Working with community groups to understand and reduce COVID-19 vaccine hesitancy among ethnic minority individuals in the UK
Lead Research Organisation:
University of Aberdeen
Department Name: Sch of Medicine, Medical Sci & Nutrition
Abstract
The UK Government's COVID-19 vaccine delivery plan of 11th Jan 2021 emphasised the need for high uptake of the vaccine but acknowledged hesitancy among some ethnic minority groups. Recent work has confirmed the unwillingness and/or uncertainty among some ethnic minority groups to take the COVID-19 vaccine. Our own work has revealed that many people in ethnic minority groups believe the vaccines to be unsafe (linked to the speed of development and deep mistrust of medical research and pharmaceutical companies), are unsure that vaccine trials have involved people like them (and therefore whether effectiveness and safety data apply to them), all against a backdrop of social inequalities. Deliberate misinformation campaigns, some of which target ethnic minority communities, play into existing anxieties.
The impact of this was starkly demonstrated by the OpenSAFELY Collaborative- data from 23.4 million adults in England show much lower rates of vaccination among Black, Mixed, South Asian and Other ethnic groups than for White groups. By 13th January, 42.5% of over-80s who were not in care homes and were White had been vaccinated, compared to 33.8% of over-80s of Indian/British Indian heritage, 23.0% of those of Bangladeshi/British Bangladeshi heritage, and 15.9% of those of African heritage.
The UK's national COVID-19 vaccine implementation strategy is clearly less effective for non-White ethnic groups. Uncertainty about receiving a vaccine presents significant challenges to achieving the societal coverage that government public health advisors have recommended.
Our proposed work will a) bring together 8-10 ethnic minority community organisations, all of which want to improve vaccine uptake in their communities; b) in collaboration with these groups do rapid systematic reviews on uptake of vaccines among ethnic minority groups and of strategies to improve uptake; c) prepare a co-produced, evidence-informed report containing recommendations regarding vaccine roll-out to ethnic minority groups, together with a co-developed agenda for further research to understand vaccine hesitancy.
Ethnic minority community organisations are at the heart of our proposal. They have the networks, experience, and credibility to engage their communities in health programmes and research. Harnessing this experience to corroborate and refine insights from different sources of evidence and tailor any resulting recommendations to the communities they represent is critical to improving COVID-19 vaccine uptake.
The impact of this was starkly demonstrated by the OpenSAFELY Collaborative- data from 23.4 million adults in England show much lower rates of vaccination among Black, Mixed, South Asian and Other ethnic groups than for White groups. By 13th January, 42.5% of over-80s who were not in care homes and were White had been vaccinated, compared to 33.8% of over-80s of Indian/British Indian heritage, 23.0% of those of Bangladeshi/British Bangladeshi heritage, and 15.9% of those of African heritage.
The UK's national COVID-19 vaccine implementation strategy is clearly less effective for non-White ethnic groups. Uncertainty about receiving a vaccine presents significant challenges to achieving the societal coverage that government public health advisors have recommended.
Our proposed work will a) bring together 8-10 ethnic minority community organisations, all of which want to improve vaccine uptake in their communities; b) in collaboration with these groups do rapid systematic reviews on uptake of vaccines among ethnic minority groups and of strategies to improve uptake; c) prepare a co-produced, evidence-informed report containing recommendations regarding vaccine roll-out to ethnic minority groups, together with a co-developed agenda for further research to understand vaccine hesitancy.
Ethnic minority community organisations are at the heart of our proposal. They have the networks, experience, and credibility to engage their communities in health programmes and research. Harnessing this experience to corroborate and refine insights from different sources of evidence and tailor any resulting recommendations to the communities they represent is critical to improving COVID-19 vaccine uptake.
Organisations
Publications
Treweek S
(2024)
Using the GRADE Evidence to Decision Framework to reach recommendations together with ethnic minority community organisations: the example of COVID-19 vaccine uptake in the UK
in Journal of Clinical Epidemiology
Description | Our literature search identified data from 26 studies providing qualitative data from 2,170 participants from ethnic minority groups and survey data from 35,831 participants. Studies were conducted in the UK, USA, and Australia. These data were then the centre of 12 hours of structured discussion with our whole collaboration. We agreed that there were three main factors affecting COVID-19 vaccine uptake by ethnic minorities in the UK, and three corresponding strategies that could be used to improve uptake. These are: Factors 1. Lack of trust in organisations and individuals advising on, or promoting, vaccine uptake. 2. Lack of culturally and linguistically appropriate information. 3. Inconvenient locations/timings of vaccine appointments. Strategies 1. Using trusted messengers to provide information. 2. Tailoring the message both culturally and linguistically, and ensuring that issues of concern to ethnic minorities are covered. 3. Providing flexible venues/times for vaccination. All our work, including all the data in our detailed Evidence to Decision Frameworks, is available at https://www.collaborationforchange.co.uk. This project is unique in that it was from the very start a collaboration between nine ethnic minority community organisations, academics and small businesses working with ethnic minorities. Academics provided rigour but the lived experience, insight and perspectives came from our ethnic minority community partners. Community organisations new in other words full partners, not participants: they helped direct the research and their lived experiences are at the heart of our findings. We aimed for clear, actionable messages underpinned by research and academic rigour. Our final report is concise (14 pages), engaging and accessible but is backed up by 100 pages of research data (available at the link above). This allows our summary statements to be tracked back to data if required, enabling us, and others, to have confidence in the factors and strategies we list. We can, for example, say with absolute confidence that lack of trust in the NHS is reducing COVID-19 vaccine uptake by ethnic minorities (Black individuals in particular) and that working with community organisations to identify messengers trusted by ethnic minorities will improve uptake. That confidence comes from our combination of community collaboration and academic rigour. |
Exploitation Route | The key users of our findings are ethnic minority community organisations, the NHS, councils and others promoting COVID-19 vaccine uptake. Our partners are already using the findings in their community work. We have had discussions with NHS England and NHS Grampian, especially about engaging Black communities. Haringey Council in London has used our work to both confirm and modify its approach to vaccine roll-out. Discussions with other organisations responsible for vaccine roll-our are ongoing. |
Sectors | Communities and Social Services/Policy,Healthcare |
URL | https://www.collaborationforchange.co.uk |
Description | The finding are about trial methodology (choice of how time is distributed between primary and secondary outcomes) and data from the project has been used in teaching to doctors in their foundation years who are interested in developing research careers. Data have also been presented to key stakeholders, including funders, within the lifetime of the project itself. |
First Year Of Impact | 2020 |
Sector | Healthcare |
Impact Types | Policy & public services |
Description | Cited by Public Health Scotland in Factors affecting uptake of the COVID-19 vaccine, June 2022 |
Geographic Reach | National |
Policy Influence Type | Citation in other policy documents |
URL | https://www.publichealthscotland.scot/publications/factors-affecting-uptake-of-the-covid-19-vaccine-... |
Description | Inequalities in screening |
Amount | £57,017 (GBP) |
Organisation | NHS Grampian |
Sector | Public |
Country | United Kingdom |
Start | 01/2023 |
End | 12/2023 |
Title | Collaboration for Change: Promoting Vaccine Uptake - Rapid Reviews and Evidence to Decision Framework, 2016-2021 |
Description | Our collaboration did two rapid systematic reviews of research evidence on factors influencing respiratory vaccine (including COVID-19) uptake in ethnic minority adults and strategies to improve uptake. In summary, these reviews and our approx 12 hours of discussion identified six factors influencing respiratory vaccine (including COVID-19) uptake in ethnic minority adults and three strategies to improve uptake. This data collection includes our extracted data for the two rapid reviews and the nine Evidence to Decision framework, the latter of which summarises our discussion in a structured way. The frameworks also present our recommendations. |
Type Of Material | Database/Collection of data |
Year Produced | 2021 |
Provided To Others? | Yes |
Impact | Impact of research dataset unclear. |
URL | https://reshare.ukdataservice.ac.uk/855248/ |
Description | Article in The Conversation |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Article on the project results in The Conversation |
Year(s) Of Engagement Activity | 2021 |
URL | https://theconversation.com/three-ways-to-improve-the-uptake-of-covid-vaccines-by-ethnic-minority-gr... |
Description | Interview for national news |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Interview about the project results with BBC Radio Scotland. |
Year(s) Of Engagement Activity | 2021 |
Description | Radio interview |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | Interview about the project results with Tayside Radio. |
Year(s) Of Engagement Activity | 2021 |
Description | TV interview |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Interview about the project results with That's TV Scotland. |
Year(s) Of Engagement Activity | 2021 |