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

Abstract

Israel, 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.

Factors Associated with COVID-19 Vaccine Hesitancy among Visible Minority Groups from a Global Context: A Scoping Review

“…For example, Nikovolski et al [15] found that negative stories on vaccine adverse effects circulating online were associated with an increased unwillingness for people to get vaccinated for COVID-19. The study [41] showed how information reliability resulted in some Arab ethnic community members believing that the COVID-19 vaccine contained non-Halal or alcohol-based components, thus in turn negatively affecting the COVID-19 vaccine uptake. A study by Gatwood et al, on matters concerning how political ideology impacts COVID-19 vaccine hesitancy, states COVID-19 vaccine hesitancy was more likely among those with more moderate or conservative political leanings, Black Americans and, residents of nonmetropolitan areas [32].…”

“…Hesitancy among several Muslim and other religious groups was also observed because of the perception that pork gelatine was one of the ingredients in the COVID-19 vaccine [44]. Among Arabs and ethnic minorities in a study conducted in Israel, UK, and the US, it was found that along with family and friends, religious leaders are relatively high influencers in vaccine decision-making [41].…”

Understanding the phases of vaccine hesitancy during the COVID-19 pandemic

“…There have been instances of vaccine complacency in the past against other vaccination drives [ 8 ]. Vaccine complacency for the same vaccine differs from region to region at the same or different periods of time depending on socio-behavioural factors.…”

Determinants of COVID-19 vaccine acceptance among adults with diabetes and in the general population in Israel: A cross-sectional study

“…Vaccine acceptance and hesitancy are complex in nature and vary across time, place, and culture [5] , [6] , [7] , [8] . However, some common factors were identified across studies conducted in 2020 in anticipation of and in the early days of the COVID-19 vaccine approval and implementation.…”