Women’s views and experiences of accessing vaccination in pregnancy during the COVID-19 pandemic: A multi-methods study in the United Kingdom

BackgroundCOVID-19 changed access to healthcare, including vaccinations, in the United Kingdom (UK). This study explored UK women’s experiences of accessing pertussis vaccination during pregnancy and infant vaccinations during COVID-19.MethodsAn online cross-sectional survey was completed, between 3rd August-11 th October 2020, by 1404 women aged 16+ years who were pregnant at some point after the first UK lockdown from March 23rd, 2020. Ten follow-up semi-structured interviews were conducted.ResultsMost women surveyed were pregnant (65.7%) and a third postnatal (34.3%). Almost all women (95.6%) were aware that pertussis vaccination is recommended in pregnancy. Most pregnant (72.1%) and postnatal women (84.0%) had received pertussis vaccination; however, access issues were reported.Over a third (39.6%) of women had a pregnancy vaccination appointment changed. COVID-19 made it physically difficult to access pregnancy vaccinations for one fifth (21.5%) of women and physically difficult to access infant vaccinations for almost half of women (45.8%). Nearly half of women (45.2%) reported feeling less safe attending pregnancy vaccinations and over three quarters (76.3%) less safe attending infant vaccinations due to COVID-19. The majority (94.2%) felt it was important to get their baby vaccinated during COVID-19.Pregnant women from ethnic-minorities and lower-income households were less likely to have been vaccinated. Minority-ethnicity women were more likely to report access problems and feeling less safe attending vaccinations for both themselves and their babies.Qualitative analysis found women experienced difficulties accessing antenatal care and relied on knowledge from previous pregnancies to access vaccines in pregnancy.ConclusionDuring the ongoing and future pandemics, healthcare services should prioritise equitable access to routine vaccinations, including tailoring services for ethnic-minority families who experience greater barriers to vaccination.HighlightsAccess to pregnancy vaccines in the United Kingdom was disrupted by the COVID-19 pandemic.UK women reported difficulties in physically accessing vaccine appointments and feeling less safe accessing vaccine appointments for themselves when pregnant and for their babies during COVID-19, with women from ethnic minorities in the UK were more likely to report difficulties.Vaccine services must ensure equitable access to vaccine appointments during the ongoing COVID-19 pandemic including tailoring services for lower income and ethnic minority families.

Claims-making in court cases on children: Religion, ethnicity, and culture in cases of Dutch minority families against the state

This paper focuses on claims made by family members in court cases against state institutions. Taking a socio-legal, empirical approach, I aim to explore claims-making in different types of cases from various fields of law, with a particular focus on issues regarding children from minority families. I will analyse in what cases these claims are made and how courts react to such claims. The paper is based on an analysis of Dutch court judgements, as well as an ongoing study including interviews with judges and court personnel; lawyers; welfare professionals; and NGOs and a study of child protection files at the courts of The Hague, Rotterdam, Utrecht, and Amsterdam. When making religious, ethnic, or cultural claims in court cases concerning their children, minority families may demand to be treated differently based on their religious, ethnic or cultural background. I will demonstrate how such claims can be shaped by the legal and institutional context as well as by litigants themselves. Although religious, ethnic, or cultural claims are relatively rare, they force courts to explicitly reflect on representations of culture, ethnicity, or religion. Therefore, studying such exceptional cases provide an interesting opportunity to study how Dutch courts deal with these representations.

A method to analyze invisibility: Navigating the dissonance between woke and safe

This article starts by considering how ‘the talk’ that black and non-black minority families give to their children comes as a duty to transfer the wisdom of how to be invisible forward through generations. It is not uncommon to think about being visible as a social good, but this is not quite so straightforward when one occupies a body deemed as ‘other.’ This article exposes this tension to explore how invisibility can be understood as an independent, complex, and nuanced social dynamic in its own right by considering literature that uses invisibility as an analytical lens, providing a synthesis of that literature to offer a preliminary multidimensional model of invisibility to extend extant tools for sociological study. This literature considers race, gender, sexuality, various presentations of power, and different social systems to demonstrate a model that identifies how the intersection of power, affect, presence, and voice fluidly transfigure across time and space to create an overall social construct of invisibility. This suggests that deeper development of a multidimensional construct of invisibility can provide a reasoned and valuable additional lens to address a range of social dynamics.

Care in practice: negotiations regarding care for the elderly in multigenerational Arab Muslim families in Denmark

Recent studies conclude that ethnic minority families in Denmark tend to be dismissive of senior housing and municipal homecare services for elderly family members. A large proportion of Muslim minority families in Denmark attach great importance to caring for the elderly as a tradition and prefer to take care of their own elderly family members at home. Nevertheless, the fact that morality, incentives, and obligations in relation to care for the elderly may be legitimized and/or contested with reference to cultural traditions and Islam has not received much attention in current research. In this article, drawing on material from ongoing ethnographic fieldwork among Arab Muslim families in Denmark, I discuss how cultural and religious backgrounds may determine and influence perceptions and behavior regarding care for the elderly. By observing and engaging in the everyday life of an Arab Muslim family, I explore how caring for elderly people with health problems at home raises specific questions about obligations and triggers negotiations across genders and generations. I argue that besides kinship and ethnicity, it is equally important to consider religiosity in an attempt to learn more about how Arab Muslims care for their elderly family members.

Beyond crisis: Enacted sense-making among ethnic minority carers of people with dementia in Australia

The ‘family crisis’ narrative is frequently used in dementia studies to explain ethnic minority families’ pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers’ agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families’ pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the ‘family crisis’ narrative as it illuminates the agency of carers’ in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy campaigns as well as initiatives that address structural inequities.