兰德报告：什么导致了黑人社区对接种新冠疫苗的犹豫以及如何解决这一现象

原文：What Contributes to COVID-19 Vaccine Hesitancy in Black Communities, and How Can It Be Addressed?

Research Questions

1. Why are Black Americans less willing to get a COVID-19 vaccine than
   Americans of other races or ethnicities?
2. How trusted are health care providers and public health officials?
3. How trusted are elected local and federal officials?
4. What contributes to mistrust in the COVID-19 vaccine?
5. What messaging strategies would be effective in encouraging COVID-19 vaccine acceptance in the Black community?

研究问题

1. 为什么与其他种族或族裔相比，美国黑人更不愿意接受COVID-19的疫苗接种？
2. 卫生保健提供者和公共卫生官员受黑人群体信任程度如何？
3. 当选地方和联邦官员受黑人群体信任程度如何？
4. 什么导致了对于COVID-19疫苗的不信任
5. 哪些消息传递策略可以有效地鼓励黑人社区接种COVID-19 疫苗？

Recent polls show that Black Americans are less willing than Americans of other races or ethnicities to be vaccinated for COVID-19. These lower vaccination rates among Black Americans would further widen COVID-19 inequities in diagnosis, hospitalization, and mortality. A main driver of hesitancy among Black Americans is thought to be general mistrust of health care systems and providers. Such mistrust has arisen in Black communities as an understandable, rational, and self-protective reaction to history, knowledge, and continuous and repeated discrimination, racism, and harmful experiences toward Black Americans by the health care system, health care providers, and the U.S. government. Such repeated, systemic discrimination experiences, as well as the perceived failure of health care organizations to take authentic measures to build trust and become more trustworthy, have led to avoidance of health care among Black Americans, which may translate further into unwillingness to accept COVID-19 vaccination.

最近的民意调查显示，与其他种族或族裔的美国人相比，美国黑人更不愿意接受COVID-19的疫苗接种。COVID-19疫苗在美国黑人群体更低的接种率会进一步加大美国黑人在新冠诊断，住院和死亡率上的几率（原文为不平等inequities）。美国黑人抵触新冠疫苗的一个主要因素是他们对卫生保健系统及其提供者的普遍的不信任。在黑人群体，由于历史、知识、持续的种族歧视、美国政府和医疗系统对于黑人的迫害，这种不信任已经发展为一种可理解的，理性的，自我保护的反应。这种持续的系统性的迫害经历，以及过去卫生保健组织未能采取实际措施重建信任导致了美国黑人对于医疗系统的抵触，这将导致未来美国黑人更不愿意接种新冠疫苗

To support efforts to reduce COVID-19 vaccine hesitancy in Black communities, RAND Corporation researchers conducted a survey of Black Americans in November–December 2020 to better understand the drivers of such reluctance. The researchers also conducted follow-up interviews with survey respondents who expressed hesitancy. Based on the results of the survey and interviews, the authors engaged with community stakeholders to identify an initial set of public health messaging and communication strategies likely to be successful in addressing COVID-19 vaccine hesitancy and increasing vaccination in Black communities.

为了减少黑人群体对于新冠疫苗的抵触情绪，兰德公司研究员在2020年11月至12月于美国黑人中进行了一项调查以更好地了解这种抵触情绪的驱动因素。研究人员还对表示犹豫的受访者进行了后续采访。基于研究结果和采访，作者同社区利益相关者（美国的居委会？）确定了一套初步的公共卫生信息传递与沟通策略，可能将成功解决黑人群体对于接种COVID-19疫苗的犹豫，增加他们的疫苗接种率。

Key Findings

主要发现

• This survey of a nationally representative sample of 207 Black Americans (conducted in November–December 2020) found high levels of vaccine hesitancy and mistrust of COVID-19 vaccines in the overall sample, and among health care workers in particular.
• 这项调查拥有207位美国黑人样本，具有全国代表性。而调查在全部样本中都发现了对于COVID-19疫苗高度的犹豫和不信任，在医护人员中尤其显著。
• Those who expressed vaccine hesitancy also showed high levels of overall mistrust, concerns about potential harm and side effects, and lack of confidence in vaccine effectiveness and safety.
• 对于COVID-19疫苗表示了高度的犹豫和不信任的人同样表达了对于疫苗潜在的危害和副作用的关心，并对疫苗的有效性和安全性缺乏信心。
• Participants reported higher trust in COVID-19 information from health care providers and public health officials than from elected local and federal officials.
• 参与者报告称：相比于从地方和联邦官员，他们更信任从医疗系统和卫生官员获得的COVID-19信息。
• Mistrust of the government’s motives and transparency around COVID-19, as well as beliefs about racism in health care, appear to be contributing to mistrust of the vaccine.
• 对于政府关于COVID-19的动机与透明度的不信任，以及相信卫生保健领域存在种族主义似乎导致黑人对于疫苗的不信任感
• Black Americans attribute their mistrust of vaccines in general and COVID-19 vaccines in particular to systemic racism, including discrimination and mistreatment in health care, as well as by the government.
• 美国黑人把他们对于疫苗（不管是一般疫苗还是新冠疫苗）的不信任尤其归因于系统性的种族主义，包括医疗保健中以及政府的歧视和虐待

Recommendations

建议

• Public health messages and communication strategies to address vaccine hesitancy should be tailored through authentic community engagement over the short term. In addition, it is critical to increase the trustworthiness of health care organizations, pharmaceutical companies, and the government over the long term.
• 应该在短期内通过真正的社区参与来量身定制公共卫生信息传递与沟通策略。另外在长期内提升医疗机构，制药公司和政府的可信赖度同样关键。
• COVID-19 vaccine messaging should first acknowledge systemic racism as a justifiable reason for mistrust before providing information about the vaccine.
• 在提供有关疫苗的信息之前，COVID-19疫苗信息传递应该首先承认系统性的种族主义是不信任的正当理由。（不是很懂美国特色）
• Education and dialogue to address health care providers’ concerns are essential, because these providers have the credibility to address vaccine hesitancy in Black communities, but many Black health care workers in our survey reported hesitancy to take the vaccine themselves.
• 通过教育和对话的方式来解决医疗保健机构所关注的问题很关键，因为这些机构在美国黑人中有一定的信誉来解决他们对于疫苗的犹豫，但是许多黑人医疗工作者在我们的调查中称他们自己就对这些疫苗不信任。😅