Partnering With the Faith-Based Community to Address
Disparities in COVID-19 Vaccination Rates and Outcomes
Among US Black and Latino Populations

The latest data from the Centers for Disease Control and
Prevention (CDC) document that Black and Latino indi-
viduals in the US are 3 times more likely than White in-
dividuals to be hospitalized for COVID-19 and twice as
likely to die from the disease.1 Of the US population of
approximately 330 million individuals, more than
100 million are Black or Latino individuals, who com-
prise 32%.2 Nevertheless, Black and Latino individuals
account for only 25% of the 184 million people in the US
who have received at least 1 dose of the COVID-19 vac-
cine, whereas White individuals account for 59% of those
who have received the vaccine.3 Similarly, Black and
Latino individuals comprise only 24% of the 159 million
persons in the US who are fully vaccinated against
COVID-19, whereas White individuals account for 60%
of those fully vaccinated.3

The proportion of White individuals who have
received a COVID-19 vaccine (47%) is about 1.4 times
higher than the proportion of Black individuals (34%)
and 1.2 times the proportion of Latino individuals
(39%) who have received a COVID-19 vaccine.4 A con-
sistent pattern continues with communities of these

racial and ethnic minority groups having substantially
lower vaccination rates in relation to their share of the
population and their overrepresentation among
COVID-19 infections and deaths. In California, Latino
individuals have received only 29% of COVID-19 vacci-
nations, although they account for 63% of those with
COVID-19, 48% of deaths related to COVID-19, and
40% of the state’s total population.4 In the District of
Columbia, Black individuals have received 43% of vac-
cinations, but comprise 56% of those with COVID-19,
71% of deaths related to COVID-19, and 46% of the
total population.4

Several factors appear to be driving these concern-
ing and unacceptable disparities in COVID-19 vaccina-
tion. Decades of published research has documented
that Black and Latino individuals have substantially
worse access to primary care and specialty care and are
much more likely to lack health insurance than White
individuals. As the medical literature and recent events,

such as the George Floyd killing, have underscored, sys-
temic racism continues to be a major challenge for the
US health care system and for US society. In addition,
Black and Latino individuals have understandably low
levels of trust in the federal government and medical
care due to egregious past events involving ethically
unacceptable studies and programs such as the US
Public Health Service and CDC 40-year Tuskegee Study
of Black men with untreated syphilis, unethical devel-
opment of the HeLa cell line from Henrietta Lacks with-
out her permission, and decades of forced sterilization
of Latina women in Puerto Rico and California. It is not
surprising, therefore, that myth-based concerns exist
among these communities that deter their willingness
to receive COVID-19 vaccination, such as beliefs that
these vaccines contain microchips to track Black indi-
viduals or that the vaccine registration process will be
used to deport Latino individuals.

How is it possible to overcome the triple burdens
of impaired access to care, systemic racism, and dis-
trust of the federal government and health care
systems to eliminate COVID-19 vaccine disparities

among Black and Latino communities?
A promising and powerful strategy is to
partner with the faith-based commu-
nity, a highly trusted resource and fre-
quent central gathering place for com-
munities that are composed of racial
and ethnic minority populations. The
National Black Church Initiative (NBCI)
is a coalition of 150 000 Black and
Latino churches aiming to eradicate
racial and ethnic disparities in health

care, technology, education, housing, and the envi-
ronment.5 The mission of the NBCI is to provide critical
wellness information to all members, congregants,
churches, and the public.

In 2021, NBCI announced a 5-year plan that offers
the CDC its 150 000 Black and Latino churches across
the US as vaccination centers. The plan will include a
national advisory committee of 9 prominent Black and
Latino physicians who have evaluated the effective-
ness of each COVID-19 vaccine; will leverage approxi-
mately 1000 Black and Latino US medical professionals
to administer vaccines; and will mobilize several million
volunteers to raise awareness among and communi-
cate to underserved communities, provide transporta-
tion to vaccination centers, and ensure that communi-
ties of racial and ethnic minority populations obtain
their second vaccinations (when indicated). The NBCI
plan has been designed to seamlessly integrate with
the efforts of local and state governments and health

[L]everaging a network of 150 000
churches to advance the public’s health
could prove to be a potent national
model for eliminating Black and Latino
racial and ethnic disparities in health
and health care across the US.

VIEWPOINT

Anthony Evans, MDiv
National Black Church
Initiative,
Washington, DC.

Joseph Webster, MD
National Black Church
Initiative,
Washington, DC.

Glenn Flores, MD
Department of
Pediatrics, University of
Miami Miller School of
Medicine, Miami,
Florida; and Holtz
Children’s Hospital,
Jackson Health System,
Miami, Florida.

Viewpoint pages 595,
597, 599, 601, 603,
605, and 607

Corresponding
Author: Glenn
Flores, MD,
Department of
Pediatrics, University of
Miami Miller School of
Medicine, 1601 NW
12th Ave, 9th Floor,
Miami, FL 33136
(glennflores@miami.
edu).

Opinion

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departments and build communities and networks of cooperation
and trust.

To date, NBCI has engaged 2.5 million volunteers and held
more than 157 vaccination events. In addition, NBCI will soon dis-
tribute a half million copies of VACCNEWS, a newspaper-style single
sheet in simple language (at an eighth-grade literacy level) that
describes COVID-19, COVID-19 vaccines, and the importance of get-
ting vaccinated. The information will be distributed in NBCI’s
150 000 churches, focusing on low-income Black and Latino com-
munities throughout the country. VACCNEWS additionally will be
posted on social media and disseminated nationally as a supple-
ment to 274 Black newspapers and regional dailies targeting Black
and Latino communities.

The NBCI plan also will provide assistance and navigation for
Black and Latino individuals to ensure that they obtain patient-
centered medical homes for primary care, enhance access to care
by collaborating with clinics and hospitals in both urban and rural
areas, launch African American National Health Week during the last
week of July every year, aim to increase childhood and adult vacci-
nation rates for all diseases by 60% over the next 10 years, and cre-
ate special emphasis programs for patients with diabetes, obesity,
or cancer. In addition, NBCI’s approximately 2.5 million nationwide
volunteers will ensure that Black and Latino individuals receive cul-
turally appropriate guidance and education in language they can un-
derstand and trust. It will also ensure that vaccine administration at
churches is an optimal fit with their beliefs, lifestyles, communi-
ties, and cultural values.

The NBCI’s national advisory committee of 5 Black and 4
Latino physicians (the NBCI COVID-19 Data and Information Com-
mittee) is doing more than just evaluating and reporting on vaccine
effectiveness and safety. NBCI national advisory committee mem-
bers will publicize the plan via Black and Latino radio stations, write
articles targeting Black and Latino newspapers and magazines,

leverage social media to eliminate vaccine myths and correct misin-
formation, directly address the concerns of Black and Latino popu-
lations, and mobilize neighborhood influencers, civic groups, and
local public health officials to advocate for vaccination.

Additionally, the NBCI plan will involve sending critical
response teams to zip code–based locations with the highest pro-
portions of impoverished residents, those living in public housing,
or both. Critical response teams will consist of a local team leader,
Latino and Black health professionals, a community representative,
5 to 10 outreach workers/volunteers, and mental health specialists.
Critical response teams will develop and disseminate culturally and
linguistically diverse multimedia outreach programs about
COVID-19 vaccinations; promote use of best practices for disease
prevention, detection, and treatment; and identify future
COVID-19 health care priorities for Black and Latino communities.

NBCI estimates indicate that the total cost of implementing
this plan is $100 million, equivalent to less than $1 per person to
ensure that all 100 million Black and Latino individuals in the US
are fully immunized against COVID-19. Although the NBCI plan is
ambitious, it would be money well spent. If successful, the NBCI
initiative could help ensure progress in the following ways: dispel
COVID-19 vaccine myths, reduce vaccine hesitancy by having cul-
turally relevant information delivered by trusted health care pro-
fessionals and volunteers of racial and ethnic minority groups,
administer COVID-19 vaccines equitably to those at greatest
risk and with the least access, eliminate COVID-19 hospitalization
and mortality disparities for Black and Latino individuals, and
empower communities of racial and ethnic minority populations
to help themselves. Indeed, the NBCI plan of leveraging a net-
work of 150 000 churches to advance the public’s health could
prove to be a potent national model for eliminating Black and
Latino racial and ethnic disparities in health and health care
across the US.

ARTICLE INFORMATION

Conflict of Interest Disclosures: None reported.

REFERENCES

1. Centers for Disease Control and Prevention. Risk
for COVID-19 infection, hospitalization, and death
by race/ethnicity. Updated July 16, 2021. Accessed
July 12, 2021. https://www.cdc.gov/coronavirus/
2019-ncov/covid-data/investigations-discovery/
hospitalization-death-by-race-ethnicity.html#print

2. US Census Bureau. Characteristics of the group
quarters population in the United States: American
Community Survey: 2019: ACS 1-year estimates
subject tables. Accessed July 12, 2021. https://data.
census.gov/cedsci/table?q=S2601A&tid=
ACSST1Y2019.S2601A

3. Centers for Disease Control and Prevention.
Demographic characteristics of people receiving
COVID-19 vaccinations in the United States.
Accessed July 11, 2021. https://covid.cdc.gov/covid-
data-tracker/#vaccination-demographic

4. Ndugga N, Pham O, Hill L, Artiga S, Alam R,
Parker N. Latest data on COVID-19 vaccinations by
race/ethnicity. Kaiser Family Foundation. Accessed
July 8, 2021. https://www.kff.org/coronavirus-
covid-19/issue-brief/latest-data-on-covid-19-
vaccinations-race-ethnicity/#

5. National Black Church Initiative. Accessed July
14, 2021. https://www.naltblackchurch.com/

Opinion Viewpoint

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