It found more than half of unvaccinated American adults who reported strong hesitancy to the vaccine had a high school education or less. Five of the top 10 reasons for bypassing inoculation included lack of knowledge about its benefits and the risks of remaining unvaccinated. 

A lack of confidence in the shot itself followed by concerns about side effects and distrust in government were listed as the greatest concerns among the vaccine hesitant, according to a draft version of , which will be published in an upcoming issue of the

鈥淰accine hesitancy is a complex problem across the U.S.,鈥� said Saif Khairat, associate professor at the University of North Carolina at Chapel Hill and the study鈥檚 principal author. 鈥淎nd the root cause of that problem is different for different people.鈥�

The study considered a number of variables, including the percent of households with no access to a vehicle; those who were unemployed; had less than a high school education; had trouble speaking English; identified as a member of a minority group; lived in poverty; were over 65 or were single parents with children under 18. 

The paper centered on data collected by the Centers for Disease Control and Prevention as of May 9, 2021. It examined statistics from nearly every county in America 鈥� Texas did not provide vaccination data 鈥� in an effort to help policymakers better understand the characteristics of vaccine holdouts.

While the study focused on information gleaned more than eight months ago, the issue remains: Just as of Jan. 20, according to the Mayo Clinic.

Vaccination rates vary widely by age. More than 84 percent of U.S. adults age 65 and older are fully inoculated, according to . The figure drops dramatically for children ages 5 to 11: It tops out at 48.4 percent of young children in Vermont and just 5.3 percent in Alabama. The CDC for this age group in November. 

continue to feel the strain 鈥� some at record levels 鈥� as COVID-related beds are filled mostly by patients who have not been inoculated. Some countries, buckling under the Omicron variant, are considering a . 

Former President Donald Trump, who once famously said he loves 鈥渢he poorly educated,鈥� downplayed the severity of the virus, though he was vaccinated. The notion has a stubborn hold on his most ardent followers who at a recent event when he said he received a vaccine booster. 

Khairat and his co-authors said public outreach targeting the undereducated should address the shot鈥檚 safety and effectiveness and include statistics on the percentage of people within their local community who have received the inoculation. Vaccine promotion efforts should incorporate discussion of a path back to normalcy through herd immunity 鈥� information, they said, best delivered by a trusted, locally recognized figure.

of American adults ages 25 and older had not earned their high school diploma as of 2017, according to the American Council on Education. Another 29 percent graduated high school but did not further their education.

Anthony DiMaggio, associate professor of political science at Lehigh University, said his recent analysis shows that age is the strongest predictor of vaccination rates 鈥� but that education also plays a major role. 

鈥淲hat is not in question is that both factors are significant in accounting for whether people are vaccinated or not, with less educated Americans and those under 60 being less likely to have gotten at least two shots by mid-2021,鈥� he said. 

John A. Romley, associate professor at the University of Southern California, helped conduct earlier this year. He and his colleagues discovered that U.S. counties that scored high on both hesitancy and 鈥渟ocial vulnerability鈥� were 鈥渆specially likely鈥� to have lower COVID-19 vaccination rates than the rest of the nation.

Romley and his team have more recently begun to focus on children. Preliminary results from their latest efforts show socioeconomic disadvantage plays a larger role in vaccination rates for kids than it does for adults.

鈥淧arents think about vaccinations for themselves differently than they think about vaccinations for their kids,鈥� Romley said. 

Some adults are required by their employers to take the vaccine. They also might realize they are more vulnerable to a more severe illness than their children, he said. Other unknowns, including the shot鈥檚 long-term impact, might also contribute to their hesitancy. 

鈥淭alking to people with respect and trying to persuade them is the only way to make progress,鈥� Romley said. 鈥淏ut in these polarized times, the conversations we have are pretty heated and I don鈥檛 think that鈥檚 helping.鈥�

Time has shown that not recommendations, are more effective in boosting vaccination rates. 

to push for a vaccine mandate for students back in October: The requirement would go into effect in July. states have followed suit. 

Individual school districts, including Los Angeles Unified, that tried the same tactic were met with immediate backlash and by the threat that additional students would go remote. New York City schools have so far not required students be vaccinated, with Mayor Eric Adams promising a decision on a mandate . 

But at least one New York City educator said mandates are not the answer, even in the face of the Omicron variant. Patrick Sprinkle, a high school social studies teacher at the N.Y.C. Lab School for Collaborative Studies in Manhattan, said he鈥檚 worried about inoculation rates and the spread of the virus, but doesn鈥檛 believe families should be forced to take the shot. 

鈥淭his remains a pressing concern for me,鈥� he said. 鈥淚t is of the utmost importance that we encourage families to have their children vaccinated, however, a mandate is an unwise policy decision as it will push more students into ineffective remote learning and deny students the highest quality education possible.鈥�

She herself moved to the United States from Bangladesh with her family when she was 5, and still remembers the feeling of struggling to communicate with her classmates in the years following. Many non-English speakers, the Quincy, Massachusetts high school junior feared, might miss out on potentially life-saving facts about the virus and immunizations.

鈥淭here’s that whole language barrier that makes it a lot more difficult to communicate and share accurate information,鈥� she told 蜜桃影视. 鈥淚t also does cause a lot of [vaccine] hesitancy.鈥�

Wanting to do her part to combat the problem, the teen in March signed on as a youth leader with the a Boston-based team of high school, undergraduate and medical students of color working to provide information about coronavirus immunizations to the area鈥檚 Black and immigrant communities.

Now, she leads online seminars 鈥� called 鈥渆mpowerment sessions鈥� 鈥� that address some of the most commonly held misconceptions about the COVID shots. The sessions not only provide facts about the vaccine, but also speak to histories of medical racism, such as the infamous Tuskegee study of untreated syphilis where for decades under the guise of free health care. 

Including information on such egregious historical events allows presenters to acknowledge the reasons that undergird many Black, Indigenous, Asian and Hispanic residents鈥� reservations about the vaccine, said the group鈥檚 director of youth programming, Laetitia Pierre-Louis.

鈥淲e make sure that we have just these raw conversations about, you know, medical racism and what happened in the past and is still, unfortunately, happening today,鈥� she told 蜜桃影视.

Amid a pandemic that at every turn has taken a disproportionate toll on people of color, killing Black Americans at of white Americans, the We Got Us Project conveys reputable information on the virus to Boston鈥檚 most vulnerable communities from voices they can trust, its leaders say.  

It鈥檚 the group鈥檚 makeup as primarily Black, Hispanic and immigrant youth that helps their message resonate for many residents, said Pierre-Louis, who is also a fourth-year premedical student at Northeastern University.

鈥淚 think it鈥檚 incredibly important who tells you about the information [on the vaccine],鈥� she said, explaining that her Haitian lineage and ability to speak French have often made her conversations with people of that background easier. 

鈥淗aving somebody who speaks with them in their own language, who understands their cultural background 鈥� and really understands what they mean when they share out their concerns about the vaccine definitely makes a large difference.鈥�

Especially in discussions with young people, said Habiba, it helps to have a peer deliver facts about the vaccine.

鈥淎 lot of times, the things that adults can say to us seem more patronizing 鈥� like the way a parent would tell a child to do their chores,鈥� she explained. 鈥淐oming from another person your own age, it kind of signifies the importance of it.鈥�

We Got Us 鈥� , the first Black woman to serve as student council president at Harvard Medical School 鈥� has so far presented to over 400 youth and adults. They鈥檝e run sessions for groups from schools designed to serve immigrant students like the and nonprofits like the . 

The team has also run door-knocking campaigns and held numerous community events. Most recently, in the primarily Black neighborhood of Roxbury, they ran a Nov. 30 session in collaboration with the Boston Children鈥檚 Hospital for youth to . 

Through its canvassing efforts, the organization has reached over 2,700 individuals, creating and distributing more than 1,500 mask and sanitizer kits and scheduling , Research Director Melissa Jones, an undergraduate student at Harvard University, told 蜜桃影视. More than half of participants in empowerment sessions said on exit surveys that if the COVID-19 vaccine were offered to them, they would 鈥渄efinitely鈥� take it.

Additionally, the youth-led organization has twice presented to members of the Massachusetts Department of Public Health to inform the agency鈥檚 approach to helping marginalized communities access vaccines.

Massachusetts has a higher-than-average overall share of Black, Hispanic and Asian residents immunized against the coronavirus compared to the rest of the U.S., according to published Dec. 2 by the Kaiser Family Foundation. But gaps still remain: The Black vaccination rate (72 percent) lags behind the white rate (81 percent) by nine points, a wider margin than the national average. Numbers published by the state indicate a slightly larger gap.

Though the Massachusetts Department of Public Health does not disaggregate youth vaccination data by race, published in late November by the Massachusetts-based Vaccine Equity Now! Coalition show that communities in the state with higher shares of economically and socially vulnerable households COVID immunization rates among 12- to 17-year olds than locales with fewer vulnerable residents. 

Across the country, racial disparities in youth vaccination worry officials. In five core counties in the San Francisco area, for example, 52 percent of Black students were immunized as of early November, compared to 85 percent of students overall 鈥� prompting fears that looming student vaccine mandates imposed by local school districts may have a .

Those disparities underscore, in the eyes of We Got Us members, the pressing nature of their work. Still, when speaking to people who have their doubts about the vaccine, the group鈥檚 motto is to 鈥渃onvey, not convince,鈥� Pierre-Louis explained. 

鈥淲e want to make sure that [participants] are empowered by the information. We want to make sure that they’re well aware of what’s being discussed about the vaccine so they can make the right decision for themselves,鈥� she said.

Not as a participant but as a youth member, Habiba herself has felt invigorated by what she鈥檚 learned. Training to lead sessions for peers, she was introduced to information that school had never taught her, such as disparities in health care and the historical events that explain some residents’ current day distrust of the medical establishment. 

鈥淥nce you start to connect those dots, it’s really eye-opening,鈥� said the high schooler, who is considering studying epidemiology in college. 

But every time she logs into a session with the We Got Us Project to promote vaccine equity, Habiba believes she鈥檚 working to combat those systemic problems.

鈥淚t definitely does feel like one small step,鈥� she said.

Pierre-Louis is similarly gratified. She鈥檚 so passionate about her responsibilities with the organization, she said, that it 鈥渄oesn’t really feel like work鈥� despite having to squeeze in training sessions between her undergraduate courses and studying for the MCAT exam. 

For her, the ultimate purpose of the project is about hearing and elevating the perspectives of marginalized communities amid a life-threatening pandemic. 

It鈥檚 how she understands the name itself, We Got Us.

鈥淚t really means we鈥檙e here for you,鈥� said the college senior. 鈥淲e鈥檙e here to fight for you. We鈥檙e going to listen to you. And we鈥檙e really here to make sure that your voices are heard.鈥�