Vaccine hesitancy among working-age adults with/without disability in the UK

Abstract Universal Credit is the UK’s globally innovative social security reform that replaces six means tested benefits with one monthly payment for working age claimants - combining social security and tax credit systems. Universal Credit expands welfare conditionality via mandatory job search conditions to enhance ‘progression’ amongst working claimants by requiring extra working hours or multiple jobs. This exposes low paid workers to tough benefit sanctions for non-compliance, which could remove essential income indefinitely or for fixed periods of up to three years. Our unique contribution is to establish how this new regime is experienced at micro level by in-work claimants over time. We present findings from Qualitative Longitudinal Research (141 interviews with 58 claimants, 2014-17), to demonstrate how UC impacts on in-work recipients and how conditionality produces a new coerced worker-claimant model of social support. We identify a series of welfare conditionality mismatches and conclude that conditionality for in-work claimants is largely counterproductive. This implies a redesign of the UK system and serves as an international warning to potential policy emulators.

Download Full-text

Predictors of COVID-19 vaccine hesitancy in the UK Household Longitudinal Study

Brain Behavior and Immunity ◽

10.1016/j.bbi.2021.03.008 ◽

2021 ◽

Author(s):

Elaine Robertson ◽

Kelly S. Reeve ◽

Claire L. Niedzwiedz ◽

Jamie Moore ◽

Margaret Blake ◽

...

Keyword(s):

Longitudinal Study ◽

Vaccine Hesitancy ◽

The Uk

Download Full-text

Understanding vaccine hesitancy: the evidence

Practice Nursing ◽

10.12968/pnur.2021.32.7.282 ◽

2021 ◽

Vol 32 (7) ◽

pp. 282-287

Author(s):

Alison While

Keyword(s):

Public Health ◽

Health Professionals ◽

Herd Immunity ◽

Public Health Intervention ◽

Health Intervention ◽

Vaccine Hesitancy ◽

Important Public Health ◽

Positive Attitudes ◽

The Uk

Vaccine hesitancy is a concern both globally and within the UK. Alison While reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations.

Download Full-text

Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees

10.1101/2021.04.12.21255313 ◽

2021 ◽

Author(s):

Anna Deal ◽

Sally E Hayward ◽

Mashal Huda ◽

Felicity Knights ◽

Alison F Crawshaw ◽

...

Keyword(s):

Primary Care ◽

Asylum Seekers ◽

Qualitative Interview ◽

Vaccine Hesitancy ◽

Undocumented Migrants ◽

Accessible Information ◽

Qualitative Interview Study ◽

The Uk ◽

Asylum Seekers And Refugees ◽

Roll Out

Introduction Early evidence confirms lower COVID-19 vaccine uptake in established ethnic minority populations, yet there has been little focus on understanding vaccine hesitancy and barriers to vaccination in migrants. Growing populations of precarious migrants (including undocumented migrants, asylum seekers and refugees) in the UK and Europe are considered to be under-immunised groups and may be excluded from health systems, yet little is known about their views on COVID-19 vaccines specifically, which are essential to identify key solutions and action points to strengthen vaccine roll-out. Methods We did an in-depth semi-structured qualitative interview study of recently arrived migrants (foreign-born, >18 years old; <10 years in the UK) to the UK with precarious immigration status between September 2020 and March 2021, seeking their input into strategies to strengthen COVID-19 vaccine delivery and uptake. We used the Three Cs model (confidence, complacency and convenience) to explore COVID-19 vaccine hesitancy, barriers and access. Data were analysed using a thematic framework approach. Data collection continued until data saturation was reached, and no novel concepts were arising. The study was approved by the University of London ethics committee (REC 2020.00630). Results We approached 20 migrant support groups nationwide, recruiting 32 migrants (mean age 37.1 years; 21 [66%] female; mean time in the UK 5.6 years [SD 3.7 years]), including refugees (n = 3), asylum seekers (n = 19), undocumented migrants (n = 8) and migrants with limited leave to remain (n = 2) from 15 different countries (5 WHO regions). 23 (72%) of 32 migrants reported being hesitant about accepting a COVID-19 vaccine and communicated concerns over vaccine content, side-effects, lack of accessible information in an appropriate language, lack of trust in the health system and low perceived need. Participants reported a range of barriers to accessing the COVID-19 vaccine and expressed concerns that their communities would be excluded from or de-prioritised in the roll-out. Undocumented migrants described fears over being charged and facing immigration checks if they present for a vaccine. All participants (n = 10) interviewed after recent government announcements that COVID-19 vaccines can be accessed without facing immigration checks remained unaware of this. Participants stated that convenience of access would be a key factor in their decision around whether to accept a vaccine and proposed alternative access points to primary care services (for example, walk-in centres in trusted places such as foodbanks, community centres and charities), alongside promoting registration with primary care for all, and working closely with communities to produce accessible information on COVID-19 vaccination. Conclusions Precarious migrants may be hesitant about accepting a COVID-19 vaccine and face multiple and unique barriers to access, requiring simple but innovative solutions to ensure equitable access and uptake. Vaccine hesitancy and low awareness around entitlement and relevant access points could be easily addressed with clear, accessible, and tailored information campaigns, co-produced and delivered by trusted sources within marginalised migrant communities. These findings have immediate relevance to the COVID-19 vaccination initiatives in the UK and in other European and high-income countries with diverse migrant populations.

Download Full-text

Moving In and Out of In-work Poverty in the UK: An Analysis of Transitions, Trajectories and Trigger Events

Journal of Social Policy ◽

10.1017/s0047279418000028 ◽

2018 ◽

Vol 47 (4) ◽

pp. 661-682 ◽

Cited By ~ 5

Author(s):

ROD HICK ◽

ALBA LANAU

Keyword(s):

Strong Predictor ◽

Working Poor ◽

Poor Families ◽

Poverty Transitions ◽

Working Age ◽

The Uk ◽

Low Pay ◽

Trigger Events

AbstractThere is growing concern about the problem of in-work poverty in the UK. Despite this, the literature on in-work poverty remains small in comparison with that on low pay and, in particular, we know relatively little about how people move in and out of in-work poverty. This paper presents an analysis of in-work poverty transitions in the UK, and extends the literature in this field in a number of identified ways. The paper finds that in-work poverty is more transitory than poverty amongst working-age adults more generally, and that the number of workers in the household is a particularly strong predictor of in-work poverty transitions. For most, in-work poverty is a temporary phenomenon, and most exits are by exiting poverty while remaining in work. However, our study finds that respondents who experience in-work poverty are three times more likely than non-poor workers to become workless, while one-quarter of respondents in workless, poor families who gained work entered in-work poverty. These findings demonstrate the limits to which work provides a route out of poverty, and points to the importance of trying to support positive transitions while minimising negative shocks faced by working poor families.

Download Full-text

What factors influence measles, mumps and rubella vaccine hesitancy among parents? A systematic review

British Journal of Child Health ◽

10.12968/chhe.2021.2.3.143 ◽

2021 ◽

Vol 2 (3) ◽

pp. 143-152

Author(s):

Jade Stewart ◽

Lynn Sayer

Keyword(s):

Systematic Review ◽

Critical Appraisal ◽

Parental Knowledge ◽

Vaccine Hesitancy ◽

Attitudes And Beliefs ◽

Rubella Vaccine ◽

The United Kingdom ◽

Health Choices ◽

The Uk ◽

Free Status

Background The United Kingdom lost its measles free status in 2019 because of an increase in measles cases, resulting from lowered vaccination uptake. Aims This review aims to gather a deeper understanding about parents' health choices for their children related to this vaccination. Methods A systematic review was carried out with a literature search using CINHAL, MEDLINE and OVID databases to identify information published between September 2016 and February 2020. A critical appraisal of seven studies was completed and a mixed methods synthesis was used to explore the results. Results The review identified factors that contribute to a parent's decision to vaccinate their child against measles, mumps and rubella. Five themes emerged: parental knowledge, attitudes and beliefs; safety concerns; specific groups related to religion and natural lifestyles; socioeconomic factors; and the source of health information. Conclusions Ongoing health promotion is required for the UK to work towards regaining its measles free status.

Download Full-text

Introduction

Transfer State ◽

10.1093/oso/9780198813262.003.0001 ◽

2019 ◽

pp. 3-28

Author(s):

Peter Sloman

Keyword(s):

Political Agenda ◽

British Politics ◽

Basic Income ◽

Minimum Income ◽

Poverty And Inequality ◽

Working Age ◽

History Of ◽

The 2008 Financial Crisis ◽

The Uk ◽

Negative Income Tax

The 2008 financial crisis and the era of austerity that followed have pushed poverty and inequality to the top of the political agenda for the first time in a generation. One of the most striking responses has been the surge of interest in a Universal Basic Income—an idea which has circulated in British politics since at least the First World War, and has intersected with proposals for more selective and conditional forms of minimum income. This introduction examines the history of guaranteed income in modern Britain from two perspectives: an ideational story about the circulation and development of basic income, Negative Income Tax, and tax credit schemes, and a public policy story about the growth of cash transfers since the 1970s. It argues that the UK has become a ‘transfer state’ in which working-age benefits play a central role in legitimating a particular form of post-industrial liberal capitalism.

Download Full-text

Ageing Populations

Productivity and the Bonus Culture ◽

10.1093/oso/9780198836117.003.0005 ◽

2019 ◽

pp. 35-37

Author(s):

Andrew Smithers

Keyword(s):

Growth Rates ◽

Total Population ◽

Living Standards ◽

Favourable Change ◽

Working Age ◽

The Uk ◽

The Impact ◽

Ageing Populations ◽

Trend Growth

The changes in demography, together with low investment and poor productivity, have been responsible for the whole of the decline in the trend growth rates of the UK and US economies. Living standards measured by GDP per person are given a boost when the population of working age grows faster than the total population. This favourable change in demography was the situation up to 2008. Until then living standards tended to improve faster than productivity. Since then the total population has been growing faster than the numbers of working age and living standards will now tend to grow less rapidly than productivity. The impact on prosperity has been sharp because we have moved from a favourable to an unfavourable situation.

Download Full-text

Cancer survivorship and work

Fitness for Work ◽

10.1093/med/9780199643240.003.0032 ◽

2013 ◽

pp. 621-638

Author(s):

Philip Wynn ◽

Shirley D’Sa

Keyword(s):

Cancer Survivors ◽

Cancer Survivorship ◽

Occupational Exposures ◽

Primary Treatment ◽

Occupational Health Services ◽

Occupational Physicians ◽

Working Age ◽

Health Related ◽

The Uk ◽

Work Capability

About 5 per cent of the overall UK cancer burden can be attributed to occupational exposures. However, occupational physicians in clinical practice are most likely to be called upon to support and advise employed patients with non-occupational cancers. Support services in the UK are being reconfigured to help the growing population of cancer survivors to live full and active lives for extended periods. Returning to the workplace is a part of this goal, and occupational physicians are likely to see increasing numbers of adults seeking still to work after treatment for conditions that in the past would have led to ill health-related retirement. Set against these improvements in clinical outcome, and the increasing emphasis on support for patients who achieve long-term survival, is evidence that many working-age adults treated for the common cancers subsequently encounter financial and occupational difficulties. People with cancer often experience a loss in income as a result of their condition. Thus, although most working adults diagnosed with primary cancer return to work, a significant minority do not. Cancer is increasingly seen as an illness that can be effectively treated, but functional outcomes vary considerably. Cancer survivorship is considered to encompass people who are undergoing primary treatment, in remission following treatment, show no symptoms of the disease following treatment, or are living with active or advanced cancer. Occupational physicians may be requested to assess work capability and provide advice on workplace support for cancer survivors in any of the survivorship states. In the UK, 98 per cent of public sector and 30 per cent of private sector employers have access to occupational health services. Employers will normally seek guidance from these services on how to manage employees who have developed a serious illness such as cancer. This means that occupational physicians can be in a key position to coordinate the vocational rehabilitation of cancer survivors. This chapter offers an overview of the evidence on work capability, rehabilitation, and occupational risk assessment that may apply to adults diagnosed with a range of cancers.

Download Full-text