Los Angeles County (LAC) is home to the largest single-race Black population in the state (794,364; 35.5% of the state total per 2020 Census Redistricting Data). As recent as September 2021, Black people had the highest rate of COVID-19 hospitalization. Los Angeles County Department of Public Health (LACDPH) reports on an ongoing basis that for every 100,000 unvaccinated Black residents, more than 15 are hospitalized with COVID-19, which is higher than for Latinx or Whites. In vaccinated Black residents they are more likely to be hospitalized. LACDPH reports that within 100,000 vaccinated Black residents, about five were hospitalized on a recent weekly basis which is twice the rate of many other groups. As of the December 21st projections from LACDPH Blacks of all ages will continue to lag behind in vaccinations compared to all other racial/ethnic groups. 

One problem for successful COVID vaccine intervention and public health advisories in Black populations is our strategies mainly target individual level factors. Such approaches fail to take into account the ways in which historical cultural events (familial legacy of health care), social networks (age/gender specific norms of behaviors) or neighborhood composition and the built health care environment (seeking care in a predominantly Black neighborhood, seeking care in facilities with high negative health outcomes) influence an individual’s behavior. Our research objective is to explore the individual (sociodemographic/health and health care access), family, and neighborhood correlates of (1) vaccine intention, (2) vaccine uptake, and (3) face covering for Black/African American single-race adults ages 18+ in California.