Despite progress in COVID-19 vaccination rates overall in Cleveland, vaccine inequity persists as young people from minoritised communities are often less likely to be vaccinated. Despite being over-represented in COVID-19 case counts and fatalities, Black residents were under-represented in COVID-19 vaccination during the first year and half of the pandemic. In Ohio, while roughly 60% of Cuyahoga County residents are fully vaccinated, just 45% of Cleveland residents are fully vaccinated. Lower-income, majority Black, east side neighbourhoods have markedly lower vaccination rates compared to higher-income, mostly white neighbourhoods. Young people ages 16-40 became eligible for the COVID-19 vaccine on March 29th, 2021, and individuals aged 12 and above were able to get vaccinated from May 2021 onward. However, large disparities exist based age, race, and zip code. This brief illustrates underlying reasons shaping COVID-19 vaccine attitudes among minority (especially Black and Latinx) youth (ages 12-18) and offers key considerations for how young people can be better engaged within Cleveland, Ohio. This brief is based on research, including in-depth interviews and focus group discussions with 61 young people across 16 neighbourhoods through a Youth Participatory Action Research (YPAR) approach in Cleveland to contextualise youth perspectives of COVID-19 vaccination and highlight areas of hesitancy and confidence. In this brief, we share findings from the study and key considerations for addressing youth ‘vaccine hesitancy’ around the COVID-19 vaccine are presented. This brief was authored by Jillian Schulte (Case Western Reserve University), Megan Schmidt-Sane (IDS), Elizabeth Benninger (Cleveland State University), Tabitha Hrynick (IDS), and Santiago Ripoll (IDS), and includes contributions from Elizabeth Davies (Cleveland State University), Diane Mastnardo, Brenda Pryor (MyCom), Brinda Athreya (Case Western Reserve University), Ivis Maldonado (MyCom) and reviews from Elizabeth Storer (LSE) and Annie Wilkinson (IDS). The research was funded through the British Academy COVID-19 Recovery: USA and UK fund (CRUSA210022). Research was based at the Institute of Development Studies. This brief is the responsibility of SSHAP.Wellcome TrustForeign, Commonwealth & Development Office (FCDO)