In U.K., Concern Grows Over Vaccine Hesitancy Among Minority Groups


LONDON — Health experts, doctors and government officials in Britain are calling for a more concerted campaign to address vaccine hesitancy among minority groups, with some also urging that those groups be designated a priority for immunization against the coronavirus because they are more at risk.

The government said on Monday that it would give 23 million pounds, or about $31 million, to local councils and other groups in England to encourage vaccines among those most at risk from the virus, including minority groups, by trying to combat misinformation and to build trust in the authorities.

The pandemic has already thrown into sharp relief the persistent racial inequalities in Britain, which have played a role in the disproportionately high rates of infection and death among minority groups and, some say, deepened their mistrust of the government.

Recent polls showed that members of Black, Asian and other minority groups in the country are less open to getting the vaccine than white people are because they worry about the vaccine’s reliability. Britain’s drug regulator, seen as a bellwether agency, has said the vaccines are safe and effective.

“I am conscious some Londoners are hesitant to receive the Covid vaccine because they are from communities which have, in the past, been let down by institutions,” Mayor Sadiq Khan of London said. “But these vaccines are safe and effective, and I urge everyone who is invited to receive one to do so.”

The stakes could hardly be higher for countries to address skepticism and anxiety around vaccinations. The British government is banking on a campaign to vaccinate tens of millions of people by April as an escape route from stop-and-start lockdowns and their crippling economic fallout.

Maureen Pryce, a 58-year-old former caregiver of Caribbean descent, said that she had stopped taking vaccinations after one of her daughters suffered a bad reaction to one years ago. Even with family members sickened by the virus and deaths increasing in her neighborhood, her mind was made up, she said.

“I’m not having it. I refuse,” she said this month. “How can we trust you?” she said of the authorities. “You have a history of lying to us.”

There are deeply rooted reasons for a mistrust of health care among minority groups, experts say, with a history of abuse and racism in the medical establishment. For 40 years ending in 1972, doctors intentionally did not treat African-American men infected with syphilis to study the course of the disease. In Nigeria, Pfizer agreed to a $35 million settlement with Kano State after 11 children died in a 1996 trial of an experimental meningitis drug.

And two French doctors spurred an outcry last April when they suggested Covid vaccines should be tested in African countries, where people had less access to personal protective equipment.

As growing numbers of people have received the vaccine without incident, vaccine hesitancy overall appears to be waning in Britain, according to a YouGov poll in January. As of Monday, about 6.5 million in Britain, out of a population of about 67 million, had received a first dose of the vaccine.

But in a survey of 12,035 people commissioned by the government’s scientific advisory group, vaccine hesitancy was higher in Black Britons and in those of Pakistani, Bangladeshi and other ethnic backgrounds.

In the city of Birmingham, for example, one health official said anecdotal evidence suggested that about half of those belonging to minority groups who were invited to receive vaccines were turning them down, according to the BBC.

Members of minority groups are not the only skeptics. Many, in fact, are “desperate” for a vaccine that has not come quickly enough, said Halima Begum, the chief executive of Runnymede Trust, a London-based organization that advocates racial equality, adding that she had two siblings with Covid-19 in the hospital.

Still, health experts and lawmakers have called for collecting more data on the vaccine rollout across different ethnic backgrounds, which they say is lacking, and to improve messaging on vaccine safety to people of color.

Covid-19 Vaccines ›

Answers to Your Vaccine Questions

While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.

Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.

Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.

No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

Opposition lawmakers have lobbied the health secretary, Matt Hancock, to consider adding minority groups to a vaccine priority list, citing statistics on mortality. Doctors received some guidance from the National Health Service to prioritize ethnic minority groups if they were already eligible because of age, said Prof. Martin Marshall, chairman of the Royal College of General Practitioners.

The Department of Health has said that priority for vaccinations would be given to older adults and to those with underlying health conditions, including in Black and ethnic minority groups.

But primary care doctors, particularly those working in multiethnic areas, have expressed worries about vaccine skepticism.

To counter misinformation, local officials and community leaders have been sending messages in several languages that the approved vaccines, though fast-tracked, have been found to be safe and effective.

But misinformation abounds online. There are baseless claims that the vaccine is a method of population control, that it could change a recipient’s DNA, or that it contains animal products such as pork, which might raise conflicts with some religious practices.

Imams are dedicating sermons this month to reassuring the Muslim community that the vaccine is halal and advising people to take it if offered. Doctors are holding Zoom sessions answering questions for the Sikh community.

Rhoda Ibrahim, a British-Somali community leader in London, said videos featuring Somali actors had been created to raise awareness about testing, mask-wearing and vaccines.

Nadhim Zahawi, the Iraqi-born British minister in charge of vaccine deployment, told BBC Radio last week he was worried that ethnic minority groups might disproportionately refuse the vaccine and become infected more quickly. But he said Monday that he was working with faith and community leaders to build awareness that vaccines were safe.

Still, many say that the British government should have invested far sooner in responding to these concerns.

Glory Nyero, a Black analyst in social care and housing from London, said she had grown up wary of the health care system and with a sense that British institutions did not always understand people of color.

“In the end, I will get it if I have to,” she said of the vaccine, adding that she worried her newborn could contract the virus.

“To hear that vaccine has only been tested and run through within a year — that creates quite a lot of hysteria,” she said.

Critics of the government said that in a year when racial injustice had become a global focus, lawmakers did not do enough to protect people of color, despite a review of data that showed glaring disparities in the coronavirus toll.

“A colorblind policy hurts those who are most impacted,” said Ms. Begum of the Runnymede Trust. She says she wants urban areas, where many minority groups live, to be vaccinated first.

Part of the chasm from the pandemic’s toll could come from longstanding disparities in wealth and housing, a government review said, noting also that people of color were more likely to be in jobs with greater exposure to the virus, such as in health care and food production.

They were also more likely to have pre-existing health conditions such as diabetes and obesity, the review added, which increased the risk and severity of the infection, and may be less likely to seek help when needed because of historical racism and negative experiences with health care or at work.

Salman Waqar, a family doctor and general secretary of the British Islamic Medical Association, is among those working to persuade people to take vaccines.

“Any community that has been ignored and neglected is especially vulnerable,” he said. “That vulnerability’s now been exploited by the anti-vaccine messaging that’s coming in.”

Benjamin Mueller contributed reporting.


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