3.2.2 Drivers of vaccine hesitancy
Belief: Individuals described their enthusiasm concerning the vaccine, appreciation of being prioritised, and the function of belief in colleagues, the NHS, and well being data in facilitating vaccine uptake. Narratives additionally highlighted the affect of experiences of discrimination and structural inequities on belief and vaccine hesitancy, and the ubiquity of issues across the vaccine throughout each those that declined to be vaccinated and people who described themselves as pro-vaccine.
Belief in vaccinations: While some individuals described a insecurity in vaccines usually, most individuals described being accepting of routine or flu vaccinations. Key issues for the COVID-19 vaccine associated to hurry of growth, lack of longitudinal knowledge, and potential uncomfortable side effects, in addition to efficacy in opposition to SARS-CoV-2 variants. There have been additionally issues concerning the underrepresentation of people from ethnic minority backgrounds in vaccine trials.
Belief in these producing, giving, and taking vaccines: Vaccine confidence amongst colleagues, household, pals and neighborhood members elevated HCW belief within the vaccine. Extra senior colleagues – notably clinicians – have been particularly influential, and conversely belief was eroded when they didn’t adhere to steerage. Some individuals described a contradiction between their very own issues round having the vaccine, but selling it for the broader public via their roles.
Perceived dangers of COVID-19 to self and others: While some individuals felt at low threat, others expressed concern concerning the threat of publicity of their function and fears of getting COVID-19, even when they didn’t produce other key threat components. Earlier an infection, understanding individuals who had been unwell or handed away from COVID-19, and issues about an infection of their households and family members typically elevated perceived threat. Individuals’ views concerning the extent to which vaccination may scale back threat additionally influenced their resolution to be vaccinated, as did their need to cut back their threat of transmission and shield their shut contacts. Individuals additionally mentioned how they perceived ethnicity to affect threat. While prioritisation of NHS staff for vaccines was welcomed, some felt ethnic minority teams ought to have been prioritised given their elevated threat.
Well being data and messaging: Accessibility and trustworthiness of well being data formed vaccine issues. Complicated data, conflicting and altering steerage, overwhelming quantities of fabric, and poor provision of knowledge in different languages contributed to an absence of belief, confusion, and finally vaccine hesitancy. Individuals additionally famous the stigma round vaccine hesitancy and lack of vaccine information.
Individuals obtained data from quite a few sources. Social media was typically described as doubtlessly deceptive or unreliable, however some individuals acknowledged its usefulness for elevating consciousness, vaccine promotion, and disseminating messaging, particularly as data shared by neighborhood members could also be extra trusted. Individuals additionally continuously accessed data via the information, or Authorities and NHS sources. Nevertheless, the constructive presentation of vaccines by these sources was felt by some to be insincere with potential dangers not being transparently communicated. This fed into suspicions round official stories on COVID-19 additional contributing to HCW distrust.
There have been various responses to the give attention to ethnic minorities. Whereas prioritisation of NHS staff for vaccines was welcomed, some felt HCWs from ethnic minority backgrounds ought to have been additional prioritised given proof of the disproportionate influence of COVID-19 on these communities. The narratives additionally illustrated discomfort with the give attention to ethnic minorities within the media, messaging and vaccine promotion campaigns, which singled out these communities as ‘vaccine hesitant’ and elevated stigma. One participant introduced consideration to discourse round reported low vaccine uptake of the vaccine amongst Black medical doctors, calling for higher transparency and accuracy round uptake charges, and higher understandings of the components that inform selections about vaccines.
Inclusive communication: Individuals highlighted the worth of speaking messages via a variety of media and languages, and interesting straight with folks to answer questions or issues, and sort out misinformation. Individuals additionally advocated for utilizing current sources similar to multilinguistic healthcare workers to strengthen the accessibility and trustworthiness of well being data.
Individuals additionally described the significance of language in how teams are described, and the necessity to keep away from assumptions or stereotyping related to ethnicity. This was essential for creating extra inclusive communication round how at-risk teams – and ethnic minority communities particularly – are described in analysis, the office, and the media.
Growing transparency and belief: Belief and knowledgeable decision-making about vaccines was influenced by how threat teams have been recognized and prioritised, who was eligible, and the perceived dangers and advantages. Individuals defined the significance of clear and clear communication via hospital Trusts.
Fairness, alternative and necessary vaccination: Individuals underscored the necessity to guarantee fairness in vaccine supply, with some advocating prioritisation of workers experiencing the best limitations to getting the vaccine, or who have been at biggest threat. While some individuals advocated for “necessary vaccinations for these selecting to work in well being and social care settings” (Participant 84, Speech and language therapist), others have been involved concerning the potential lack of fairness for individuals who selected to not have the vaccine, and that mandating vaccination may create additional ethnic divides between communities and improve stigma and discrimination. Individuals additionally mentioned how making certain fairness in accessibility and alternative to have the vaccine can be paramount for bettering supply.
Outreach via involvement: Individuals described how the vaccine roll-out might be improved via higher engagement with and involvement of HCWs, notably these from ethnic minority communities. The narratives pointed to the shortage of inclusion of marginalised communities all through the pandemic, and the potential profit of accelerating visibility of much less effectively represented teams within the media to advertise vaccine uptake and belief.
Individuals additionally mentioned the significance of selling vaccination via trusted networks, and the worth of extra proactive involvement and engagement of healthcare staff from various ethnic backgrounds. An essential side of each constructing belief and growing accessibility was acknowledging cultural variations in understandings of and entry to vaccines. Individuals highlighted how the involvement of minoritised communities can play an essential function in bridging cultural divides, and the potential advantage of outreach actions for addressing logistical challenges in delivering the vaccine.