More than 12 million people in the UK have now had at least one dose of a COVID vaccine, with a further three million projected by 15th February. It's a positive step towards bringing everyone back to some kind of normality after an unimaginably difficult year. But of course, as with anything new and unknown, a lot of people are understandably feeling hesitant and asking questions.
Last April, statistics revealed that people from Black, Asian or ethnic minority (BAME) backgrounds were more likely than white people to die from the virus. Meanwhile a new study has found that up to 72% of Black people are unlikely to have the jab. The report from the Scientific Advisory Group for Emergencies (Sage) found that historical issues of unethical healthcare research, and structural and institutional racism and discrimination are key reasons for lower levels of trust among Black people in the vaccination programme.
Black women are particularly hesitant to get the vaccine, especially after a new report found that Black women are still four times more likely than white women to die in pregnancy or childbirth in the UK. It comes as a report published in December by the Joint Committee on Human Rights highlighted the lack of an NHS target to end the disparity and urged the government to introduce one.
Ahead, we speak to GP Dr Adwoa Danso to understand why Black women are less likely to have the jab and what needs to be done to engage communities and rebuild the trust between them and medical professionals.
Hi Dr Danso, these statistics are pretty high. Despite Black people being disproportionately impacted by the virus, why do you think they are less likely to take the vaccine?
There is a mistrust of the health system within the UK. There is a history of health policies and scientific studies that have specifically negatively impacted these communities. The idea of treating Black people as experimental subjects was again brought to the forefront last April when two French scientists on national TV suggested trialling vaccines in Africa "where there are no masks, no treatment or intensive care". They continued: "A little bit like it's been done for certain AIDS studies, where among prostitutes, we try things, because we know that they are highly exposed and don't protect themselves." This served as a harsh reminder of the colonial instincts within medicine. The messages from the government have been confusing, especially for those Black and Asian minority groups. There is clear evidence that Black and Asian individuals had a higher risk of COVID-19 infection and mortality but on publication of the COVID vaccination priority groups by the Joint Committee on Vaccination and Immunisation (JCVI), these at-risk groups were not included. Speaking to a number of colleagues, Black people are not outright declining the vaccine but rather delaying the vaccination until there is further data and information.
So how do you think we can reach out to Black and brown communities to help them trust the vaccine roll-out?
Good vaccine coverage within BAME groups is an important factor which heavily impacts the success of the vaccination programme. There needs to be an emphasis on improving access to healthcare throughout medicine now more than ever. The government must work with community leaders and associations to increase openness to the vaccine. Our media and NHS England must work collaboratively and show Black and brown people having the vaccine as well as publishing real-time data of the ethnicity of those who have already been vaccinated against COVID-19.
Black women have expressed their fears over the new data which shows that they are four times more likely than white women to die in childbirth. Do you think these stats have some impact on why some Black women are reluctant to take the vaccine?
When we look further into both of these statistics, they are underpinned by the issues of structural racism and racial bias that sadly exist within the health system. COVID-19 has highlighted existing health inequalities. As difficult as it may be, it is important for Black women to engage with services and programmes available. There are useful, legitimate resources available. The Royal Colleges, including the Royal College of Obstetrics and Gynaecologists, have set up a task force to eradicate the health inequalities that exist for Black women. Addressing the lack of trust is not something that can be addressed overnight but acknowledging its existence is a great start.
Some women have expressed their fear about potentially developing fertility problems if they have the vaccine. Can the vaccine have this effect?
There is currently no known risk associated with giving non-live vaccines (which all the current COVID-19 vaccines are) during pregnancy. There is currently no suggestion that the vaccine could interfere with fertility, there really is no evidence for this and women who have been vaccinated have not gone on to experience any fertility problems. Studies will continue to monitor this.
How do you think social media has played a part in vaccine misinformation?
There has been a surge of misinformation and fake news exploiting fear and uncertainty around the current situation. Social media has propelled and amplified the spread. We have seen information circulating including potential cures, origin of the outbreak and government conspiracies. Social media platforms, including Facebook, have taken steps to remove misleading content. Social media platforms should be more accountable of potential dangerous information and users should be wary to not take all content at face value.
Have you had the vaccine?
I had my vaccine a few weeks ago and I am due my second dose in a few days' time. I did quite a lot of reading beforehand as I was not sure what to expect. I arrived on time, was 'checked in' and advised to use hand sanitiser before sitting down in the waiting room, with four others all socially distanced in the same room. After one minute of waiting, I was ushered into a consulting room. A doctor asked me questions to check for any contraindications (reasons a certain treatment shouldn't be given), checking my date of birth and any allergies. I was given the go-ahead and immediately given the vaccine. I had the Pfizer vaccine. It was completely painless and very quick. After the vaccination, I was observed for 15 minutes. I did have a mild sore arm for two days but I've certainly been in more pain after a gym workout!
Is the Oxford AstraZeneca vaccine any safer or more traditional than the Pfizer and Moderna vaccines?
The Pfizer and Moderna vaccines use new mRNA technology known as mRNA vaccines. When injected, the body creates a spike protein; the body then mounts an immune response, making antibodies ready to fight the virus. The Oxford vaccine is a vector vaccine which uses a modified, harmless virus to create an immune response. Both vaccines are safe and have been proven to be effective against COVID-19. Before the introduction of any vaccine there are rigorous steps that must be followed. These steps assess safety and effectiveness and are tested on an increasing number of participants during the trial phases. The data from these trials is analysed by an independent regulatory body, the Medicines and Healthcare products Regulatory Agency (MHRA), before any medication or vaccine can be approved.
Is the vaccine safe for those with pre-existing conditions, or those who are allergic to various drugs, such as penicillin?
Those with specific pre-existing conditions are at increased risk of morbidity and mortality for COVID-19 and therefore should be prioritised for the vaccine, especially those over the age of 65. Currently individuals with a history of anaphylactic reaction to multiple drugs or unexplained anaphylaxis are advised against receiving the Pfizer vaccine, in these instances the AstraZeneca can be given as an alternative provided there are no contraindications. If there are any allergies to the ingredients of any vaccine, it should not be given. A full list of ingredients can be found at www.sps.nhs.uk. If you are unsure and need further advice, please speak with your GP.
What about young people? Do the possible side effects of a vaccine outweigh the benefits for those who are unlikely to be severely affected by the virus?
The virus is not suitable for anybody under the age of 16. Everyone over the age of 16 must be aware that there are some mild side effects associated with the vaccine. Typically these side effects don't last longer than a few days and can include a sore arm, feeling tired and achy. It is advisable to have the vaccine not only for one's own protection but to also protect the most vulnerable. The potential side effects do not compare to the risk associated with contracting the COVID-19 virus.
What would you like people to know about the vaccine?
In order for us to return to any kind of normality, we must all continue to play our part. The only way we can tackle the virus is to take the opportunities to get vaccinated. If you have already had COVID-19, you would still need to get the vaccination. From the evidence we have, the natural immunity after having COVID-19 does not seem to last very long. The vaccine ultimately protects against death, severe disease and long-term complications associated with the disease.
Having the vaccine is not compulsory but it is strongly advised. Be fully informed and use reputable sources for further information about COVID-19 and the vaccines.
The World Health Organization has declared COVID-19 a global pandemic. It says you can protect yourself by washing your hands, covering your mouth when sneezing or coughing (ideally with a tissue), avoid touching your eyes, nose and mouth and don't get too close to people who are coughing, sneezing or with a fever.