ACADEMIA Letters A Study of the High Acceptance Level of Asian Americans for COVID-19 Vaccination Xiao Li, The University of Texas Health Science Center at Houston Hongying Liu, Nanjing University of Finance and Economics Asian Americans have been in the spotlight since the COVID-19 epidemic in China has metastasized into a global pandemic. An increasing number of studies have suggested that Asian Americans have been struggling during this pandemic, including the wave of anti-Asian discrimination and the higher mortality rate of COVID-19 among Asian Americans. Nonetheless, Asian Americans have the highest acceptance level for the COVID-19 vaccination. Hanson (2021) indicated that Asian Americans was the racial group of having the highest percentage (17.4%) in taking vaccines vaccinated at least one dose by March 9, 2021, compared to Indigenous (17.25), White (16.4%), Black (8.9%), and Latino (8.3%). PWC (2021) also discovered that Asian Americans in Virginia had a high level of willingness to receive COVID-19 vaccination. Trying to better understand Asian Americans as a fast-growing racial group in the US, this study investigated the reasons for the high acceptance level of Asian Americans for COVID-19 vaccination through in-depth personal interviews with 15 Asian Americans. First, this study has found that Asian Americans were very mindful for the prevention of COVID-19, which matched the conclusions of previous studies (Hearne, & Niño, 2021). All interviewees have reported that they vigilantly took multiple prevention strategies to ward off COVID-19. For example, they always a) wear masks when going outside, b) frequently wash hands, c) significantly reduce the frequency of being outside, d) keep social distancing outside their home, and e) use alcohol gel or Lysol spray to disinfect package deliveries. Moreover, the interviewees frequently communicated with their families, friends, and other social connections in Asia to seek more prevention tips and suggestions that they can follow to reduce infection risks. Particularly for Chinese Americans, they read many COVID-related Academia Letters, July 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Xiao Li, lilac.lee2014@gmail.com Citation: Li, X., Liu, H. (2021). A Study of the High Acceptance Level of Asian Americans for COVID-19 Vaccination. Academia Letters, Article 1470. https://doi.org/10.20935/AL1470. 1 articles through the WeChat App and believed that mask wearing, hand-washing, and social distancing were very effective and necessary as self-protections in the pandemic. Second, Asian Americans are more likely to respect their government authorities. With the Confucian culture and traditions, many Asian Americans greatly respect the hierarchic and deferential social authority (Feng, 1994). Although 80% of the interviewees lost their trust in CDC by some CDC misleading guidelines in the onset of the pandemic in the US, such as discouraging mask wearing, they were still willing to follow CDC COVID-19 guidelines as long as these guidelines are consistent with the mainstream guidelines in their Asian countries. Moreover, 73% of the interviewees reported that they believe that vaccine is the most effective prevention for COVID-19, and they trust the professionalism and authority of FDA. 33% of the interviewees pointed out that FDA is one of the most respected scientific authorities and health organizations to guarantee the safety and effectiveness of new medicine, regardless of political intervention. Furthermore, the considerable psychological distress of Asian Americans during the COVID19 pandemic has been motivating them to accept vaccination. Asian Americans are facing two components of distress. Firstly, they have higher anxieties toward the COVID-19 infection due to their direct or indirect experience of SARS epidemic in 2003, so that many Asian Americans are concerned with the lethal danger of the new Coronavirus pandemic (Dhanani, & Franz, 2020). In addition, 87% of the interviewees expressed their beliefs that the COVID19 infection may lead to lifelong sequelae. Secondly, there has been a distress stemming from anti-Asian Racism due to the suspected origin of the pandemic. Many news and studies have suggested that there were exacerbating hostility of racism and xenophobia towards Asian Americans, especially Chinese Americans being suspected to be the source of the pandemic (Gover, Harper, & Langton, 2020; Le, Cha, Han, & Tseng, 2020). Under such mounting pressure, Asian Americans are eager to take definitive and terminating actions to address these challenges. They regard vaccination as the light at the end of the tunnel for the pandemic. Last but not least, Asian Americans tend to believe that vaccines are effective solutions for stopping COVID-19 based on their health literacy. Li, Mitchell, & Decker (2021) have found that Asian Americans were inclined to have high level of self-perceived health literacy, regardless of their social demographic factors, such as education background and income levels. Similarly, this study has also found that Asian Americans were quite confident with their health literacy mainly due to the universal health preservation philosophy in the Asian culture. For example, health preservation is a prevalent topic in TV shows or magazines among Asian groups, especially for elderly people. All interviewees reported that they did much research for the effectiveness and side effects of all the COVID-19 vaccines, such as Pfizer, Moderna, and Johnson & Johnson, which are the mainstream vaccines in the US. 87% Academia Letters, July 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Xiao Li, lilac.lee2014@gmail.com Citation: Li, X., Liu, H. (2021). A Study of the High Acceptance Level of Asian Americans for COVID-19 Vaccination. Academia Letters, Article 1470. https://doi.org/10.20935/AL1470. 2 of the interviewees fully embrace and actively support the vaccination strategy and believe that the pandemic will eventually end if most residents are willing to roll up their sleeves for vaccine injections. 80% of the interviewees have the basic knowledge of these three vaccines by knowing the efficacy rate of these three vaccines from the official data. Moreover, 73% of the interviewees prefer taking the first two vaccines because their efficacy rates are higher than the third one. Based on the analysis above, this study has multiple recommendations for practitioners: a) to strengthen the vaccination accessibility of Asian Americans in their populated areas to leverage their higher affinity to vaccination and to accelerate the coverage of vaccination, b) to implement appropriately targeted policy to encourage and facilitate the Asian American communities to motivate other American racial and ethnic groups to accept vaccinations, and c) take necessary actions to curb the unhealthy anti-Asian discriminatory wave and provide social assistance partnering with Asian organizations in a hope of reducing psychological distress of Asian Americans and physical violence towards them. References Dhanani, L. Y., & Franz, B. (2020). Unexpected public health consequences of the COVID19 pandemic: a national survey examining anti-Asian attitudes in the USA. International journal of public health, 65(6), 747-754. Feng, J. (1994). Asian-American Children: What Teachers Should Know. ERIC Digest.1-6. https://files.eric.ed.gov/fulltext/ED369577.pdf Gover, A. R., Harper, S. B., & Langton, L. (2020). Anti-Asian hate crime during the COVID19 pandemic: Exploring the reproduction of inequality. American journal of criminal justice, 45(4), 647-667. Hanson, M. (2021). Inoculation nation: limited COVID-19 vaccine data shows uneven access by race. Retrieved from https://www.apmresearchlab.org/covid/vaccines-by-race Hearne, B. N., & Niño, M. D. (2021). Understanding How Race, Ethnicity, and Gender Shape Mask-Wearing Adherence During the COVID-19 Pandemic: Evidence from the COVID Impact Survey. Journal of racial and ethnic health disparities, 1-8. Le, T. K., Cha, L., Han, H. R., & Tseng, W. (2020). Anti-Asian Xenophobia and Asian American COVID-19 Disparities, 110(9), 1371-1373. Academia Letters, July 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Xiao Li, lilac.lee2014@gmail.com Citation: Li, X., Liu, H. (2021). A Study of the High Acceptance Level of Asian Americans for COVID-19 Vaccination. Academia Letters, Article 1470. https://doi.org/10.20935/AL1470. 3 Li, X., Mitchell, P. J., & Decker, J. P. (2021, March 12). Healthcare prevention and disparities of Asian Americans during the COVID-19 pandemic. Manuscript submitted for publication. PWC. (2021, Feb 10, 2021). Challenges and Recommendations for COVID-19 Vaccine Roll Out in Asian American Communities in Virginia. Retrieved from https://coronavirus. pwcgov.org/news/challenges-and-recommendations-for-covid-19-vaccine-roll-out-in-asianamerican-communities-in-virginia/ Academia Letters, July 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Xiao Li, lilac.lee2014@gmail.com Citation: Li, X., Liu, H. (2021). A Study of the High Acceptance Level of Asian Americans for COVID-19 Vaccination. Academia Letters, Article 1470. https://doi.org/10.20935/AL1470. 4