Cascini and colleagues' systematic review provides relevant and important evidence of the role of social media in shaping COVID-19 vaccination attitudes. However, my ongoing, in-depth ethnographic research in the past 9 months among Roma communities in Italy, Bulgaria, and the UK, has revealed aspects of vaccine intent and uptake among minority ethnic groups that the review has not captured. In the context of higher vaccine hesitancy among minority ethnic groups, the following considerations should be taken seriously in public health interventions.There is a complex web of barriers to vaccination for minority ethnic groups. Through ethnographic evidence, our research, found that access to misinformation on social media was not the main reason for low vaccine uptake. Minority ethnic groups responded to the COVID-19 vaccination campaign based on their socioeconomic circumstances, which were exacerbated by the pandemic; for instance, lack of access to transportation to vaccination centres, barriers in accessing health-care, education, employment, and accommodation, and a previous history of discrimination. This is why it is important to consider the interplay between pre-existing structural and social inequalities with new forms of marginalisation created by the COVID-19 pandemic in relation to vaccine uptake.Our respondents encountered barriers to accessing health systems, and they were more reliant on social media as a source of health information. For minority ethnic groups, social media was an avenue of accessing networks of trust, and those of family, friends, and important established and new relationships of support. Therefore, an improved understanding of the use of social media platforms by minority ethnic populations is highly necessary to understand and improve vaccine uptake.
Declaration of interests
The research project ‘Ethnographies of (Dis)Engagement’ in Italy was funded through the British Academy COVID-19 Recovery: G7 Fund (COVG7210058).