Advisers from the UK’s Scientific Advisory Group for Emergencies (Sage) have raised fresh concerns over COVID vaccine uptake among black, Asian and minority ethnic communities (BAME) as, The Guardian reports, research showed up to 72% of black people said they were unlikely to have the jab. Historical issues of unethical healthcare research, and structural and institutional racism and discrimination, are key reasons for lower levels of trust in the vaccination programme, a report from Sage said.
The figures come from the UK Household Longitudinal Study, which conducts annual interviews to gain a long-term perspective on British people’s lives.
In late November, the researchers at the University of Glasgow, Ipsos MORI UK and Public Health Scotland contacted 12,035 participants to investigate the prevalence of coronavirus vaccine hesitancy in the UK, and whether certain subgroups were more likely to be affected by it.
Overall, the study found high levels of willingness to be vaccinated, with 82% of people saying they were likely or very likely to have the jab – rising to 96% among people over the age of 75.
Women, younger people and those with lower levels of education were less willing, but hesitancy was particularly high among people from black groups, where 72% said they were unlikely or very unlikely to be vaccinated. Among Pakistani and Bangladeshi groups this figure was 42%. Eastern European groups were also less willing.
The Guardian reports that these figures are higher than previous estimates by the Royal Society for Public Health. Its poll of 2,076 UK adults found 57% of respondents from BAME backgrounds would take a COVID jab if advised by their GP or another health professional, compared with 79% of white respondents.
“Trust is particularly important for black communities that have low trust in healthcare organisations and research findings due to historical issues of unethical healthcare research,” said the Sage experts.
“Trust is also undermined by structural and institutional racism and discrimination. Minority ethnic groups have historically been underrepresented within health research, including vaccines trials, which can influence trust in a particular vaccine being perceived as appropriate and safe, and concerns that immunisation research is not ethnically heterogenous.”
The report emphasised the need for engagement with trusted sources such as GPs, and scientists from within BAME communities to respond to concerns about vaccine safety and efficacy.
Study details
Predictors of COVID-19 vaccine hesitancy in the UK Household Longitudinal Study
Elaine Robertson, Kelly S Reeve, Claire L Niedzwiedz, Jamie Moore, Margaret Blake, Michael Green, Srinivasa Vittal Katikireddi, Michaela J Benzeval
Published in MedRxiv on 27 December 2020
Abstract
Background
Vaccination is crucial to address the COVID-19 pandemic but vaccine hesitancy could undermine control efforts. We aimed to investigate the prevalence of COVID-19 vaccine hesitancy in the UK population, identify which population subgroups are more likely to be vaccine hesitant, and report stated reasons for vaccine hesitancy.
Methods
Nationally representative survey data from 12,035 participants were collected from 24th November to 1st December 2020 for wave 6 of the ‘Understanding Society’ COVID-19 web survey. Participants were asked how likely or unlikely they would be to have a vaccine if offered and their main reason for hesitancy. Cross-sectional analysis assessed prevalence of vaccine hesitancy and logistic regression models conducted.
Findings
Overall intention to be vaccinated was high (82% likely/very likely). Vaccine hesitancy was higher in women (21.0% vs 14.7%), younger age groups (26.5% in 16-24 year olds vs 4.5% in 75+) and less educated (18.6% no qualifications vs 13.2% degree qualified). Vaccine hesitancy was particularly high in Black (71.8%), Pakistani/Bangladeshi (42.3%), Mixed (32.4%) and non-UK/Irish White (26.4%) ethnic groups. Fully adjusted models showed gender, education and ethnicity were independently associated with vaccine hesitancy. Odds ratios for vaccine hesitancy were 12.96 (95% CI:7.34, 22.89) in the Black/Black British and 2.31 (95% CI:1.55, 3.44) in Pakistani/Bangladeshi ethnic groups (compared to White British/Irish ethnicity) and 3.24 (95%CI:1.93, 5.45) for people with no qualifications compared to degree educated. The main reason for hesitancy was fears over unknown future effects.
Interpretation
Older people at greatest COVID-19 mortality risk expressed the greatest willingness to be vaccinated but Black and Pakistani/Bangladeshi ethnic groups had greater vaccine hesitancy. Vaccine programmes should prioritise measures to improve uptake in specific minority ethnic groups.
[link url="https://www.theguardian.com/world/2021/jan/16/covid-vaccine-black-people-unlikely-covid-jab-uk"]Full report in The Guardian[/link]
[link url="https://www.medrxiv.org/content/10.1101/2020.12.27.20248899v1.full.pdf"]UK Household Longitudinal study[/link]
[link url="https://www.rsph.org.uk/about-us/news/new-poll-finds-bame-groups-less-likely-to-want-covid-vaccine.html"]Royal Society of Public Health poll[/link]