Scientists have for weeks been calling for more granular data on the rollout of the Covid-19 vaccination programme to show if any particular groups are being left behind.
Last week, NHS England published Covid vaccination uptake figures broken down by ethnicity, for the first time.
It also addressed concerns that ethnicity was not being routinely collected for Covid vaccinations by adding ethnicity reporting to Pinnacle – the system being used to record jabs – as a ‘supplementary measure’.
Speaking to Healthcare Leader, Dr Habib Naqvi MBE, director of the recently formed NHS Race and Health Observatory, says this is ‘fantastic news’ and that ‘real-time data on vaccination uptake by ethnicity will help us to better meet the needs of diverse communities’ via public messaging on the Covid vaccine and its delivery.
Tracking inequality data, in general, is ‘absolutely essential’, he adds.
‘We know in the healthcare sector – what doesn’t get measured, doesn’t get done.’
Dr Habib Naqvi – who was appointed to head up the Observatory in August last year – says there is a ‘significant risk’ that Covid-19 vaccine coverage is lower among ethnic minority groups, and ‘we need to better understand and address barriers to uptake head on’.
Researchers recently found that 20.5% of the over 80 black community had been vaccinated against Covid by 13 January, compared to 42.5% of the over 80 white population.
Meanwhile, in December, a survey by the Royal Society of Public Health (RSPH) found only 57% of black, Asian and minority ethnic (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.
Dr Naqvi says we need to see more diverse community-based vaccination sites across the country, and that the recent opening of a vaccination hub inside a mosque in Birmingham and a gurdwara in Bedford was a positive step. However, this needs to be ‘ramped up’, as these community venues – which are often large and accessible – ‘can increase the confidence and trust that we need our diverse communities to have in the vaccination programme’, he says.
Mistrust in the programme is also being fueled by fake news and misinformation, he adds – and seems to be scaring some members of the BAME population into potentially not taking the vaccine.
‘Better planning and clear action required’
For Dr Naqvi, faith and local community leaders have a key role to play – they can help deliver the message that the Covid-19 vaccines have gone through the rigorous regulatory approval processes and are safe to take, as this cannot be done through a ‘top down’ only approach, he says.
‘We cannot escape the very sad reality of over 100,000 deaths from Covid now [in the UK], but what we can do is learn lessons from previous waves of the pandemic,’ he adds.
Last June, a report by Public Health England (PHE) confirmed that some ethnic 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 Naqvi says we need ‘better planning and clear action to protect and prioritise the people that are most at risk from the disease, which includes BAME communities’.
While BAME people have not been listed as a vaccination priority group by the Joint Committee on Vaccination and Immunisation (JCVI), its guidance does recommend that ‘inequalities are identified and addressed’ in the implementation of the vaccine programme.
He explains that the NHS Race and Health Observatory has written to the JCVI – urging it to find out if that advice is being followed at a local level, and if not, to ‘emphasise and reaffirm that guidance with a level of urgency’.
Dr Naqvi says the Observatory launched in May last year with the goal of facilitating high-quality research and reviews, making policy recommendations for change on the basis of that evidence, and helping to support the implementation of those suggestions on the ground.
As part of that role, the organisation looks to focus on ‘deep-seated’ issues that lead to differential access, experience and health outcomes, such as e.g. lower uptake of Covid vaccinations within BAME communities, as well as why health inequalities exist across a range of ‘areas that span from neonatal health, all the way to end of life care’.
He says the organisation will need to examine a number of areas within the NHS, such as whether the policies and processes are fit-for-purpose for delivering equity, and whether the cultures within organisations are compassionate and promote fairness at all levels.
But Dr Naqvi is also clear that we need to look at racial inequality in its ‘global form’.
‘Yes, the NHS has a role to play in tackling ethnic inequalities. But it’s not the only enabler of racial equality or equity. What we need to really think about is the life experiences and the day-to-day encounters of BAME people within wider society,’ he says.
‘And so racial inequality is not just embedded within the NHS, it’s a system-wide and global challenge that requires a system-wide and global response.’