scholarly journals Ethnic and minority group differences in engagement with COVID-19 vaccination programmes – at Pandemic Pace; when vaccine confidence in mass rollout meets local vaccine hesitancy

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
John A. Reid ◽  
Mzwandile A. Mabhala
Keyword(s):  
Public Health ◽  
Ethnic Minorities ◽  
Social Systems ◽  
Minority Group ◽  
Reproductive Age ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Vaccine Confidence ◽  
The Uk ◽  
Roll Out

AbstractIsrael, the UK, the USA, and some other wealthier countries lead in the implementation of COVID-19 vaccine mass vaccination programmes. Evidence from these countries indicates that their ethnic minorities could be as disproportionately disadvantaged in COVID-19 vaccines roll-out as they were affected by COVID-19-related serious illnesses. Their disadvantage is linked to their lower social status and fewer social goods compared with dominant population groups.Albeit limited by methodology, early studies attribute lower uptake of COVID-19 amongst ethnic minorities to the wider determinants of vaccine uptake, hesitancy or lack of vaccine confidence, including lower levels of trust and greater concerns about vaccine safety. Early sentinel studies are needed in all early adopter countries.One emerging theme among those of reproductive age in minority communities concerns a worry regarding COVID-19 vaccine’s potential adverse effect on fertility. Respected professional groups reassure this is not a credible rationale. Drug and vaccine regulators use understandable, cautious and conditional language in emergency licencing of new gene-based vaccines. Technical assessments on whether there is any potential genotoxicity or reproductive toxicity should be more emphatic.From a public health perspective, sentinel studies should identify such community concerns and act early to produce convincing explanations and evidence. Local public health workforces need to be diverse, multiskilled, and able to engage well with minorities and vulnerable groups. The local Directors of Public Health in the UK are based in each local government area and have a remit and opportunity to stimulate speedy action to increase vaccine uptake.During the rapid Pandemic Pace of the vaccines roll-out, extra efforts to minimise uptake variations are likely to achieve improvements in the next year or two. We expect variations will not disappear however, given that underlying inequalities persist in less inclusive social systems.

scholarly journals COVID-19 vaccine hesitancy in an ethnically diverse community: descriptive findings from the Born in Bradford study

2021 ◽  
Vol 6 ◽  
pp. 23
Author(s):  
Josie Dickerson ◽  
Bridget Lockyer ◽  
Rachael H. Moss ◽  
Charlotte Endacott ◽  
Brian Kelly ◽  
...  
Keyword(s):  
Ethnic Minorities ◽  
Hospital Admissions ◽  
Ethnically Diverse ◽  
Research Programme ◽  
Vaccine Hesitancy ◽  
Born In Bradford ◽  
Diverse Community ◽  
The Uk ◽  
Roll Out ◽  
Deprived Areas

Background: The roll out of coronavirus disease 2019 (COVID-19) vaccines are underway in the UK, and ensuring good uptake in vulnerable communities will be critical to reducing hospital admissions and deaths. There is emerging evidence that vaccine hesitancy is higher in ethnic minorities and deprived areas, and that this may be caused by distrust and misinformation in the community.  This study aims to understand COVID-19 vaccine hesitancy in an ethnically diverse and deprived population of Bradford through the Born in Bradford (BiB) research programme. Methods: Surveys were sent to parents in BiB who had taken part in a previous Covid-19 survey (n=1727). Cross tabulations explored variation by ethnicity and deprivation. Answers to a question asking the main reason for hesitancy was analysed using thematic analysis. Results: 535 (31%) of those invited between 29 th October-9 th December 2020 participated. 48% were White British, 37% Pakistani heritage and 15% from other ethnicities; 46% were from the most deprived quintile of the Index of Multiple Deprivation. 29% of respondents do want a vaccine, 10% do not. The majority had not thought about it (29%) or were unsure (30%). Vaccine hesitancy differed by ethnicity and deprivation: 43% (95% CIs: 37-54%) of White British and 60% (35-81%) in the least deprived areas do want a vaccine, compared to 13% (9-19%) of Pakistani heritage and 20% (15-26%) in the most deprived areas. Reasons for not wanting a vaccine were commonly explained by confusion and distrust which was linked to exposure to misinformation. Conclusions: There is a risk of unequitable roll out of the vaccination programme in the UK with higher vaccine hesitancy in ethnic minorities and those living in deprived areas. There is an urgent need to tackle misinformation that is leading to uncertainty and confusion about the vaccines.

scholarly journals Vaccine Confidence and Hesitancy at the Start of COVID-19 Vaccine Deployment in the UK: An Embedded Mixed-Methods Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Chrissy h. Roberts ◽  
Hannah Brindle ◽  
Nina T. Rogers ◽  
Rosalind M. Eggo ◽  
Luisa Enria ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
Vaccine Development ◽  
Collective Responsibility ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Demographic Groups ◽  
Vaccine Confidence ◽  
The Uk ◽  
Dominant Narratives

Background: Approval for the use of COVID-19 vaccines has been granted in a number of countries but there are concerns that vaccine uptake may be low amongst certain groups.Methods: This study used a mixed methods approach based on online survey and an embedded quantitative/qualitative design to explore perceptions and attitudes that were associated with intention to either accept or refuse offers of vaccination in different demographic groups during the early stages of the UK's mass COVID-19 vaccination programme (December 2020). Analysis used multivariate logistic regression, structural text modeling and anthropological assessments.Results: Of 4,535 respondents, 85% (n = 3,859) were willing to have a COVID-19 vaccine. The rapidity of vaccine development and uncertainties about safety were common reasons for COVID-19 vaccine hesitancy. There was no evidence for the widespread influence of mis-information, although broader vaccine hesitancy was associated with intentions to refuse COVID-19 vaccines (OR 20.60, 95% CI 14.20–30.30, p < 0.001). Low levels of trust in the decision-making (OR 1.63, 95% CI 1.08, 2.48, p = 0.021) and truthfulness (OR 8.76, 95% CI 4.15–19.90, p < 0.001) of the UK government were independently associated with higher odds of refusing COVID-19 vaccines. Compared to political centrists, conservatives and liberals were, respectively, more (OR 2.05, 95%CI 1.51–2.80, p < 0.001) and less (OR 0.30, 95% CI 0.22–0.41, p < 0.001) likely to refuse offered vaccines. Those who were willing to be vaccinated cited both personal and public protection as reasons, with some alluding to having a sense of collective responsibility.Conclusion: Dominant narratives of COVID-19 vaccine hesitancy are misconceived as primarily being driven by misinformation. Key indicators of UK vaccine acceptance include prior behaviors, transparency of the scientific process of vaccine development, mistrust in science and leadership and individual political views. Vaccine programmes should leverage the sense of altruism, citizenship and collective responsibility that motivated many participants to get vaccinated.

scholarly journals Vaccine Confidence and Hesitancy at the start of COVID-19 vaccine deployment in the UK: An embedded mixed-methods study

2021 ◽  
Author(s):  
Chrissy h Roberts ◽  
Hannah Brindle ◽  
Nina Trivedy Rogers ◽  
Rosalind M Eggo ◽  
Luisa Enria ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
Vaccine Development ◽  
Collective Responsibility ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Demographic Groups ◽  
Vaccine Confidence ◽  
The Uk ◽  
Dominant Narratives

Introduction Approval for the use of COVID-19 vaccines has been granted in a number of countries but there are concerns that vaccine uptake may be low amongst certain groups. Methods This study used a mixed methods approach based on online survey and an embedded quantitative/qualitative design to explore perceptions and attitudes that were associated with intention to either accept or refuse offers of vaccination in different demographic groups during the early stages of the UK's mass COVID-19 vaccination programme (December 2020). Analysis used multivariate logistic regression, structural text modelling and anthropological assessments. Results Of 4,535 respondents, 85% (n=3,859) were willing to have a COVID-19 vaccine. The rapidity of vaccine development and uncertainties about safety were common reasons for COVID-19 vaccine hesitancy. There was no evidence for the widespread influence of mis-information, although broader vaccine hesitancy was associated with intentions to refuse COVID-19 vaccines (OR 20.60, 95% CI 14.20-30.30, p<0.001). Low levels of trust in the decision-making (OR 1.63, 95% CI 1.08, 2.48, p=0.021) and truthfulness (OR 8.76, 95% CI 4.15-19.90, p<0.001) of the UK government were independently associated with higher odds of refusing COVID-19 vaccines. Compared to political centrists, conservatives and liberals were respectively more (OR 2.05, 95%CI 1.51-2.80, p<0.001) and less (OR 0.30, 95% CI 0.22-0.41, p<0.001) likely to refuse offered vaccines. Those who were willing to be vaccinated cited both personal and public protection as reasons, with some alluding to having a sense of collective responsibility. Conclusion Dominant narratives of COVID-19 vaccine hesitancy are misconceived as primarily being driven by misinformation. Key indicators of UK vaccine acceptance include prior behaviours, transparency of the scientific process of vaccine development, mistrust in science and leadership and individual political views. Vaccine programmes should leverage the sense of altruism, citizenship and collective responsibility that motivated many participants to get vaccinated.

scholarly journals COVID-19 vaccine hesitancy in an ethnically diverse community: descriptive findings from the Born in Bradford study

2021 ◽  
Vol 6 ◽  
pp. 23
Author(s):  
Josie Dickerson ◽  
Bridget Lockyer ◽  
Rachael H. Moss ◽  
Charlotte Endacott ◽  
Brian Kelly ◽  
...  
Keyword(s):  
Ethnic Minorities ◽  
Hospital Admissions ◽  
Ethnically Diverse ◽  
Vaccine Hesitancy ◽  
Born In Bradford ◽  
Diverse Community ◽  
Questionnaire Surveys ◽  
The Uk ◽  
Roll Out ◽  
Deprived Areas

Background: The roll out of coronavirus disease 2019 (COVID-19) vaccines are now underway in the UK, and ensuring good uptake in vulnerable communities will be critical to reducing hospital admissions and deaths. There is emerging evidence that vaccine hesitancy is higher in ethnic minorities and deprived areas, and that this may be caused by misinformation in the community.  This study aims to understand COVID-19 vaccine hesitancy in an ethnically diverse and deprived population. Methods: Questionnaire surveys were sent to parents in the Born in Bradford study. Cross tabulations explored variation by ethnicity and deprivation. Text from open-ended questions was analysed using thematic analysis. Results: 535 (31%) of 1727 invited between 29th October-9th December 2020 participated in the study. 154 (29%) of respondents do want a vaccine, 53 (10%) do not. The majority had not thought about it (N=154, 29%) or were unsure (N=161, 30%). Vaccine hesitancy differed significantly by ethnicity and deprivation: 43% (95% CIs: 37-54%) of White British and 60% (35-81%) in the least deprived areas do want a vaccine, compared to 13% (9-19%) of Pakistani heritage and 20% (15-26%) in the most deprived areas. Those that distrusted the NHS were more likely to not want a vaccine (30%, 15-50%).  Reasons for not wanting a vaccine were commonly explained by confusion and distrust caused by prevalent misinformation. Conclusions: There is a much higher level of vaccine hesitancy in ethnic minorities, those living in deprived areas and those that distrust the NHS. There is an urgent need to tackle the overwhelming misinformation about COVID-19 that is leading to this uncertainty and confusion about the vaccines. If not addressed there is a high risk of unequitable roll out of the vaccination programme in the UK.

scholarly journals Engaging general population: Vaccine confidence, communication and mandatory law

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P L Lopalco
Keyword(s):  
Public Health ◽  
General Population ◽  
Core Competencies ◽  
Rapid Evolution ◽  
Effective Communication ◽  
Communication Strategy ◽  
Vaccine Uptake ◽  
Public Health Decision ◽  
Novel Technologies ◽  
Vaccine Confidence

Abstract Hesitancy is defined as the reluctance or refusal to be vaccinated even in case of vaccine availability and is included by the WHO among the top ten threats to global health. Vaccine confidence is an essential component of the hesitancy. Fear of adverse events and lack of trust in vaccine efficacy discourage the public and drive them toward the choice of refusal. Misinformation and lack of effective communication strategies may seriously jeopardize vaccination programmes. Providing effective communication requires specific competencies that often are not part of the common core competencies of those involved in vaccination programmes. In particular, the rapid evolution of the communication environment due to novel technologies makes the task even more difficult. The general population in order to comply with the official vaccine recommendation throughout the life course is therefore a complex task. In the presence of worrying signals of lack of vaccine confidence, public health decision can be driven by emergency decisions rather than investing in mid-terms communication programmes. Vaccination mandates are public health measures that are proven to be effective in increasing vaccine uptake. Increasing anti-vaccine sentiment may be a potential negative trade-off. For this reason, the introduction of vaccination mandates should be combined with a structured communication strategy. In addition, vaccine sentiment should be actively monitored when any change in vaccine offer policy is implemented.

Understanding vaccine hesitancy: the evidence

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.

scholarly journals COVID-19 vaccine brand hesitancy and other challenges to vaccination in the Philippines

2022 ◽  
Vol 2 (1) ◽  
pp. e0000165
Author(s):  
Arianna Maever L. Amit ◽  
Veincent Christian F. Pepito ◽  
Lourdes Sumpaico-Tanchanco ◽  
Manuel M. Dayrit
Keyword(s):  
Ecological Model ◽  
The Philippines ◽  
Vaccine Uptake ◽  
Phone Call ◽  
Vulnerable Groups ◽  
Vaccine Hesitancy ◽  
Middle Income ◽  
Political Issues ◽  
Vaccination Uptake ◽  
Vaccine Confidence

Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, Cebuano, and/or English via online platforms such as Zoom or via phone call. All interviews were recorded, transcribed verbatim, translated, and analysed using inductive content analysis. To highlight the complex reasons for delaying and/or refusing COVID-19 vaccines, we embedded our findings within the social ecological model. Our analysis showed that individual perceptions play a major role in the decision to vaccinate. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may either positively or negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting in vaccination delays and refusals. Perceptions about the inefficiency and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalised groups. Recognising and addressing concerns at all levels are needed to improve COVID-19 vaccination uptake and reach. Strengthening health literacy is a critical tool to combat misinformation that undermines vaccine confidence. Vaccination systems must also consider the needs of marginalised and vulnerable groups to ensure their access to vaccines. In all these efforts to improve vaccine uptake, governments will need to engage with communities to ‘co-create’ solutions.

scholarly journals 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

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.

scholarly journals Structural Barriers to Health-provider Training Programmes for Ethnic Minorities: The Case of the Katu and Diabetes Management in Vietnam

2020 ◽  
pp. 30-42
Author(s):  
Caroline Bec ◽  
Geoff J. Wells ◽  
Joshua J. Solomon
Keyword(s):  
Public Health ◽  
Ethnic Minorities ◽  
Diabetes Management ◽  
Medical Training ◽  
Qualitative Case Study ◽  
Contextual Factors ◽  
Minority Group ◽  
World Health ◽  
Local Context

Background: Training of primary care practitioners is one of the most implemented interventions in medical international development programmes targeting non-communicable diseases (NCD). Yet in many cases their effectiveness is below expectations. One potential cause of this is that they struggle to account for local context, especially when working with ethnic minorities. Here we begin to address this gap through a qualitative case-study of how local contextual factors have impacted the success of a World Health Organization (WHO) healthcare training programme on Type 2 diabetes with an ethnic minority group in rural central Vietnam. Design: A qualitative case-study collected data during 2018. We conducted 25 semi-structured interviews, two focus groups, and participant observation with patients, healthcare professionals, and members of a local non-governmental organisation involved in the programme. We used thematic coding to identify important contextual factors and how they helped or hindered programme delivery. Next, we synthesised each of these themes in a narrative style, drawing on the rich detail provided by respondents. Results: We found that, despite using a notionally decentralised approach, the effectiveness of the training was hindered by social, political, and economic determinants of health which influenced the inhabitants’ relations to healthcare and diabetes. Particular barriers were the political perceptions of minorities, their economic access to services, the healthcare prejudices toward ethnic rural populations and the rigidity of medical training. Conclusions: Given the similarity of our case with other WHO NCD programmes, we view that our findings are of wider relevance to global public health policy and practice. We suggest that better recognising and addressing local contextual factors would make such programmes more polyvocal, grounded, and resilient, as well as enabling them to better support long-term transformative change in public health systems. We conclude by discussing methods for implementing this in practice.

scholarly journals Myths Surrounding Covid-19 Vaccine Candidates: A Guide to Fight Back

2021 ◽  
Author(s):  
John Zizzo
Keyword(s):  
Public Health ◽  
Herd Immunity ◽  
Vaccine Uptake ◽  
Protective Measure ◽  
Vaccine Hesitancy ◽  
Health Providers ◽  
Vaccine Candidates ◽  
The Public ◽  
News Organizations ◽  
Public Health Officials

The Covid-19 pandemic has propelled public health officials into the socio-political sphere due to the need for constantly updated information on behalf of the public. However, many individuals choose to acquire health information/guidance from indirect sources, including social media, news organizations, and general word of mouth. As a result, myths and false narratives about various essential health topics, including vaccine characteristics and protective measures, can circulate un-verified between millions of individuals with little recourse. These can further widen the “gap” between public knowledge and current research, resulting in lower vaccine uptake (vaccine hesitancy) and protective measure adherence. Such actions have profound implications as nations attempt to achieve herd immunity and end the pandemic once and for all. Thus, it is vital that public health officials, health providers, researchers, and the general public be able to differentiate common Covid-19 myths from facts and be prepared to approach such interactions via sound reasoning and research-based evidence. This chapter will serve as a guide to accomplish just that.

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