Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff

Abstract

Objective: COVID-19-related inequities experienced by racial and ethnic minority groups including healthcare professionals mirror wider health inequities, which risk being perpetuated by lower uptake of vaccination. We aim to better understand lower uptake among racial and ethnic minority staff groups to inform initiatives to enhance uptake. Design: Twenty-five semi-structured interviews were conducted (October 2020-January 2021) with UK-based healthcare staff. Data were inductively and thematically analysed. Results: Vaccine decision-making processes were underpinned by an overarching theme, 'weighing up risks of harm against potential benefits to self and others'. Sub-themes included 'fear of harm', 'moral/ethical objections', 'potential benefits to self and others', 'information and misinformation', and 'institutional or workplace pressure'. We identified ways in which these were weighted more heavily towards vaccine hesitancy for racial and ethnic minority staff groups influenced by perceptions about institutional and structural discrimination. This included suspicions and fear around institutional pressure to be vaccinated, racial injustices in vaccine development and testing, religious or ethical concerns, and legitimacy and accessibility of vaccine messaging and communication. Conclusions: Drawing on a critical race perspective, we conclude that acknowledging historical and contemporary abuses of power is essential to avoid perpetuating and aggravating mistrust by decontextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.

Levers and Barriers to Vaccinate against COVID-19 in the Multicultural Context of French Guiana: A Qualitative Cross-Sectional Survey among Health Care Workers

“…Another very important factor is the hope of a return to normalcy: a return to cultural life and the possibility of moving around, a very important element in French Guiana, which is located on the other side of the Atlantic from Metropolitan France and is therefore subject to air flights. These aspects are in line with the motivations of the general population in several other studies [16,20].…”

“…Fear of side effects is a known barrier of willingness to get vaccinated among health care workers elsewhere in Europe [15][16][17]. It often goes hand in hand with a lack of trust in laboratories and health authorities and could be improved with communication [18].…”

A Qualitative Exploration of Perceptions of the COVID-19 Vaccine in the United Kingdom During the Later Stages of the Vaccine Rollout

“…In-depth, qualitative exploration would be useful in aiding understanding of how these beliefs and attitudes are developed and sustained. While there have been some qualitative UK studies on people's attitudes and beliefs about COVID-19 vaccination, these have been small-scale and focused on certain populations (healthcare staff) 17 or locations (a city in the North of England). 18 Furthermore, much of the research reviewed here was conducted either prior to or in the early stages of the COVID-19 vaccination program.…”

Staying “One Step Ahead of a Racist”: Expanding Understandings of the Experiences of the Covid-19 Pandemic Among People From Minoritized Ethnic Groups Living in Britain

“…This distrust of the Government’s motivations could also affect people’s engagement with other aspects of the Government’s response to the pandemic, for example in relation to the Covid-19 vaccine, voicing suspicions and concerns which have also been raised by NHS staff ( Woodhead et al, 2021 ):…”

“…There was no way, as a Black person, I was going to take on anything that white upper-class person was going to tell me, because they weren't going to have any thoughts on my behaviour or what was going to help me (IP07, Female, 53, Black Caribbean). This distrust of the Government's motivations could also affect people's engagement with other aspects of the Government's response to the pandemic, for example in relation to the Covid-19 vaccine, voicing suspicions and concerns which have also been raised by NHS staff (Woodhead et al, 2021):…”