Julia Darko is a GP Specialty Trainee and Academic Clinical Fellow in General Practice at Kings College London. She is on Twitter: @DrJuliaDarko
As the UK’s vaccine roll out programme continues, there are emerging concerns about the rates of vaccine uptake in some minority ethnic communities. A recent report by the Scientific Advisory Group for Emergencies (SAGE), suggests high rates of vaccine hesitancy in Black, Pakistani and Bangladeshi groups.1 The Royal College of General Practitioners have called for the dissemination of a high-profile national campaign to increase COVID-19 vaccine uptake in BAME groups following findings that White people are approximately twice as likely to be vaccinated than people from Black and Asian ethnic backgrounds.2
Such figures have given rise to concern amongst healthcare professionals, policy makers and the wider public. A surge in media attention has followed, and various reporting is exploring this issue. While open and honest dialogue should always be encouraged, the national conversation about vaccine hesitancy in minority ethnic groups must be undertaken cautiously and sensitively.
Minority ethnic groups are not homogenous, and neither are their concerns, experiences or fears.
The reasons underlying a higher degree of vaccine hesitancy in some BAME communities are varied, multi-faceted and intersectional. Minority ethnic groups are not homogenous, and neither are their concerns, experiences or fears. In a recent public discussion facilitated by Westminster Council participants expressed a significant breadth of concerns.3 These included the safety profile of the vaccine for minority groups, the range of ethnic representation in clinical trials, the uncertainty about longer-term side effects, worries about the speed of the COVID-19 vaccine production, ethical and religious queries about contents of the vaccine, the UK government’s scheduling for first and second doses, mistrust in socio-political institutions, effects of historical disenfranchisement, structural racism and more. While some doubts are undeniably linked to the rise in harmful conspiracy theories, most appear to be rooted in genuine concern and lay misinformation.
Strategies to facilitate and inform widespread dialogue are likely to be hugely beneficial in allaying hesitancy. However, we must ensure such dialogue does not pave the way for discriminatory rhetoric that will in turn label entire ethnic groups living the the UK as ‘anti-vax’.
History has repeatedly shown the risk of marginalisation faced by minority ethnic communities. Constructing a narrative that places minority ethnic groups at the centre of blame for failures of the COVID-19 vaccination programme leaves these communities open to abuse and targeted racism. Healthcare professionals have a particular duty to approach this topic sensitively and direct the conversation in a way that is supportive, encouraging and empowering of groups where vaccine hesitancy is more prevalent.
In turn, the government has a continued duty to first acknowledge and then dismantle the consequences of structural disenfranchisement that have historically contributed to minority ethnic individuals feeling alienated and overlooked, and therefore unsurprisingly tentative about the prospect that, on this occasion, the government truly has their best interest at heart.
1. Scientific Advisory Group for Emergencies. Factors influencing COVID-19 vaccine uptake among minority ethnic groups, 17 December 2020. 2021. https://www.gov.uk/government/publications/factors-influencing-covid-19-vaccine-uptake-among-minority-ethnic-groups-17-december-2020
2. Royal College of General Practitioners. GPs call for high-profile campaign backed by faith leaders and prominent figures from BAME communities to increase COVID-19 vaccine uptake. 7 February 2021. https://www.rcgp.org.uk/about-us/news/2021/february/gps-call-for-high-profile-campaign-backed-by-faith-leaders.aspx
3. Westminster Council. COVID-19 vaccination: an open online discussion. 3 February 2021. https://www.westminster.gov.uk/event/covid-19-vaccination-open-online-discussion