Grocery store workers’ knowledge, attitudes, and barriers influencing uptake of COVID-19 vaccine in the United States: a qualitative study

The objective of the study was to gain insight into the knowledge, behavior, attitudes and beliefs related to COVID-19 vaccines, and communication preferences of U.S. grocery store workers. In-depth interviews were conducted from May 2021 through June 2022 with 75 grocery store workers across the United States (US) who identified themselves as Asian, Black, Hispanic, or White persons. Researchers used maximum variation sampling to recruit a diverse sample by race and ethnicity, age, sex, union status, and geographic location. Rapid Turn-Around (RTA) techniques were utilized to conduct qualitative data analysis. Of the 75 total participants, 39 were female and 36 were male. Participants identified as Asian (n = 16), Black or African American (n = 19), Hispanic or Latino (n = 16) and White (n = 22) persons and ranged in age: 18–34 years (n = 28), 35–49 years (n = 20) and ≥ 50 years (n = 27). Most (79%) participants reported that they were vaccinated against COVID-19 and considered various factors when deciding to get vaccinated such as protecting oneself and loved ones, vaccine safety and potential side effects, others’ experiences with vaccination, the vaccine development process, beliefs regarding their immune systems, vaccine effectiveness, and similarities between the COVID-19 and influenza vaccines. Most unvaccinated women expressed concerns about side effects, compared to about half of the unvaccinated men. Specifically, most unvaccinated female workers had concerns related to fertility issues. Participants’ attitudes regarding employer vaccine incentives and mandates and sources used to learn about the vaccine varied by vaccination status. Although participants’ employers had provided them information regarding the COVID-19 vaccine, these communications were not in participants’ preferred formats. Unvaccinated participants’ attitudes and beliefs suggest there is a critical opportunity to address misinformation related to COVID-19 vaccines and potential side effects among grocery store workers. This study provides evidence of a gap for culturally and linguistically appropriate health communication efforts that are aligned with grocery workers’ health communication preferences.