Covid-19 Vaccine Uptake in the BAME (Black, Asian, and Minority Ethnic) Community

Barriers and interventions to improve vaccine acceptance

Photo by Ivan Diaz on Unsplash

On the 4th of January 2021, England entered the third lockdown in an attempt to suppress the spread of the new Covid-19 variant. Wales is already in lockdown since the 20th of December 2020. For these restrictions to be gradually lifted, there needs to be a successful rollout of vaccines.

According to the latest research by RSPH (Royal Society for Public Health) and ONS (Office for National Statistics), vaccine uptake in England and Wales has been lower amongst the BAME (Black, Asian, and Minority Ethnic) communities compared to non-BAME individuals.

According to the Royal College of General Practitioners, BAME communities make up 13.6% of the population in England but only 7.8% of all the vaccines have been taken up by these communities. Also, researchers from the University of Oxford and London School of Hygiene and Tropical Medicine found that Black people over the age of 80 were half as likely to be vaccinated compared to white people in England. In Wales, vaccine uptake is 85.6% amongst people of white ethnicities compared to 71.5% amongst BAME ethnicities.

This is particularly important considering minority ethnic groups are disproportionately affected by the pandemic according to a paper by the Scientific Advisory Group of Emergencies (SAGE). Moreover, the reduced uptake would further exacerbate these healthcare inequalities.

Similar trends have been observed with previous national vaccination programmes. A QResearch study of previous national vaccination programmes demonstrated disparities in vaccination uptake across different ethnic groups in children under 18 years of age (rotavirus, MMR, Men C, influenza) and adults over 65 (influenza and pneumococcal). For adults over the age of 65, there was a consistently reduced uptake amongst the Black African and Black Caribbean populations compared to White ethnic groups.

In this article, we are going to focus on the barriers to vaccine uptake and interventions that could be employed in order to increase participation in the national vaccination programme.

Some of the barriers to vaccine uptake are summarised here:

• Fear of side effects and long-term impact on health are the most common reasons for vaccine hesitancy according to the Office for National Statistics.
• Lack of trust was common particularly amongst the black populations due to previous unethical research in this group and under-representation of ethnic minorities in the research and vaccine trials. Also, ethnic minorities have poorer access to healthcare and poorer experience of healthcare compared to their white counterparts, which ultimately adds to the mistrust.
• People from ethnic minority backgrounds are more likely to be living in areas of socioeconomic deprivation and struggle with access to appropriate transport needed to reach vaccination centres.

Interventions to increase vaccine uptake:

• Trust in the vaccine can be increased by encouraging trusted health care professionals to offer and recommend the vaccine. This will especially hold more value if it comes from health care professionals who are also from ethnic minorities.
• Provide access in community-based settings, encouraging support from family and friends, and providing support with transport and booking appointments.
• Better communication from faith leaders, health care workers, and community leaders by using community forums to tackle fears and misinformation spread amongst the BAME communities. This is particularly important in mitigating doubts about the vaccines’ religious acceptability e.g. the rumours that the vaccine contains pork, aborted foetal cells, microchips that would change one's DNA etc.
• Encourage social media companies to remove any anti-vaccination information.

In conclusion, there are numerous barriers that people with BAME background face in getting the COVID vaccine. Therefore, interventions need to be placed to encourage vaccine uptake, stop the spread of Covid-19 and allow for life to slowly go back to normal pre-COVID.