Background. Coronavirus Disease 2019 (COVID-19) vaccine rates in Mississippi are below the national average. Vaccine hesitance is particularly high among rural adults in Mississippi.Purpose. To investigate community members’ beliefs about the COVID-19 vaccine and perceived barriers and enablers of vaccination to inform the development of vaccine education materials.Methods. We conducted in-depth interviews with 20 adult community members in the Appalachian region of Mississippi. Interview notes were analyzed using thematic analysis.Results. Major themes identified were related to barriers and enablers of COVID-19 vaccination. Barriers included safety concerns such as a fear of side effects, fertility issues, death, and distrust of governing bodies. Enablers included a desire to protect individual and community health, as well as a desire to return to social activities. Access to vaccinations were also found to be a non-issue within Mississippi communities. Dominant themes within each concept are reported.Conclusion. Perceptions about the COVID-19 vaccines varied across Mississippi communities; however, the barriers and enablers identified provide significant insight into Mississippians’ attitudes towards vaccination. Messaging focused on the positive aspects of COVID-19 vaccines may contribute to increasing vaccinations in the state. These insights will inform the development of vaccine education and promotion materials in Mississippi.



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