COVID-19 Testing and Barriers to Vaccine Hesitancy in the Lumbee Tribe of North Carolina

Abstract

During the COVID-19 pandemic, the North Carolina Central University Advanced Center for COVID-19 Related Disparities (ACCORD), the Lumbee Tribe of North Carolina, and the University of North Carolina at Pembroke (UNCP) established a partnership named Building Resistance and Vital Equity (BRAVE) to perform COVID-19 testing for Native Americans living in the Lumbee tribal territory of Cumberland, Hoke, Robeson, and Scotland counties. BRAVE was also charged with studying the barriers to COVID-19 testing and vaccine hesitancy in this population. North Carolina has the largest American Indian population in the Eastern United States [1]. The state is home to one federally recognized and seven state-recognized tribes representing 167,808 individuals (1.6% of the total population) [2]. More than half of American Indians in North Carolina live in rural, underserved Tier 1 counties: Cumberland (1.4%), Hoke (8.4%), Robeson (39.4%), and Scotland (11.5%) [3]. COVID-19 vaccination rates among those living in the more rural counties have been significantly lower than the state average (48%), with Cumberland, Hoke, Robeson, and Scotland counties reporting vaccination rates of 47.4%, 23.4%, 27%, and 34.5%, respectively [4].