also more likely to be disadvantaged and have incomes below the federal poverty threshold, lack access to the internet, hold jobs where working remotely isn't an option, have limited access to care, and potentially even be undocumented and not speak English—all factors that make getting vaccinated more difficult.

Children of color are disproportionately struggling during the pandemic and, since kids under 6 months aren't yet eligible to be vaccinated, it's even more crucial that their parents and relatives get the COVID-19 vaccine to help protect the whole family.

Dr. Williams says poverty is a key factor in getting people vaccinated.

"There are less vaccine sites in areas with high concentrations of poverty and more vaccine sites in neighborhoods with low levels of poverty," says Dr. Williams of her work in New York City. "So if we can develop clear messaging around eligibility, cost, and make it easier for people to access the vaccine in a way that is convenient (i.e., walk-ins accepted), we are likely to continue to see an uptake in vaccinations."

2. Lack of child care

While some exceptions exist, many vaccine distribution centers only allow the person with the appointment to enter the site. And, sure, some parents might be able to bring their kids along to their appointment, but it requires them to decide if they're willing to risk bringing their potentially unvaccinated children around so many other unvaccinated individuals.

"I think barriers impacting vulnerable groups exist for a few reasons," says Héctor E. Alcalá, assistant professor of public health at Stony Brook University. "The first is unequal access to resources like health care, income, and child care. To ameliorate this, we need to invest in government programs like universal health care, universal child care, and universal paid time off. This will help break down the financial barriers that exist to care."

3. No transportation

Volunteers across the U.S. are helping those with no vehicle, no license, or medical conditions where travel isn't an option, but there's more work to be done, especially since access to transportation is limited for low-income families.

In rural areas, even finding a pharmacy or health center proves difficult. According to a February 2021 study by the University of Pittsburgh's School of Pharmacy and the West Health Policy Center, many residents in urban counties in Atlanta, Houston, Dallas, Detroit, and New Orleans had to travel over a mile to get to a vaccination site, though it wasn't uncommon for Black residents to have to travel at least 10 miles.

4. Vaccine hesitancy

Jennifer Haythe, M.D., is an associate professor of medicine at Columbia University Center for Advanced Cardiac Care in New York and worked in the cardiac intensive care unit treating COVID-19 patients in March 2020. She says vaccine hesitancy has been the biggest barrier she's seen in her community.

Dr. Haythe cites a lack of trust in the federal government, feelings that the vaccine has not been tested long enough, misinformation about how mRNA vaccines work, and religion as the reasons she sees for people not wanting to be vaccinated. And some people, specifically many BIPOC individuals, have a lack of trust in health care stemming from a long history of discrimination and implicit bias.

This vaccine hesitancy is often supported and intensified by false messaging on social media. According to an independent report, Facebook users viewed health misinformation 3.8 billion times in 2020. Case in point: It's almost impossible not to see anti-vaccine sentiments or conspiracy theories on social media and in parenting groups.

How to Break Down Barriers

"As a society, we all have a responsibility in addressing barriers to vaccine uptake," says Dr. Williams. On a large scale, she says political figures, communities, religious leaders, role models, and other community leaders sharing clear, consistent, and simple messages about vaccinations would help reduce hesitancy in many populations. On a personal level, there are also things parents can do to help at home or in their communities.

Offer help to friends and family

One of the simplest ways to help in your community? Reach out to your loved ones, ask how they're doing, and offer assistance. Babysitting, helping to make appointments, driving people to appointments—no good deed is too small.

"It may also help to reach out to organizations, like schools, churches, or employers that you are a part of, and ask them if they're willing to host vaccine educational sessions, that include showing people how to navigate the vaccine registration procedure," says Alcalá.

It's also more than OK to ask for help if you need it. In two-parent households, one parent often bears the brunt of responsibility at home, and in the case of heterosexual couples, that's often the mom. This responsibility may even extend to making vaccination appointments for partners, parents, and children—it's time we divvy things up.

Support organizations making a difference

Organizations around the country are already doing some of the heavy lifting to break down vaccination barriers. Considering volunteering or donating to nonprofits like Project HOPE that have been helping with the global response to COVID-19.

You can also reach out to your local health department or health care centers and ask how you can help.

Stop the spread of misinformation

Social media use is up during the pandemic—but so, too, is the frequency of posts you'll see with fake or misleading information about COVID-19. A 2019 report found that half of all parents of small children were exposed to negative vaccine messages on social media—and that was before the pandemic when families became even more glued to their devices. With around 7 in 10 U.S. adults on Facebook and 3 in 4 new or expectant parents in a Facebook group, it's no wonder there's an entire campaign to help stop the spread of misinformation.

Meta's COVID-19 Information Centers for Facebook and Instagram, for example, connect people with accurate information about COVID-19 and vaccines, including a vaccine tool that will help people find out where and when they can get vaccinated.

And by sharing relevant vaccine information from trustworthy sources on your own social media accounts, you can help be part of the solution.

Share the news

There's one super simple way you can let others know how easy (and safe) the vaccination process is: Share the news of your shot. After all, you did your part to help the U.S. get back to normal—it's OK to brag!

"In general, people want to conform to others in the groups with which they identify, so sharing your reasons and experience with getting vaccinated might also be helpful," says Dr. Williams. "We do need to make it easy for people to get vaccinated and to provide reputable information."

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