A qualitative study on addressing COVID-19 vaccine hesitancy in marginalised communities in the UK - Professional and public perspectives

Abstract

Background: Vaccine hesitancy is known to be a significant issue for vaccination programmes. It has been shown to be particularly significant in communities marginalised by ethnicity, poverty and other social factors. Objective: In this paper we report on the efforts of the UK COVID-19 vaccination programme to overcome vaccine hesitancy in one locality, and how those efforts were viewed by the people targeted by and delivering the initiatives. Method: We conducted a qualitative study, interviewing staff delivering the vaccination programme (n = 8) and community members drawn from marginalised groups (n = 40). Framework thematic analysis was used. Results: The diversity of the marginalised communities in terms of their immigration status, language, cultural needs and other characteristics required extensive and varied efforts by services to deliver vaccine equity initiatives. These efforts included offering vaccines in community centres and places of worship, involving community and faith leaders to build trust among communities, delivering information in different languages and offering gift vouchers. Community members had a complex mixture of reasons for accepting or not accepting the vaccine. Reasons for not accepting the vaccine included a lack of trust in vaccine effectiveness and what were perceived as coercive measures by the state. Conclusion: The initiatives were perceived to be broadly successful in promoting COVID-19 vaccine uptake, however there were no precise measures of success or failure of individual components. Policy and health services need to consider the complex and dynamic nature of vaccine hesitancy and build trust and improve communication with marginalised groups.