Community-Engaged Curriculum Development Using Racial Justice and Biomedical Lenses to Address COVID-19 Vaccine Hesitancy in Black Individuals with Rheumatologic Conditions

Eseosa Osaghae^1*Greta Sirek²Tonya Roberson³Mia Chandler⁴Ariel Childs⁵Monica Crespo-Bosque⁶Gina Curry⁷Amar Dhand⁸Mary Dollear⁹Alice Eggleston¹⁰Nnenna Ezeh¹¹Dieufort Fleurissaint¹²Denice Garrett¹³Gail Granville¹⁴Muriel Jean- Jacques¹⁵Elena Losina^16,17Holly Milaeger¹Lutfiyya Muhammad¹⁸Mary Ann Nelson¹⁹Chisa Nosamiefan²⁰Bisola Ojikutu^17,21,22Neil Pillai¹Marie Jacques Toussaint¹²Mary Beth Son⁴Ana Valle²Jessica Williams²³Michael York⁶Karen Mancera-Cuevas²⁴Candace Feldman²Rosalind Ramsey-Goldman¹

• ¹Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
• ²Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
• ³Governors State University College of Health and Human Services, University Park, IL, United States
• ⁴Rheumatology Program, Boston Children’s Hospital, Boston, MA, United States
• ⁵Vital CxNs, Boston, MA, United States
• ⁶Department of Rheumatology, Boston Medical Center, Boston, MA, United States
• ⁷Office of Community Engagement and Cancer Health Equity, Comprehensive Cancer Center, University of Chicago, Chicago, IL, United States
• ⁸Division of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
• ⁹Lupus Society of Illinois, Chicago, IL, United States
• ¹⁰Alliance Chicago, Chicago, IL, United States
• ¹¹Department of Internal Medicine and Dermatology, Brigham and Women's Hospital, Boston, MA, United States
• ¹²True Alliance Center, Inc, Boston, MA, United States
• ¹³Action for Bridgeport Community Development, Inc. (A.B.C.D., Inc.), Bridgeport, CT, United States
• ¹⁴Mattapan Community Development Corp; Women of Courage, Boston, MA, United States
• ¹⁵Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
• ¹⁶The Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedics, Brigham and Women’s Hospital, Boston, MA, United States
• ¹⁷Harvard Medical School, Boston, Massachusetts, United States
• ¹⁸Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
• ¹⁹Mission Hill Health Movement Inc, Roxbury, MA, United States
• ²⁰The Labalaba Foundation for Lupus Advocacy and Awareness, South Weymouth, MA, United States
• ²¹Boston Public Health Commission, Boston, Massachusetts, United States
• ²²Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
• ²³Division of Rheumatology, Department of Medicine, Emory School of Medicine, Atlanta, GA, United States
• ²⁴National Health Council, Department of Health Equity, Washington, D.C., United States

Despite the efficacy of the COVID-19 vaccine in reducing mortality and illness severity, racial inequities in vaccination uptake persist. Among individuals with rheumatologic conditions who are often immunocompromised, the impact of disparities in preventive care threatens to widen existing inequities in adverse outcomes related to COVID-19 infection. There exists an urgent need to develop interventions that reduce COVID-19 vaccine hesitancy and promote vaccine uptake. We leveraged long-standing community-academic partnerships in two cities to develop a curriculum that will be part of an intervention to decrease COVID-19 vaccine hesitancy within Black communities. We describe the collaborative efforts that resulted in the creation of two interactive virtual curricula with similar core content but different theoretical lenses. One lens uses a racial justice approach to acknowledge the effects of historical and current structural racism on vaccine hesitancy, the other utilizes a traditional biomedical lens. In a future trial, we will compare the efficacy of these curricula to empower Black individuals identified as Popular Opinion Leaders (POLs), or trusted community members with large social networks, to disseminate health information to promote COVID-19 vaccine uptake. Strategies to reduce racial inequities in COVID-19 vaccine uptake must begin with accurately identifying and empathetically acknowledging the root causes of vaccine hesitancy, as well as addressing nuanced concerns that drive vaccine avoidance amongst Black individuals. Community engagement and collaboration are central in creating interventions to develop and test culturally relevant strategies, as observed with our curricula, that bridge scientific efforts with community concerns and practices.