The views of ethnic minority and vulnerable communities towards participation in COVID-19 vaccine trials

Ekezie, Winifred; Czyznikowska, Barbara M; Rohit, Sundeep; Harrison, J; Miah, Nasima; Campbell-Morris, Pamela; Khunti, Kamlesh

doi:10.1093/pubmed/fdaa196

Cited by 45 publications

(51 citation statements)

References 4 publications

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“…Our findings provide insight into factors likely to impact on COVID-19 vaccine roll-out in migrant communities, concurring with previous studies that demonstrate that migrants may trust their social networks over medical professionals (22) and that they may be more likely than the general population to believe COVID-19 misinformation (23) and mistrust COVID-19 vaccine research (21). Specifically engaging diverse migrant groups in the UK, and co-designing interventions to facilitate COVID-19 vaccine uptake, is therefore a crucial next step.…”

Section: Discussionsupporting

confidence: 90%

“…We suggest solutions to improve access to primary care for migrants in this pandemic, demonstrating the need for flexible and adapted policies in order to minimise disparities (20). Interventions to address structural inequalities and social and economic constraints that reduce migrants’ autonomy to be able to protect themselves from suffering serious illness from COVID-19 are needed (4,11) and to ensure culturally and linguistically appropriate information about COVID-19 and the COVID-19 vaccine (21).…”

Section: Discussionmentioning

confidence: 99%

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Impact of COVID-19 on Migrants’ Access to Primary Care: A National Qualitative Study

Knights

Carter²,

Deal

et al. 2021

Preprint

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BackgroundThe COVID-19 pandemic has led to considerable changes in the delivery of primary care in the UK, including rapid digitalisation, yet the extent to which these have impacted on marginalised migrant groups – already facing existing barriers to NHS care – is unknown. Understanding the perspectives and experiences of health professionals and migrants will support initiatives to deliver more effective health services, including delivery of the COVID-19 vaccine, to marginalised groups.AimTo understand the impact of the COVID-19 pandemic on migrants and their access to primary healthcare, and implications for COVID-19 vaccine roll out.Design and SettingPrimary care professionals, administrative staff, and migrants (foreign born; >18 years; <10 years in UK), were recruited in three phases using purposive, convenience and snowball sampling from urban, suburban and rural settings.MethodsIn-depth semi-structured interviews were conducted by telephone. Data were analysed iteratively, informed by thematic analysis.Results64 clinicians were recruited in Phase 1 (25 GPs, 15 nurses, 7 HCAs, 1 Pharmacists); Phase 2 comprised administrative staff (11 PMs and 5 receptionists); and in Phase 3 we recruited 17 migrants (88% asylum seekers; 65% female; mean time in UK 4 years). We found that digitalisation and virtual consultations (telephone, video, and online form-based) have amplified existing inequalities in access to healthcare for many migrants due to lack of digital literacy and access to technology, compounded by language barriers. Use of virtual consultations has resulted in concerns around building trust and the risk of missing safeguarding cues. Participants highlighted challenges around registering and accessing healthcare due to the physical closure of surgeries. Participants reported indirect discrimination, language and communication barriers, and lack of access to targeted and tailored COVID-19 information or interventions. In addition, migrants reported a range of specific beliefs around COVID-19 and on potential COVID-19 vaccines, from acceptance to mistrust, often influenced by misinformation. PCPs raised concerns that migrants may have increased risk factors for poor general health and to severe illness from COVID-19, in part due to their social and economic situation. Innovative opportunities were suggested to engage migrant groups through translated digital health advice using text templates and YouTube which merit further exploration.ConclusionPandemic-related changes in primary care delivery may be here to stay, and some migrant groups are at risk of digital exclusion and may need targeted additional support to access services. As primary care networks operationalise the delivery of the COVID-19 vaccine, these findings provide critical information on specific strategies required to support migrant population to access primary care and overcome misinformation around COVID-19 and the COVID-19 vaccine.How this fits inThe impact of pandemic-related shifts in primary care delivery on marginalised migrant groups, who may already face major disparities in accessing primary care, is poorly elucidated. We found that the rapid digitalisation of primary care services and physical closure of surgeries during the pandemic have amplified disparities in access to healthcare for specific migrant groups, with many lacking access to and capacity to use technology, compounded by language barriers. Migrants may be at increased risk of misinformation about COVID-19, which merits further consideration as COVID-19 vaccine roll out begins. Improved outreach to local migrant community organisations and places of worship, alongside co-designing with migrants more inclusive delivery approaches and creative integration of migrant ambassadors into information-sharing campaigns are needed. Primary care can maximise the opportunities of digitalisation for migrants through flexible engagement by multiple modalities (e.g. text, email, letter and YouTube videos) to provide targeted, translated advice and information, virtual group consultations for patients with a specific condition, and working with local leaders and NGOs to access and disseminate information through informal communication channels.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on Migrants’ Access to Primary Care: A National Qualitative Study

Knights

Carter²,

Deal

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In the U.K., England appeared to have greater vaccine uptake compared to other countries where increased vaccine hesitancy has been documented (Table S7). 30,31 Lower vaccine uptake among Black persons in the U.S. were comparable among specific sociodemographic groups, including frontline HCWs (Table 4A) and individuals living in communities with lower educational attainment (Table 4C). Notably, in the U.K., Black frontline…”

Section: Racial/ethnic Disparities In Covid-19 Vaccine Uptakementioning

confidence: 98%

Racial and ethnic differences in COVID-19 vaccine hesitancy and uptake

Nguyen

Joshi

Drew

et al. 2021

Preprint

129

114

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Background: Racial and ethnic minorities have been disproportionately impacted by COVID-19. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy and limited access may result in disparities in uptake. Methods: We performed a cohort study among U.S. and U.K. participants in the smartphone-based COVID Symptom Study (March 24, 2020-February 16, 2021). We used logistic regression to estimate odds ratios (ORs) of COVID-19 vaccine hesitancy (unsure/not willing) and receipt. Results: In the U.S. (n=87,388), compared to White non-Hispanic participants, the multivariable ORs of vaccine hesitancy were 3.15 (95% CI: 2.86 to 3.47) for Black participants, 1.42 (1.28 to 1.58) for Hispanic participants, 1.34 (1.18 to 1.52) for Asian participants, and 2.02 (1.70 to 2.39) for participants reporting more than one race/other. In the U.K. (n=1,254,294), racial and ethnic minorities had similarly elevated hesitancy: compared to White participants, their corresponding ORs were 2.84 (95% CI: 2.69 to 2.99) for Black participants, 1.66 (1.57 to 1.76) for South Asian participants, 1.84 (1.70 to 1.98) for Middle East/East Asian participants, and 1.48 (1.39 to 1.57) for participants reporting more than one race/other. Among U.S. participants, the OR of vaccine receipt was 0.71 (0.64 to 0.79) for Black participants, a disparity that persisted among individuals who specifically endorsed a willingness to obtain a vaccine. In contrast, disparities in uptake were not observed in the U.K. Conclusions: COVID-19 vaccine hesitancy was greater among racial and ethnic minorities, and Black participants living in the U.S. were less likely to receive a vaccine than White participants. Lower uptake among Black participants in the U.S. during the initial vaccine rollout is attributable to both hesitancy and disparities in access.

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“… 6 Studies also shows that the emerging biopolitics, as introduced by Michel Foucault, where a government takes the power of determinacy over the death or survival of a population, is coming to reality, increasing more the level of fear, anxiety and hesitancy 7 especially to minorities. 8 …”

mentioning

confidence: 99%

Building public trust: a response to COVID-19 vaccine hesitancy predicament

Vergara¹,

Sarmiento

Lagman³

2021

Journal of Public Health

163

100

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With the rollout of vaccines against COVID-19, an optimistic and a negative attitude among people have arisen. Surprisingly, surveys among people reveal that there is a significant rate of distrust against the vaccines. In a recent short report published in this journal, vaccine hesitancy was found out among medical students. Hence, wide array of research has been springing, recommending various approaches in assisting authorities deal with vaccine hesitancy such as proper and effective strategic communication as a solution. This study suggests however that a more ‘localized’ public education and role-modelling from public officials and health authorities can help a lot in building public trust. The study aims to contribute to the further development of public health mechanisms in the rolling-out and distribution of vaccines against COVID-19.

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The views of ethnic minority and vulnerable communities towards participation in COVID-19 vaccine trials

Cited by 45 publications

References 4 publications

Impact of COVID-19 on Migrants’ Access to Primary Care: A National Qualitative Study

Impact of COVID-19 on Migrants’ Access to Primary Care: A National Qualitative Study

Racial and ethnic differences in COVID-19 vaccine hesitancy and uptake

Building public trust: a response to COVID-19 vaccine hesitancy predicament

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