Opinion

Covid-19 vaccination: rebuilding trust

21 May 2021

A panel of esteemed speakers convened by Unite-CPHVA explored vaccine uptake among black, Asian and ethnic minority communities.

The roll-out of the Covid vaccines across the UK has been a huge success, but a significant uptake gap has opened up, with fewer people from black, Asian and ethnic minority backgrounds getting the jab than white people, even though they have been hardest hit by the pandemic.

At this live virtual member event on 8 April, speakers offered insights into the complex issues behind this picture, and how the vaccination programme might reach more communities.

Organised by Unite (health) lead professional officer Ethel Rodrigues, the discussion and question session were chaired by CPHVA Executive chair Janet Taylor. The event kicked off with an explanation of how the body’s immune system works and the function of vaccinations from Dr Donald Palmer, an associate professor of immunology. Then followed other speakers exploring the issues. Here’s a summary…

‘A lot of this mistrust isn’t just coming from misinformation’

Marsha de Cordova Shadow secretary of state for equalities

Marsha called for ‘a proper plan of communication and engagement that really reaches into every community and builds up the trust’.

She said: ‘A lot of this mistrust isn’t just coming from misinformation. It’s from many historical incidents of medical and structural racism and inequality.’

She was critical of the recently published government-commissioned report into racial inequality, which she said ‘downplays the role of inequality and structural and institutional racism, particularly in our health service’.

‘This kind of language and this kind of narrative will not go any way into promoting the take-up that we need to ensure that all of our communities remain protected,’ she added.

‘This virus hasn’t been the great leveller’

Sadiq Khan London mayor

Sadiq began by thanking CPs and HVs for doing ‘an amazing job’, saying he was ‘in awe’ of them for ‘literally risking your personal safety to keep us, our families and communities safe’.

He described the pandemic’s unequal toll, saying: ‘This virus hasn’t been the great leveller; although we are all facing the same storm, we are in different-sized boats.’

During the first wave, ‘black British people were four times more likely to lose their lives than white British people’, while in the second wave ‘if you were a British person of Pakistani or Bengali origin you were three times more likely to lose your life.’

‘The bad news is compounded when you see the take-up rate for the vaccine,’ added Sadiq, with 90% of white British people over 70 having received the jab, compared to 60% of those above the age of 70 who are black African for example.

He said the government ‘has not understood there is a very good reason why people of colour aren’t receiving the vaccine. It’s because their experience of government, their experience of people in positions of power and influence, hasn’t been a good one.’

He concluded: ‘As we come out of the lockdown restrictions, we have got to be vigilant about the consequences of this virus and make sure we have trusted message carriers educating people across the country.’

‘These fundamental principles link inextricably with promotion of the vaccination’

Gina Awoko Higginbottom Emeritus professor of ethnicity and community health, and honorary vice-president of Unite-CPHVA

Gina emphasised the position of an HV as a ‘family health promotion specialist’ who is ‘ideally placed to provide support and information about the vaccine’.

The ‘fundamental principles’ of health visiting ‘link inextricably with promotion of the vaccination’ explained Gina.

CPs are well placed to carry this out, because they have ‘a high level of trust’, ‘know the ethnocultural diversity within their case load’ and are ‘skilled in crafting ethnoculturally specific messages’.

‘Engage with our communities where they are’

Yvonne Coghill Special adviser at the NHS Race and Health Observatory

Yvonne said that building trust is ‘absolutely critical’, as is ‘repeating these messages time and time and time again.’

She emphasised the need for people to ‘engage with our communities where they are, rather than expect our communities to come to them,’ to ‘give them the opportunities to ask all the questions,’ using professionals ‘who they actually trust and believe in to give them the messages’.

‘I almost lost a colleague who contracted Covid from their day-to-day working life’

Dr Itai Matumbike Consultant forensic psychiatrist and medical director of Northamptonshire Healthcare NHS Foundation Trust

Itai spoke about the ‘massive, life-changing impact’ for families who have lost ‘breadwinners who were working on the frontline’, ‘not just losing a loved one but having a completely different life’.

He added: ‘I lost quite a lot of good friends and relatives through Covid. In the first wave I almost lost a colleague who contracted Covid from their day-to-day working life. That was very impactful on me, and I would not wish that on anyone.’

‘There is still a lot to do, still a lot to learn’

Louise Letley Nurse manager for research, immunisation operations, Public Health England

Louise said: ‘There is still a lot to do, still a lot to learn.’

Uptake among frontline NHS workers was ‘not equal across the country’. It was lower in London, and among social care workers who at first ‘weren’t receiving offers of vaccination as quickly’.

But there was ‘one exciting piece of information’: a study showed that ‘healthcare workers who had been vaccinated were 72% less likely to develop infection after one dose of the vaccine, rising to 86% after the second dose.’

‘The strength of a vaccination programme really depends on how vigilant we are in terms of monitoring it’

Philip Cruz Vaccine medical director for GlaxoSmithKline in the UK and Ireland

Philip looked at vaccine safety and the complexity of production. After discovery, a sequence of events was followed, ‘from pre-clinical, phase one, phase two, phase three’. Then raw materials needed to be sourced, and the product manufactured, purified and matured. 

He also noted that 70% of production time is dedicated to testing and release, emphasising ‘no compromise’ in quality control.

Monitoring ‘continues through the lifecycle of a vaccine or a vaccination programme,’ he added. 

‘The strength of a vaccination programme really depends on how vigilant we are in terms of monitoring it.’


To watch the event, visit bit.ly/CP_vaccine

Image Credit | iStock | Parliament UK | Shutterstock | RCPCH 

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