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‘Culturally competent’ public health message needed to tackle Covid vaccine hesitancy among BAME people


By Awil Mohamoud
Reporter
17 December 2020

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An alliance with BAME voluntary organisations and a ‘culturally competent’ public health message are needed to reassure minority communities about the Covid vaccine, health leaders have warned.

It comes after a survey by the Royal Society of Public Health (RSPH) found 57% of BAME respondents were ‘likely to accept’ a Covid-19 vaccine if advised to by a health professional, compared with 79% of those from white backgrounds.

Confidence was lowest among respondents of Asian ethnicity, with 55% likely to say yes, the survey found. 

However, over a third (35%) of BAME respondents who said they were not willing to get vaccinated said they would likely change their minds if given more information by their GP about the vaccine’s effectiveness – almost twice as many as the 18% of white people who said they would not have the vaccine.

The report also revealed hesitation about the vaccine among lower income groups, with 70% of lowest earners likely to accept the jab compared to 84% of highest earners.

This comes as more than 137,000 people in the UK have received the first dose of the Pfizer/BioNTech Covid-19 vaccine in the first week of the vaccination programme, according to Government figures.

Gaining trust and engaging with communities

Responding to the survey, Jabeer Butt, chief executive of the Race Equality Foundation, said: ‘These findings are not surprising in light of past experience of the reach of vaccines to BAME communities, but they appear to be particularly worrying as it suggests the Covid vaccine may not reach communities that have been disproportionately impacted.

‘It is imperative that the NHS uses trusted channels like BAME-led voluntary organisations to reach and address concerns of BAME communities and ensure that the disproportionate impact of Covid is not exacerbated.’

In June, a report by Public Health England (PHE) confirmed that some ethinic minority groups are up to twice as likely to die from coronavirus compared to their white counterparts, after taking account of outside factors, including age and deprivation levels. 

Dr Chaand Nagpaul, BMA council chair, said the survey underlines the ‘urgent need for culturally competent public health communications’, co-created and delivered by local ethnic minority leaders so that it is ‘trusted and relevant’ to communities. 

This must focus on providing clear information, and challenging misinformation to reassure people of the vaccine’s safety, while delivering it in a way that is tailored to local communities, he said. He added that there should also be meaningful translation into multiple languages.

Dan Wellings, senior fellow at The King’s Fund, said that work to understand what is driving vaccine hesitancy within these communities would be best done locally. 

He added: ‘Lessons need to be learned from recent government programmes that have fallen flat because they were too centralised and failed to adequately involve those who know and work closely with their local communities.’

Mr Wellings also called for data on vaccine uptake for each area to be published regularly, so efforts can be targeted on groups where this is low. 

‘Highly concerning’

Christina Marriott, chief executive of RSPH, said it was ‘highly concerning’ but not surprising people living in poorer areas and those from minority ethnic communities are less likely to want the vaccine.

She added: ‘ We have known for years that different communities have different levels of satisfaction in the NHS and more recently we have seen anti-vaccination messages have been specifically targeted at different groups, including different ethnic or religious communities.

‘But these are exactly the groups which have suffered most through Covid. They continue to be most at risk of getting ill and most at risk of dying. So the Government, the NHS and local public health must rapidly and proactively work with these communities. And their most effective ways of working will be with the local community groups.’

The NHS’ plan

Nadhim Zahawi, the Government minister responsible for Covid vaccine deployment, said: ‘Vaccines are the most effective way to protect people from coronavirus and will save thousands of lives. All vaccines go through a robust clinical trial process and are only given to patients once they have met the strict safety, effectiveness and quality standards of the UK’s medicines regulator, the MHRA.

‘The NHS will provide advice and information at every possible opportunity, including working closely with BAME communities, to support those receiving a vaccine and to anyone who has questions about the vaccination process.’

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