To date,the United States(U.S.)has been the most heavily impacted country by the coronavirus disease 2019(COVID-19).By November 30,2020,when this paper was written,13.5 million cases were reported in the U.S.with over 268000 deaths.Historically,vaccines have been one of the most effective and efficient technical tools for controlling a communicable disease.While the development of these vaccines has certainly been a challenge,it could be more challenging to achieve robust vaccine uptake because of many barriers.In this review,we focused on two types of barriers documented from long-term experience in the U.S.:structural and attitudinal.Structural barriers are systemic issues that impact one''s ability to access a service,and they include time,transportation,cost,and clinic or outlet location;while attitudinal barriers are beliefs or perceptions that impact the willingness of at-risk individuals to seek out and/or accept a service.In the context of vaccination they include beliefs about the communicable disease,beliefs about vaccines,fear,and trust in healthcare and governmental agencies.Of the attitudinal barriers,public trust is a barrier that is of particular importance.In addition to affecting reception of vaccines,it may exacerbate disparities and reduce the likelihood of success of a vaccination program.Recommendations are made to overcome attitudinal barriers to help improve the effectiveness of vaccination programs for COVID-19 control in the U.S.,such as building public support through bipartisan endorsements and leveraging social media platforms to promote vaccination.
展开▼
