Empowering communities during the COVID-19 pandemic: insights from trusted messengers about their work addressing COVID-19 vaccine hesitancy.

Community-based trusted messengers were vital actors, bridging the gap between public health recommendations and community member decisions about the COVID-19 vaccine, particularly in areas hardest hit by the pandemic. However, less is known about the tactics they use to do their work. This study reports results from five focus groups of outreach workers to understand: (1) their perceptions of vaccine confidence and hesitancy; (2) their specific tactics for rebuilding trust and delivering clear, consistent messages about the COVID-19 vaccine; and (3) the external environmental factors shaping their community's perceptions of the pandemic. Three key themes emerged around trusted messengers' perceptions of factors influencing vaccine uptake, their tactics in the community, and other environmental factors influencing vaccine decisions. We report these factors and practical suggestions for training and supporting trusted messengers.