Covid-19 vaccine rollout worsened existing health inequalities, find researchers
The wide inequalities in Covid-19 vaccine uptake between people from ethnic minority groups and White British people are far greater than for the pre-pandemic flu jab, a study by University of 野狼社区 health researchers has found.
The findings, published in PLoS Medicine , overturns the prevailing view that ethnic inequalities in Covid-19 vaccine uptake simply follow previous trends in people鈥檚 willingness to take up vaccination.
Instead, the researchers suggest, the Covid-19 vaccination programme has created additional and different inequalities beyond pre-existing inequalities in vaccine uptake.
Adjusting for age and clinical vulnerability, people from Arab, mixed White and Black African, mixed White and Black Caribbean, and all Black or Black British backgrounds were less than half as likely to take up Covid-19 vaccination compared to the White British group.
Inequalities in Covid-19 vaccine uptake were at least double the size of flu vaccine inequalities for almost half (7/16) of ethnic minority groups.
Differences between the two types of vaccine were particularly stark for those from a Bangladeshi background.
After adjusting for age and clinical vulnerability, people belonging to the Bangladeshi group were almost 10% more likely to have taken up flu vaccination, yet over 40% less likely to have taken up the Covid-19 vaccine, compared to the White British group.
Most worryingly, ethnic inequalities were highest amongst people at the highest risk of severe Covid-19 鈥� older and more clinically vulnerable people, and those living in the most income-deprived areas.
The researchers examined 752,715 people eligible for the Covid-19 vaccine between December 2020 and April 2021, and the flu vaccine between September 2019 and March 2020.
鈥淲e found ethnic inequalities in Covid-19 vaccine uptake are far wider than those seen previously for seasonal Influenza vaccine, and exist even among those recently vaccinated against Influenza,鈥� said lead author Dr Ruth Watkinson from The University of 野狼社区.
鈥淔urther research and community engagement is needed to build trust and confidence amongst minority ethnic communities, and to better understand and remove barriers to vaccine access.鈥�
We found ethnic inequalities in Covid-19 vaccine uptake are far wider than those seen previously for seasonal Influenza vaccine, and exist even among those recently vaccinated against Influenza
Online public discussion groups with diverse members of the Greater 野狼社区 community identified themes which could explain the inequalities.
Stephanie Gillibrand, another 野狼社区 researcher involved in the study said: 鈥淓xisting mistrust stemming from racism, experiences of culturally insensitive healthcare, and awareness of previous unethical healthcare research were all themes raised in discussion groups.
鈥渃oncerns about potential unknown side-effects of Covid-19 vaccines compared to existing vaccines may have been heightened among people from minority ethnic groups due to their underrepresentation in Covid-19 vaccine clinical trials.鈥�
鈥淎dditional research is required to further explore the complex social, political and structural drivers and barriers to vaccine uptake which drive these statistics, as highlighted by our public engagement work鈥�
Nicolas Filer, a public contributor involved in the study said: 鈥淓specially interesting was the clear exposure of differences in vaccine uptake within different ethnic minority groups and communities within the broader widely used classifications.
鈥淥nce the more special needs of some of our community were recognized and responded to by the NHS, their vaccine take up was greatly increased.鈥�
Dr Watkinson added: 鈥淓ven for healthcare services provided free at the point of use, disadvantaged populations with the greatest 鈥榥eed鈥� for care tend to have lower uptake of services.
鈥淩esidential segregation driven by systemic racism may have resulted in barriers - in terms of journey time and cost - to accessing large centralised vaccination sites for some communities.
鈥淗owever, local solutions such as vaccine pop ups and local centres have now expanded vaccine access across Greater 野狼社区. These innovations, alongside providing culturally-sensitive vaccination options, are crucial for equitable access.鈥�
Issues around racism were raised in the discussion groups. Some people from ethnic minority backgrounds reported difficulties booking and traveling to vaccination appointments, as well as a lack of official vaccine information translated into additional languages.
While Covid-19 vaccines were initially only available at booked appointments in mass vaccination centres, flu vaccines are available through GP practices and community pharmacies, which often operate drop-in services and are more accessible in areas of high deprivation.
The research team recognise the partnership of Greater 野狼社区 Health and Social Care Partnership, Health Innovation 野狼社区 and Graphnet Health, on behalf of GM localities in the provision of data required to undertake the work. This work uses data provided by patients and collected by the NHS as part of their care and support.
The paper Ethnic inequalities in Covid-19 vaccine uptake and comparison to seasonal Influenza vaccine uptake in Greater 野狼社区, UK: a cohort study is available here