Charlotte Woodhead1,2, Juliana Onwumere3,4, Rebecca Rhead1, Monalisa Bora-White5, Zoe Chui1, Naomi Clifford6, Luke Connor1, Cerisse Gunasinghe1, Hannah Harwood1, Paula Meriez7, Ghazala Mir8, Jessica Jones Nielsen9, Anne Marie Rafferty10, Nathan Stanley1, Dorothy Peprah11, Stephani L Hatch1,2. 1. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 2. ESRC Centre for Society and Mental Health, King's College London, London, UK. 3. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 4. South London and Maudsley NHS Foundation Trust, London, UK. 5. Avon and Wiltshire Mental Health NHS Partnership Trust, Bristol, UK. 6. Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK. 7. Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. 8. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. 9. Department of Psychology, City University of London, London, UK. 10. Department of Adult Nursing, Florence Nightingale Faculty for Nursing, Midwifery and Palliative Care, King's College London, London, UK. 11. London School of Hygiene and Tropical Medicine, London, UK.
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 de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.
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 de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.
Authors: Laia Bécares; Richard J Shaw; Srinivasa Vittal Katikireddi; Patricia Irizar; Sarah Amele; Dharmi Kapadia; James Nazroo; Harry Taylor Journal: SSM Popul Health Date: 2022-06-24
Authors: Ruth Elizabeth Watkinson; Richard Williams; Stephanie Gillibrand; Caroline Sanders; Matt Sutton Journal: PLoS Med Date: 2022-03-03 Impact factor: 11.069