The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health emergency. As a novel condition, there is no known definitive treatment for the condition, except for the use of vaccines as a control measure. In the literature, the issue of inequalities in healthcare systems has been documented as a hindrance to COVID-19 vaccination; however, the specific inequalities in healthcare systems that hinder COVID-19 vaccination are poorly understood. Guided by the fundamental cause theory (FCT), this study aims to address this gap among Black people, a minority group vulnerable to inequalities in healthcare systems. Thirty-five Black people (age range = 21-58 years) residing in either the United States of America (USA) or the United Kingdom (UK) participated in this study. Qualitative data were collected and analyzed using thematic analysis. Most USA participants and a few UK participants narrated that no inequalities in healthcare systems hinder them from receiving COVID-19 vaccines. Contrarily, most UK participants and a few USA participants narrated inequalities in healthcare systems that hinder them from receiving COVID-19 vaccines. These are mistrust of the healthcare system, health policies regarding COVID-19 vaccination, historical factors (such as historical abuse of Black bodies by health professionals), residential location, and dissatisfaction with health services. In terms of what governments must do to correct these inequalities, participants recommended the need for acknowledgment and community engagement. This is the first international collaboration to examine this problem. Important implications for theory, healthcare systems, and COVID-19 vaccination program planning are highlighted. Finally, there are members of other minority groups and vulnerable communities who are not Black people. Such groups could face unique inequalities that hinder COVID-19 vaccination. Therefore, future studies should include such groups.

2019 年冠状病毒病 (COVID-19) 大流行是一场前所未有的全球卫生紧急事件。作为一种新型疾病，除了使用疫苗作为控制措施外，没有已知的针对该疾病的明确治疗方法。在文献中，医疗保健系统的不平等问题已被记录为 COVID-19 疫苗接种的障碍；然而，人们对医疗保健系统中阻碍 COVID-19 疫苗接种的具体不平等现象知之甚少。在根本原因理论 (FCT) 的指导下，本研究旨在解决黑人之间的差距，这是一个容易受到医疗保健系统不平等影响的少数群体。居住在美利坚合众国 (USA) 或英国 (UK) 的 35 名黑人（年龄范围 = 21-58 岁）参与了这项研究。使用主题分析收集和分析定性数据。大多数美国参与者和一些英国参与者叙述说，医疗保健系统中没有任何不平等阻碍他们接种 COVID-19 疫苗。相反，大多数英国参与者和少数美国参与者讲述了医疗保健系统中的不平等现象，这些不平等阻碍了他们接种 COVID-19 疫苗。这些是对医疗保健系统的不信任、有关 COVID-19 疫苗接种的卫生政策、历史因素（例如卫生专业人员对黑人身体的历史虐待）、居住地点以及对卫生服务的不满。关于政府必须采取哪些措施来纠正这些不平等，与会者建议需要承认和社区参与。这是第一个研究这个问题的国际合作。强调了对理论、医疗保健系统和 COVID-19 疫苗接种计划规划的重要影响。最后，还有其他少数群体和弱势社区的成员不是黑人。这些群体可能面临阻碍 COVID-19 疫苗接种的独特不平等。因此，未来的研究应该包括这些群体。