HEALTH Research Institute

Houston, TX

With the emergence of the highly transmissible Omicron variant in Houston, the need is more critical than ever for Houston families to become fully vaccinated. Yet, for some diverse communities throughout Houston, there are significant barriers in place and vaccine hesitancy remains a complex challenge that’s been weighted in historic structural inequities.  

Delving further into the reasons for why vaccine hesitancy exists in Houston’s underrepresented neighborhoods is University of Houston's Dr. Ezemenari Obasi who leads the HEALTH Center for Addictions Research & Cancer Prevention—a NIH national Research Center at Minority Institutions (RCMI).  African American Texans who comprise 13 percent of the population in Texas account for more than 7 percent of people vaccinated, according to state data. Yet, according to Texas Department of State Health Services, Texans whose race or ethnicity is unknown account for just over 17 percent vaccinated. 

"The bottom line is that Omicron is in Houston, and it's at a much higher rate than we know, and eventually that will come to light," Dr. Obasi said. "But I think we need to be less focused on the fear of the various variants and more focused on how to stop the virus. If we take the right steps, it doesn't matter what the latest variant is, it will cease to exist because it can't change and propagate. If we don't do anything different, then we might get through the whole Greek alphabet with these variants." 

Through a significant $711,773 grant from National Institute on Minority Health and Health Disparities (NIMHD), Dr. Obasi and the HEALTH-RCMI research team in partnership with the Houston Health Department have begun to identify the palpable challenges that underserved communities in Houston grapple with when it comes to vaccine hesitancy.  

"The work we're trying to do is to try to get more of a sense of what are the challenges from a community's perspective," Dr. Obasi said. "How can we mitigate the things that are within ​the community's control? How do we provide the information that is needed to make informed decisions? What we want to do is empower people with strategies that make sense from their cultural standpoint." 

Dr. Ezemenari Obasi speaks about vaccine hesitancy in the news

See full interview on Fox News here

Hear full interview on NPR, Houston Public Media here

More specifically, the SARS-CoV-2 (COVID-19) vaccine initiative strives to identify misconceptions surrounding vaccinations and seeks to find effective ways to dispel those vaccination myths which are respected in the community. Through data compiled through the HEALTH-RCMI research, University of Houston's Dr. Isabel Leal uncovered several key findings about why some community members are wary of vaccines. Some of the barriers stated included earned medical mistrust, structural inequities including access to internet, and politicization of the vaccine. 

“COVID-19 is happening in a context of all this mistrust in terms of the government,” Dr. Leal said. “That is a big factor. Given all this disinformation that has happened, it has set the stage for mass chaos and confusion.” 

Dr. Leal added that the initial focus groups involved in the SARS-CoV-2 (COVID-19) vaccine initiative included Houston health providers, federally qualified health centers (FQHC), community-based organizations and faith-based organizations.

“We’re gearing up to do interviews with community members in different super neighborhoods next year,” Dr. Leal said. 

After a briefing of the new findings regarding community barriers, Dr. Obasi said that the crucial key to understanding vaccine hesitancy in Black, Indigenous, and People of Color (BIPOC) communities is simply to listen to the community members. 

"One of those things that I appreciated from the data that was shared in that meeting was that folks just want to be heard," Dr. Obasi said. "They want you to hear what their real questions are and feel like you've given them due diligence in your response to them versus a flippant, 'you just need to do your part.' The whole shame, blame-thing, that just doesn't work. There are real questions." 

In essence, the pivotal question lies more saliently in the fact that Black, Indigenous and People of Color account for approximately 39 percent of the COVID-19 deaths at the onset of the pandemic. 

"For me, it's less about the percentage of BIPOC folks who are vaccinated or unvaccinated, let's look at the fact that they are dying at a much higher rate—and how do we come up with a comprehensive strategy to mitigate this disproportionate death rate associated with COVID-19," Dr. Obasi said. "When you begin to engage folks from these communities, you have to take into consideration cultural practices, family beliefs, history—and so the messaging needs to be tailored by the folks you're trying to reach." 

So, what truly works to dispel misconceptions and lead to more trust when discussing vaccines in BIPOC communities? Dr. Obasi emphasizes it starts with truly listening to people. In a data breakdown about what works to bring greater vaccine awareness, there were several key findings including one-on-one personal conversations, consistent messaging across institutions, keeping politics out of public health, focusing on the needs of the disenfranchised, sharing best practices, communicating in preferred languages, and sharing consistent, transparent messaging. 

"What we want to do is empower people with strategies that make sense from their cultural standpoint," Dr. Obasi said. "I think if you look at some of those findings—they are really rooted in cultural practices. If you're within a collectivist community, you're dependent upon one another. Relationships involve hands-on, one-on-one conversations and interactions. You cannot gain access to a person or a community, if you're unwilling to engage them in ways that make sense to them.” 

By: Alison Medley