The purpose of this project was to survey rural, minority, and underserved Alabamians regarding their perceptions of COVID-19 information, testing, and vaccination. Community health workers surveyed 3721 individuals from October 20-December 31, 2020. Participants came from 46 of Alabama's 67 counties (35 rural and 11 urban counties) and were largely Black (69.6%), female (56.5%), and between the ages of 40-59 years (34.8%). The majority of respondents reported that recommendations from public health agencies were easy to understand, information on COVID-19 was easy to find, and they felt confident in keeping themselves safe from infection. Most also reported they would get tested for COVID-19 if they had been exposed to someone who tested positive. Hesitancy to receive a COVID-19 vaccine was very high among all respondents; only 38.7% said they would be vaccinated. Significant differences by sex, race/ethnicity, age, and/or rural/urban status were seen for all survey items. Findings from this survey differ from other published studies and will be of interest to states with large rural, underserved, and minority populations as they tailor messaging for those most vulnerable. Findings also are now validated by Alabama's poor response to vaccine administration, which falls far short of the national vaccination rate, putting Alabamians at even greater risk. Building vaccine confidence among low vaccine populations remains challenging yet is imperative, especially for those populations with preexisting economic, social, and physical conditions that place them at continued high risk for COVID-19 infection.