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 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 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 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 The impact of post-hospital remote monitoring of COVID-19 patients using pulse oximetry: a national observational study using hospital activity data

2022 ◽  
Author(s):  
Theo Georghiou ◽  
Chris Sherlaw-Johnson ◽  
Efthalia Massou ◽  
Stephen Morris ◽  
Nadia E Crellin ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Hospital Admissions ◽  
Local Level ◽  
Research Programme ◽  
Early Discharge ◽  
Hospital Data ◽  
Activity Data ◽  
Discharge From Hospital ◽  
The Impact ◽  
Roll Out

Background There was a national roll out of "COVID Virtual Wards" (CVW) during England's second COVID-19 wave (Autumn 2020 - Spring 2021). These services used remote pulse oximetry monitoring for COVID-19 patients following discharge from hospital. A key aim was to enable rapid detection of patient deterioration. It was anticipated that the services would support early discharge and avoid readmissions, reducing pressure on beds. This study is an evaluation of the impact of the CVW services on hospital activity. Methods Using retrospective patient-level hospital admissions data, we built multivariate models to analyse the relationship between the implementation of CVW services and hospital activity outcomes: length of COVID-19 related stays and subsequent COVID-19 readmissions within 28 days. We used data from more than 98% of recorded COVID-19 hospital stays in England, where the patient was discharged alive between mid-August 2020 and late February 2021. Findings We found a longer length of stay for COVID-19 patients discharged from hospitals where a CVW was available, when compared to patients discharged from hospitals where there was no CVW (adjusted IRR 1.05, 95% CI 1.01 to 1.09). We found no evidence of a relationship between the availability of CVW and subsequent rates of readmission for COVID-19 (adjusted OR 0.95, 95% CI 0.89 to 1.02). Interpretation We found no evidence of early discharges or reduced readmissions associated with the roll out of COVID Virtual Wards across England. Our analysis made pragmatic use of national-scale hospital data, but it is possible that a lack of specific data (for example, on which patients were enrolled) may have meant that true impacts, especially at a local level, were not ultimately discernible. Funding This is independent research funded by the National Institute for Health Research, Health Services & Delivery Research programme and NHSEI.

scholarly journals Vaccination against COVID-19: Factors That Influence Vaccine Hesitancy among an Ethnically Diverse Community in the UK

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 106
Author(s):  
Erica Jane Cook ◽  
Elizabeth Elliott ◽  
Alfredo Gaitan ◽  
Ifunanya Nduka ◽  
Sally Cartwright ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Vaccine Development ◽  
Qualitative Content Analysis ◽  
Ethnically Diverse ◽  
Binary Logistic Regression ◽  
Sociodemographic Factors ◽  
Influential Factors ◽  
Vaccine Hesitancy ◽  
Binary Logistic Regression Analysis ◽  
Diverse Community

The UK’s minority ethnic population, despite being at higher risk of COVID-19 and experiencing poorer health outcomes, continue to have lower uptake of the COVID-19 vaccine compared with their white British counterparts. Given the importance of the vaccination programme in improving health outcomes, this research sought to examine the influential factors that impact the decision to accept the COVID-19 vaccination among an ethnically diverse community. A total of 1058 residents from Luton, UK, a large town with an ethnically diverse population, completed a community survey. Questions centred around uptake or individuals’ intentions to accept the offer of COVID-19 vaccination alongside demographics, knowledge, and views on the vaccine. A binary logistic regression analysis was conducted to determine the most significant predictors of vaccine hesitancy, while respondents’ reasons for not getting vaccinated were identified using qualitative content analysis. Findings revealed that age and ethnicity were the only sociodemographic factors to predict vaccine hesitancy. Knowledge of symptoms and transmission routes, alongside ensuring information about COVID-19 was objectively sourced, were all identified as protective factors against vaccine hesitancy. Qualitative analysis revealed that ‘lack of trust in government/authorities’ and ‘concern of the speed of vaccine development’ were the most common reasons for non-uptake. This research reinforces the importance of age, ethnicity, and knowledge as influential factors in predicting vaccine hesitancy. Further, this study uncovers some of the barriers of uptake that can be utilised in developing promotional campaigns to reduce vaccine hesitancy in certain sections of the diverse UK population.

scholarly journals Establishing data linkage between welfare and health data in the UK: Overcoming barriers to linking government datasets

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
S Vittal Katikireddi ◽  
Alastair Leyland
Keyword(s):  
Data Linkage ◽  
Hospital Admissions ◽  
Job Insecurity ◽  
Demographic Data ◽  
Research Programme ◽  
Third Party ◽  
Research Network ◽  
Health Records ◽  
Level Information ◽  
The Uk

ABSTRACT ObjectivesEmployment and welfare policy have major impacts on population health and health inequalities. We sought to develop a novel data linkage between administrative welfare data (held by the UK Government’s Department for Work and Pensions, DWP) and health records (from the National Health Service, NHS). We describe the challenges we faced establishing this linkage and explain how they have been overcome over five years. ApproachNational Records Scotland (NRS) is the organisation responsible for statutory demographic data in Scotland, including conducting the decennial census, registering births and deaths. They will act as a Trusted Third Party to facilitate linkage under Scots common law. This work will be supported by the UK’s Administrative Data Research Network. Following a successful pilot, a further project is intended to link data for England and Wales (subject to further applications). ResultsThe Work & Pensions Longitudinal Study (WPLS) is a person-level longitudinal dataset that links benefit and programme information held by DWP since January 2004 with employment records from Her Majesty’s Revenue & Customs for people who have had a benefit spell. The WPLS allows transitions between different benefits and/or employment statuses to be ascertained, including timing of transitions and salaried income post-employment. However, the WPLS includes very limited health information. NHS Scotland has exceptional administrative health records, including person-level information on deaths, hospital admissions (including admission/discharge dates, diagnoses, procedures etc.), cancer registrations (including type, stage, treatment) and community prescriptions. A particular strength is the availability of a unique population identifier which facilitates deterministic linkage across health records. Key issues that needed to be addressed to facilitate the linkage included identification of appropriate research questions that were of high priority to government policymakers, the availability of research infrastructure and reassurances about data security. However, delays in establishing the linkage have been common – particularly as a consequence of the multiple organisations involved and time constraints on public sector staff required to process the linkage. Research topics to be investigated include improved prediction of health and welfare outcomes, investigating the health impacts of job insecurity and evaluating impacts of welfare reform. ConclusionEvidence to improve alignment between health and welfare goals will be achieved through linkage of administrative records in this five year research programme. It has been essential to consider how best to achieve public benefit and minimise privacy risks, while ensuring the needs of policymakers are central to the development of the research.

scholarly journals COVID-19 Vaccine Efficacy in a Diverse Urban Healthcare Worker Population

2021 ◽  
Author(s):  
Eirini Iliaki ◽  
Fan-Yun Lan ◽  
Costas A. Christophi ◽  
Guido Guidotti ◽  
Alexander D. Jobrack ◽  
...  
Keyword(s):  
Vaccine Efficacy ◽  
Ethnically Diverse ◽  
Health Department ◽  
Vaccine Hesitancy ◽  
Medical Providers ◽  
Cox Models ◽  
Community Healthcare ◽  
Black African ◽  
Diverse Community ◽  
Immunization Campaign

Objective: To investigate COVID-19 vaccine efficacy (VE) among healthcare workers (HCWs) in an ethnically diverse community healthcare system, during its initial immunization campaign. Methods: HCWs of the system were retrospectively included from the beginning of a COVID-19 vaccination program (December 16, 2020) until March 31, 2021. Those with a prior COVID-19 infection before December 15 were excluded. The Occupational Health department of the system ran a COVID-19 screening and testing referral program for workers, consistently throughout the study period. A master database had been established and updated comprising of the demographics, COVID-19 PCR assays, and vaccinations of each HCW. Andersen-Gill extension of the Cox models were built to estimate the VE of fully/partially vaccinated person-days at risk. Results: Among the 4317 eligible HCWs, 3249 (75%) received any vaccination during the study period. Vaccinated HCWs were older, less likely to be Black/African American, Hispanic/Latino or identify as two or more races, and more likely to be medical providers. After adjusting for age, sex, race, and the statewide background incidence at the time of vaccination, we observed a VE of 80.2% (95% CI: 57.5-90.8%) for ≧14 days after the first dose of Pfizer/Moderna, and 95.5% (95% CI: 88.2-98.3%) among those fully vaccinated (i.e. ≧14 days after the second dose of Pfizer/Moderna or the single dose of J&J/Janssen). Conclusion: COVID-19 vaccine effectiveness in the real world is promising, and these data in concert with culturally appropriate may decrease vaccine hesitancy.

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