Abstract
New York City (NYC) was the first epicenter of the COVID-19 pandemic in the USA. Despite the availability of COVID-19 vaccines by 2021, vaccination rates varied among racial and ethnic groups, further exacerbating COVID-19-related health disparities. This study explores the relationship between vaccination status and perspectives on COVID-19-related topics among racially and ethnically diverse NYC residents. The New York Community Engagement Alliance Against COVID-19 Disparities (NYCEAL) conducted focus groups with NYC residents to explore their perceptions about vaccine effectiveness and barriers to vaccination that may impact vaccine decision-making. We conducted seven focus groups between December 2021 and April 2022 in English and Spanish with individuals grouped based on vaccination status: (1) those vaccinated when vaccines first became available, (2) those vaccinated after mandates were announced, and (3) those who remained unvaccinated. Transcripts were initially analyzed using a priori and in vivo codes, and the team utilized framework analysis to examine similarities and differences across groups. Emerging themes centered on trust in science, perceived vaccine effectiveness, and the evolution of people's COVID-19-related perspectives, experiences, and behaviors over time. Although there were distinctions between groups on concepts like trust in science and perceived vaccine effectiveness, people's cognitive biases seemed to affect their perceptions but not necessarily their (vaccine-related) behaviors. Findings from this study may help public health professionals understand vaccine decision-making from the perspective of a diverse set of New Yorkers for use during future epidemics.