Perspectives of Vietnamese Americans Regarding COVID-19 Vaccine Acceptance, Trusted Sources of Information, and Pandemic-related Challenges

Journal of Racial and Ethnic Health Disparities https://doi.org/10.1007/s40615-025-02327-7 Perspectives of Vietnamese Americans Regarding COVID‑19 Vaccine Acceptance, Trusted Sources of Information, and Pandemic‑related Challenges Celine Nguyen1,2 · Ben King3,4 · Jannette Diep5 · Lauren Gilbert6 · Bich‑May Nguyen3 Received: 6 March 2024 / Revised: 2 January 2025 / Accepted: 18 February 2025 © The Author(s) 2025 Abstract Background Due to limited research on Asian Americans and COVID-19, we investigated the perspectives of Vietnamese Americans regarding COVID-19 vaccine acceptance, trusted sources of information, and pandemic-related challenges. Methods Vietnamese American adult residents in Texas were recruited between September 2021 through March 2022 to complete the NIH CEAL Common Survey 2 electronically in English or Vietnamese, which contains 23 questions about social determinants of health, information, trust, risk perception, testing and disease control, COVID-19 vaccination, and demographics. We analyzed data using bivariate logistic or linear regression models. Results Of the 224 completed responses, 181 participants were vaccinated (80.8%), 20 (8.9%) were partially (one of two-dose courses) vaccinated, and nine (4%) were unvaccinated. Of the unvaccinated individuals, 44.4% reported that getting vaccinated in the next 3 months was “not likely at all,” and the top barriers included safety concerns (77.8%), side effects (66.7%), and vaccine efficacy (44.4%). Vietnamese-language responders had significantly higher odds of experiencing non-medical challenges in obtaining food (OR = 2.08, p = 0.020) and transportation (OR = 2.56, p = 0.008) than English-language responders. Older age was significantly associated with reporting non-medical challenges in obtaining food (β = 8.39, p < 0.001), water (β = 9.58, p < 0.05), medications (β = 6.43, p < 0.05), and transportation (β = 5.69, p < 0.05). Conclusion Our findings describe barriers to vaccine acceptance and reveal variance in the prevalence of non-medical challenges among Vietnamese-language participants. It also showed within-group variation in COVID-19 vaccine attitudes and trusted sources of information among Vietnamese Americans. Research with disaggregated data can guide strategies to address non-medical health disparities in diverse communities. Keywords COVID-19 vaccines · Vaccine hesitancy · Immunization · Vaccination · Vietnamese Americans · Asian Americans Introduction * Bich‑May Nguyen 1 Vietnamese Culture and Science Association, Houston, TX, USA 2 The University of Texas Southwestern Medical School, Dallas, TX, USA 3 Tilman J. Fertitta Family College of Medicine, The University of Houston, 5055 Medical Circle, Houston, TX, USA 4 Humana Integrated Health Systems Sciences Institute, University of Houston, Houston, TX, USA 5 Boat People SOS Houston, Houston, TX, USA 6 University of Wyoming, Laramie, WY, USA The COVID-19 pandemic has disproportionately affected people of color in the United States, highlighting the need for comprehensive research investigating how COVID-19 has impacted diverse ethnic groups. Existing studies show that disaggregated COVID-19 data within individual Asian American and Pacific Islander (AAPI) subgroups are not commonly reported, limiting understanding of potential disparities across this heterogeneous population [1]. Preliminary research examining disaggregated data on COVID-19 reveals disproportionately high mortality rates among AAPIs, with Vietnamese individuals exhibiting nearly double the odds of hospitalization related to COVID-19 than non-Hispanic whites and several Asian subgroups [2, 3]. Unfortunately, there is limited research Vol.:(0123456789) Journal of Racial and Ethnic Health Disparities evaluating disaggregated data on the facilitators and barriers of COVID-19 vaccine uptake among Vietnamese Americans. While some studies have disaggregated data on COVID19 vaccine willingness in AAPI communities, exploration of community-specific characteristics or reasons associated with vaccine acceptance is limited [4]. Despite a subpopulation exceeding 2.3 million in the United States in 2023, Vietnamese Americans have received modest research attention [5]. In addition to being overrepresented in COVID-19 cases, additional research suggests that Vietnamese Americans who work in high-contact industries face an increased risk of infection [5]. Analyzing the facilitators and obstacles associated with COVID-19 vaccination uptake among Vietnamese Americans could offer valuable insights into actionable strategies for community leaders, government entities, and institutions seeking to engage this specific population effectively. Identifying individual beliefs and barriers is the crucial first step in promoting health, especially in COVID-19 prevention. Health behaviors, including vaccination acceptance, within the Vietnamese American community are often deeply rooted in Vietnamese culture, and thus can deviate significantly from those of the general population and other minority groups [6]. Cultural differences, personal beliefs, limited English proficiency, and diverse trusted information sources may further influence COVID-19 vaccine access and acceptance, influencing health behaviors and outcomes [7–9]. Exploring these factors can provide insights into the influence of individual beliefs and barriers on COVID-19 vaccine acceptance among the distinct demographic segments of the Vietnamese American community. Resource-related barriers, such as lack of access to a primary care provider, and education level, can greatly impact health and health prevention behaviors [10]. After the enactment of the Affordable Care Act, the number of uninsured Vietnamese Americans is currently comparable to white Americans [10, 11]. Among the literature on hepatitis B virus (HBV) screening and vaccination behaviors, lack of a regular source of care were associated with fewer HBV screening behaviors among Vietnamese Americans [12, 13]. One study investigating the prevalence and barriers of HBV screening and vaccination among Asian Americans found that while Vietnamese Americans had the lowest rates of screening and vaccination as a subgroup; being younger, having a higher knowledge of HBV, and having health insurance were significantly associated with HBV vaccine uptake rates within the Vietnamese American subgroup [14]. However, the association between similar sociodemographic and person-level factors, including a regular source of care, continued health insurance coverage during the pandemic, and education level, has not yet been explored in patterns of COVID-19 vaccine uptake in this demographic group. For immigrants, including Vietnamese Americans, social support and social networks are important factors associated with health information-seeking behavior [15, 16]. Studies focusing on Vietnamese Americans have identified that improvements in family and community safety, root (...truncated)