Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff

Charlotte Woodhead; Juliana Onwumere; Rebecca Rhead; Monalisa Bora-White; Zoe Chui; Naomi Clifford; Luke Connor; Cerisse Gunasinghe; Hannah Harwood; Paula Meriez; Ghazala Mir; Jessica Jones Nielsen; Anne Marie Rafferty; Nathan Stanley; Dorothy Peprah; Stephani Hatch

doi:10.1080/13557858.2021.1936464

Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff

Charlotte Woodhead^*, Juliana Onwumere, Rebecca Rhead, Monalisa Bora-White, Zoe Chui, Naomi Clifford, Luke Connor, Cerisse Gunasinghe, Hannah Harwood, Paula Meriez, Ghazala Mir, Jessica Jones Nielsen, Anne Marie Rafferty, Nathan Stanley, Dorothy Peprah, Stephani Hatch

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

40 Citations (Scopus)

235 Downloads (Pure)

Abstract

Objective: COVID-19-related inequities experienced by racial and ethnic minority groups including healthcare professionals mirror wider health inequities, which risk being perpetuated by lower uptake of vaccination. We aim to better understand lower uptake among racial and ethnic minority staff groups to inform initiatives to enhance uptake. Design: Twenty-five semi-structured interviews were conducted (October 2020–January 2021) with UK-based healthcare staff. Data were inductively and thematically analysed. Results: Vaccine decision-making processes were underpinned by an overarching theme, ‘weighing up risks of harm against potential benefits to self and others’. Sub-themes included ‘fear of harm’, ‘moral/ethical objections’, ‘potential benefits to self and others’, ‘information and misinformation’, and ‘institutional or workplace pressure’. We identified ways in which these were weighted more heavily towards vaccine hesitancy for racial and ethnic minority staff groups influenced by perceptions about institutional and structural discrimination. This included suspicions and fear around institutional pressure to be vaccinated, racial injustices in vaccine development and testing, religious or ethical concerns, and legitimacy and accessibility of vaccine messaging and communication. Conclusions: Drawing on a critical race perspective, we conclude that acknowledging historical and contemporary abuses of power is essential to avoid perpetuating and aggravating mistrust by de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.

Original language	English
Journal	Ethnicity and Health
DOIs	https://doi.org/10.1080/13557858.2021.1936464
Publication status	Published - 6 Jun 2021

Keywords

Race
ethnicity
COVID-19
Vaccine hesitancy
healthcare staff
discrimination

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1080/13557858.2021.1936464

Vaccine hesitancy_Ethnicity and Health_ACCEPTEDAccepted author manuscript, 380 KB

Cite this

Woodhead, C., Onwumere, J., Rhead, R., Bora-White, M., Chui, Z., Clifford, N., Connor, L., Gunasinghe, C., Harwood, H., Meriez, P., Mir, G., Jones Nielsen, J., Rafferty, A. M., Stanley, N., Peprah, D., & Hatch, S. (2021). Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff. Ethnicity and Health. https://doi.org/10.1080/13557858.2021.1936464

@article{ac3db465d1b74b94aad0ed33672c4c72,

title = "Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff",

abstract = "Objective: COVID-19-related inequities experienced by racial and ethnic minority groups including healthcare professionals mirror wider health inequities, which risk being perpetuated by lower uptake of vaccination. We aim to better understand lower uptake among racial and ethnic minority staff groups to inform initiatives to enhance uptake. Design: Twenty-five semi-structured interviews were conducted (October 2020–January 2021) with UK-based healthcare staff. Data were inductively and thematically analysed. Results: Vaccine decision-making processes were underpinned by an overarching theme, {\textquoteleft}weighing up risks of harm against potential benefits to self and others{\textquoteright}. Sub-themes included {\textquoteleft}fear of harm{\textquoteright}, {\textquoteleft}moral/ethical objections{\textquoteright}, {\textquoteleft}potential benefits to self and others{\textquoteright}, {\textquoteleft}information and misinformation{\textquoteright}, and {\textquoteleft}institutional or workplace pressure{\textquoteright}. We identified ways in which these were weighted more heavily towards vaccine hesitancy for racial and ethnic minority staff groups influenced by perceptions about institutional and structural discrimination. This included suspicions and fear around institutional pressure to be vaccinated, racial injustices in vaccine development and testing, religious or ethical concerns, and legitimacy and accessibility of vaccine messaging and communication. Conclusions: Drawing on a critical race perspective, we conclude that acknowledging historical and contemporary abuses of power is essential to avoid perpetuating and aggravating mistrust by de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.",

keywords = "Race, ethnicity, COVID-19, Vaccine hesitancy, healthcare staff, discrimination",

author = "Charlotte Woodhead and Juliana Onwumere and Rebecca Rhead and Monalisa Bora-White and Zoe Chui and Naomi Clifford and Luke Connor and Cerisse Gunasinghe and Hannah Harwood and Paula Meriez and Ghazala Mir and {Jones Nielsen}, Jessica and Rafferty, {Anne Marie} and Nathan Stanley and Dorothy Peprah and Stephani Hatch",

note = "Funding Information: This paper represents independent research funded by the Wellcome Trust [203380/Z/16/Z] and the Economic and Social Research Council (ESRC) [ES/V009931/1]. S. L. H. and J.O. are part-funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. C.W. and S.L.H. are supported by the ESRC Centre for Society and Mental Health at King{\textquoteright}s College London (ESRC Reference: ES/S012567/1). The funders had no involvement in study design, data collection, analysis, interpretation or the decision to submit for publication. The views expressed are those of the author(s) and not necessarily those of the funders. Publisher Copyright: {\textcopyright} 2021 Informa UK Limited, trading as Taylor & Francis Group.",

year = "2021",

month = jun,

day = "6",

doi = "10.1080/13557858.2021.1936464",

language = "English",

journal = "Ethnicity and Health",

issn = "1355-7858",

publisher = "Routledge",

}

TY - JOUR

T1 - Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff

AU - Woodhead, Charlotte

AU - Onwumere, Juliana

AU - Rhead, Rebecca

AU - Bora-White, Monalisa

AU - Chui, Zoe

AU - Clifford, Naomi

AU - Connor, Luke

AU - Gunasinghe, Cerisse

AU - Harwood, Hannah

AU - Meriez, Paula

AU - Mir, Ghazala

AU - Jones Nielsen, Jessica

AU - Rafferty, Anne Marie

AU - Stanley, Nathan

AU - Peprah, Dorothy

AU - Hatch, Stephani

N1 - Funding Information: This paper represents independent research funded by the Wellcome Trust [203380/Z/16/Z] and the Economic and Social Research Council (ESRC) [ES/V009931/1]. S. L. H. and J.O. are part-funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. C.W. and S.L.H. are supported by the ESRC Centre for Society and Mental Health at King’s College London (ESRC Reference: ES/S012567/1). The funders had no involvement in study design, data collection, analysis, interpretation or the decision to submit for publication. The views expressed are those of the author(s) and not necessarily those of the funders. Publisher Copyright: © 2021 Informa UK Limited, trading as Taylor & Francis Group.

PY - 2021/6/6

Y1 - 2021/6/6

N2 - Objective: COVID-19-related inequities experienced by racial and ethnic minority groups including healthcare professionals mirror wider health inequities, which risk being perpetuated by lower uptake of vaccination. We aim to better understand lower uptake among racial and ethnic minority staff groups to inform initiatives to enhance uptake. Design: Twenty-five semi-structured interviews were conducted (October 2020–January 2021) with UK-based healthcare staff. Data were inductively and thematically analysed. Results: Vaccine decision-making processes were underpinned by an overarching theme, ‘weighing up risks of harm against potential benefits to self and others’. Sub-themes included ‘fear of harm’, ‘moral/ethical objections’, ‘potential benefits to self and others’, ‘information and misinformation’, and ‘institutional or workplace pressure’. We identified ways in which these were weighted more heavily towards vaccine hesitancy for racial and ethnic minority staff groups influenced by perceptions about institutional and structural discrimination. This included suspicions and fear around institutional pressure to be vaccinated, racial injustices in vaccine development and testing, religious or ethical concerns, and legitimacy and accessibility of vaccine messaging and communication. Conclusions: Drawing on a critical race perspective, we conclude that acknowledging historical and contemporary abuses of power is essential to avoid perpetuating and aggravating mistrust by de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.

AB - Objective: COVID-19-related inequities experienced by racial and ethnic minority groups including healthcare professionals mirror wider health inequities, which risk being perpetuated by lower uptake of vaccination. We aim to better understand lower uptake among racial and ethnic minority staff groups to inform initiatives to enhance uptake. Design: Twenty-five semi-structured interviews were conducted (October 2020–January 2021) with UK-based healthcare staff. Data were inductively and thematically analysed. Results: Vaccine decision-making processes were underpinned by an overarching theme, ‘weighing up risks of harm against potential benefits to self and others’. Sub-themes included ‘fear of harm’, ‘moral/ethical objections’, ‘potential benefits to self and others’, ‘information and misinformation’, and ‘institutional or workplace pressure’. We identified ways in which these were weighted more heavily towards vaccine hesitancy for racial and ethnic minority staff groups influenced by perceptions about institutional and structural discrimination. This included suspicions and fear around institutional pressure to be vaccinated, racial injustices in vaccine development and testing, religious or ethical concerns, and legitimacy and accessibility of vaccine messaging and communication. Conclusions: Drawing on a critical race perspective, we conclude that acknowledging historical and contemporary abuses of power is essential to avoid perpetuating and aggravating mistrust by de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.

KW - Race

KW - ethnicity

KW - COVID-19

KW - Vaccine hesitancy

KW - healthcare staff

KW - discrimination

UR - http://www.scopus.com/inward/record.url?scp=85107466532&partnerID=8YFLogxK

U2 - 10.1080/13557858.2021.1936464

DO - 10.1080/13557858.2021.1936464

M3 - Article

SN - 1355-7858

JO - Ethnicity and Health

JF - Ethnicity and Health

ER -

Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

TIDES Phase 2 Interview Study

Cite this

Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Datasets

TIDES Phase 2 Interview Study

Cite this