Heading off vaccine hesitancy

CSU anthropologists work to reduce barriers and misperceptions surrounding COVID vaccines

Graduate Programs in the Liberal Arts at CSU

One of the most troubling aspects of the response to the COVID-19 pandemic has been the low vaccination rates among socially marginalized communities. Individuals from communities of color, non-native English speakers, those who are incarcerated, and those experiencing homelessness and transient people have generally been more hesitant to receive COVID-19 vaccines than others – even as virus infections have been disproportionately higher for these groups in many places.

Pueblo County, Colorado, a metropolitan area south of Denver with relatively high poverty rates and COVID infections, was a case in point even after the county established a mass-vaccination center at the county fairgrounds. So, last year, when the Federal Emergency Management Agency asked why and what could be done to overcome a potential public-health crisis, it turned to Colorado State University Professor Emeritus Kate Browne and a team of cultural anthropologists.

“The anthropological perspective can really help us understand the thinking process and the narratives and barriers behind vaccine hesitancy,” said Joshua Bauer, an anthropology master’s candidate who worked on the project. “The social and human dimensions of multi-faceted disasters” – from hurricanes to pandemics – “are so entangled with concepts of identity, loyalty to community, the sort of ‘insider-outsider’ dynamics of who you trust, who you don’t trust, as well as the constant negotiations that people have to make.” Anthropologists, Bauer said, can help with the untangling of those barriers.

CSU Professor Emeritus Kate Browne speaking with a FEMA worker.
CSU Professor Emeritus Kate Browne speaking with a FEMA worker.

This past summer, Browne recruited Bauer and Shadi Azadegan (M.A. ’21) — “two of the most exceptional students I have ever worked with,” she said – to help lead a study and co-author a report, funded through a grant from FEMA. The project investigated what Browne refers to as “the ‘why’ questions,” gathering insight to identify and address the reasons and rationales for vaccine hesitancy among marginalized and diverse populations in Pueblo County and how to overcome those barriers and shift attitudes. Bauer studies archaeology but calls cultural anthropology “my first love.” After completing Browne’s Resilience, Well-Being, and Social Justice course in Spring 2021 – “a crash course in social-science and cultural field work,” according to Bauer – he jumped at the opportunity to collaborate with her on ethnographic research.

“Ethnography – spending time on the ground with people who we observe and talk to and who come to trust us and confide their stories with us – is the gold standard method for anthropologists,” said Browne who co-leads the Culture and Disaster Action Network, a group of researchers and practitioners who study disaster response and resilience and which has been working with FEMA and emergency managers since 2018. “Although this was his first cultural interviewing situation, Joshua’s language skills, cultural sensitivity, and quick resourcefulness at pivotal moments all impressed me.”

Bauer and Azadegan compiled advance research on Pueblo County and its ethnic diversity, social history, and data on positive cases of COVID-19 and vaccination patterns. Bauer, who speaks Spanish, served as the primary contact for Latinx community groups. He also communicated with trusted, local community members – culture brokers, in ethnographic terms – to enlist them to organize and facilitate five focus groups in Pueblo to increase participation from target populations. Through those focus groups, Browne and Bauer listened to male and female inmates, migrant farmworkers, and homeless populations share their concerns and perceptions toward COVID vaccines and public health. In the case of migrant farmworkers, the CSU anthropologists heard that individuals were willing to receive a vaccine but were worried that missing a day of work to get a shot might get them fired. For this community, the risk and consequences of getting COVID are less than the costs of losing their job and income to support families here, and in some cases abroad. Other respondents said they worried that government officials might arrest or deport them if they tried to get a vaccine at the county’s mass vaccination site and expressed a distrust of government based on personal experiences or examples from history. Such barriers made it less likely for immigrants to go to a large, centralized, government-run vaccination site, like the county fairgrounds.

Kate Browne and Joshua Bauer
Professor Emeritus Kate Browne and anthropology graduate student Joshua Bauer

“It’s not necessarily political,” Bauer said. “It was related to trust and institutions, which does have political connotations but, really, a lot of people feel like they’ve been let down by institutions. People have very real and valid reasons for not wanting to take what they see as that leap of faith.”

Browne added that the historical traumas suffered by many communities of color are part of the legacy that people live with and are influenced by.

Based on their observations, the CSU-led team published a 47-page report for FEMA. The report shares specific messages and actionable recommendations addressing groups’ expressed reasons for vaccine hesitancy and perceived barriers as well as ratings for assessing groups’ potential to change their positions toward vaccines. Bauer and Browne conducted a post-study webinar for the FEMA Office of Higher Education and Region 8 (Northern Rockies) officials, and Browne also presented findings to FEMA’s D.C. leaders, including Deputy Administrator Erik Hooks, this February.

One of the most emphatic recommendations from the study suggests following the group’s own methods and working with culture brokers – those trusted individuals who can bridge gaps and help build trust between impacted communities and organizations such as FEMA and health-services providers. Browne’s post-Katrina research with African American families helped reveal the critical role of culture brokers to help impacted communities communicate with outside agencies and service providers and recover their resilience.

“Our work is a great example of how anthropology and social science can break through the stalemates of entrenched social problems to locate a sustainable path forward,” Browne said. “This kind of work offers incredible promise, and I believe that is why we are the first academics to break through to the top levels of FEMA and other federal agencies.”

Bauer is also encouraged by the response from FEMA and sees opportunities for anthropologists who study disaster response and resilience.

“It is encouraging that FEMA is so interested in this type of work because they do want to get better [serving marginalized communities],” Bauer said. “I think it bodes well for our field and social science in general. Maybe anthropology is garnering the respect that it has long deserved.”

The Department of Anthropology and Geography offers an M.A. and Ph.D. in Anthropology. Visit the department website to learn more about these programs.