Ministers have been criticised for failing to act more urgently on coronavirus vaccine disparities after data showed that white people are almost twice as likely to have been vaccinated as black people among over-80s in England.
Black, Asian and mixed ethnicity people are all less likely to have been vaccinated than white people among those aged 80 and above in England, according to new research. A lower proportion of ethnic minorities have been shown to have received at least one vaccine dose up to 27 January.
Equality campaigners have said calls to ministers 10 months ago to take urgent action to protect overexposed black, Asian and minority ethnic (BAME) communities were ignored, leading to the current vaccine uptake crisis.
Halima Begum, chief executive of the Runnymede Trust, said she first raised concerns about the dangerous exposure of these communities in March last year. “This isn’t about vaccine refusal, because that very rhetoric implies that these communities are doing something wrong, it’s their fault somehow,” she said. “We need to balance the conversation away from hesitancy and uptake to the response to BAME groups and their institutional mistrust now, and how they might be supported to show trust back in our public services like the NHS and the police.”
The trust says the government should prioritise the rollout of vaccines to BAME communities in dense urban areas “where the need is greatest” and work with community leaders to address misinformation and boost vaccine confidence.
“There is an important conversation going on around fake news and its impact on vaccine uptake, particularly in BAME communities. [However,] there are other issues at play that need addressing, including deep-seated multigenerational reservations and fear that some people in BAME communities have about accessing the NHS,” Begum said.
“That fear is often based on past experience, whether incidents of simple misunderstanding, cultural confusion or, in the case of some patients, an outright fear of perceived hostility and racism.”
Experts and politicians have expressed growing concerns over vaccine scepticism within minority ethnic groups, prompting the government to launch a targeted publicity campaign to increase confidence. In January ministers pledged a fund worth more than £23m to try to quell the spread of misinformation about the vaccine and in the past few days politicians and celebrities have released videos to encourage people from BAME communities to get the jab.
Last week, a report published in the Health Service Journal revealed a similar worrying trend among NHS workers, with fewer black and Filipino NHS staff vaccinated amid hesitancy concerns.
Previous data from the Office for National Statistics (ONS) suggested that black people had a fourfold higher risk of dying from Covid than white people, and that there were significant differences in mortality between ethnic groups and between the sexes.
Terence Channer, an African-Caribbean solicitor who specialises in healthcare law, said he was deeply concerned by the statistics, but that some concerns of the black community were justifiable. “Racism in healthcare breeds distrust and in addressing vaccine hesitancy, racism in healthcare has to be tackled. The other issues are the theological or religious concerns that have to be addressed head on to engender black trust in vaccination,” he said.
Channer urged the government to allow a black-led independent expert taskforce to have oversight of the vaccination process to raise black confidence levels. He also called for urgent research to be conducted on whether the black community would be less hesitant if black experts had oversight.
“We have the expertise. I call on the government to have designated vaccination centres manned by black clinicians,” he said.
Dr Priscilla Nkwenti, the chief executive of BHA for Equality, which challenges health inequalities in minority ethnic communities, said she had come across many examples of discrimination and poor practice in healthcare provision that could create and had created distrust.
“There is a lack of meaningful involvement and engagement with BAME communities. We hope that any work targeting such communities should meaningfully engage them so as to win trust, allay fears and dispel myths and thus lead to increased uptake of health provision,” she said.
The vaccines minister, Nadhim Zahawi, said he was looking into addressing refusal rates when asked whether the government was keeping a record of who has refused the vaccine so far. Speaking on Radio 4’s Today programme, Zahawi said: “Vaccine uptake in the UK is running incredibly high amongst adults, 85% according to the ONS study, but the 15% who are vaccine-hesitant skew heavily towards BAME communities.”
When asked specifically whether the government was recording who was refusing to be vaccinated, Zahawi said: “We’ll absolutely look at how we are addressing the issues of refusal rates at the moment. This is the highest uptake of any vaccination programme, including all the flu vaccination programmes in the NHS so far. Currently, the good news is the UK is a standout country in terms of people wanting to keep themselves safe and vaccinated and keep their families and communities safe.”
The data is based on 23.4m anonymised primary care patient records in England from OpenSafely. The study, by academics at the University of Oxford and London School of Hygiene & Tropical Medicine, has yet to be peer-reviewed, and covers people, excluding care home residents, who received a dose of the vaccine up to 27 January.
Additional reporting: Niko Kommenda and Aamna Mohdin