Covid-19 vaccination hesitancy

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Covid-19 vaccination hesitancy
Autor: Razai, Mohammad S ; Chaudhry, Umar A R ; Doerholt, Katja ; Bauld, Linda ; Majeed, Azeem
Assuntos: Age groups ; Breast feeding ; Children ; Communication ; Community ; Conspiracy ; Coronaviruses ; COVID-19 ; COVID-19 vaccines ; DNA vaccines ; Education ; Ethnicity ; False information ; Herpes zoster ; Influenza ; Long-term effects ; Medical personnel ; Minority & ethnic groups ; Pandemics ; Pharmaceutical industry ; Polls & surveys ; Practice ; Public health ; Racial discrimination ; Racism ; Religion ; Religious groups ; Rotavirus ; Safety ; Side effects ; Social networks ; Trust ; Vaccines
É parte de: BMJ (Online), 2021-05, Vol.373, p.n1138-n1138
Notas: Practice Pointer
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Descrição: Correspondence to M Razai mrazai@sgul.ac.uk What you need to know Lack of confidence in vaccines for covid-19 poses direct and indirect threats to health, and could derail efforts to end the current pandemic Concerns about unknown future effects, side effects, and a lack of trust are common reasons given by people who say they are unlikely to have a covid-19 vaccine No single intervention is likely to be able to address vaccine hesitancy Consider barriers to uptake of vaccination at a population level and in groups who have lower rates of vaccine uptake Develop local approaches by engaging members of the community and co-producing communications and materials that meet population needs Rollout of covid-19 vaccination is well underway, with more than 700 million doses given worldwide as of April 2021.1 Vaccination is highly effective at reducing severe illness and death from covid-19. The UK Household Longitudinal survey asked 12 035 participants (in November 2020) “how likely or unlikely would you be to take the vaccine?” Overall only 18% of respondents were hesitant (answering unlikely or very unlikely), in contrast with high levels of hesitancy in people of Black ethnicity (72%) followed by South Asians of Pakistani and Bangladeshi heritage (both 42%), and mixed ethnicities (32%), though levels of vaccine hesitancy were comparable with White people in respondents of Chinese ethnicity.14 UK data (as of 11 March 2021) show lower vaccination rates (among those eligible for vaccination) in Black African and Black Caribbean (58.8% and 68.7%, respectively), Bangladeshi (72.7%), and Pakistani (74%) ethnic groups compared with White British (91.3%), and lower vaccination rates in people who live in more deprived areas (most deprived 87%, least deprived 92.1%).15 Higher vaccine hesitancy is also reported among women (women 21%, men 15%), younger age groups (28% in 25-34 years, versus 14% in 55-64 years), and in people with a lower education level (24% in secondary school graduates; 13% in university graduates).14 These data follow a historical trend in the UK of lower uptake of pneumococcal, influenza, rotavirus, and shingles vaccines among socioeconomically disadvantaged individuals161718 and ethnic minorities.1119 Similarly, a lower uptake has been observed with childhood immunisations in ethnic minority populations.11 Variation in covid-19 vaccination rates is also seen between religious groups. The ‘Understanding Society’ UK Household Longitudinal survey highlighted that the main reason for hesitancy was concerns about future unknown effects, with 42.7% of respondents specifying this.14 Less common reasons included those under the bracket of “other” (12.2%), worries about side effects (11.4%), concern that others are in more urgent need of the vaccine (7.7%), and lack of trust in vaccines (7.6%).14 However, the survey found that people of Black ethnicities were more likely to state that they “don’t trust vaccines” compared with White people (29.2% v 5.7%), and people of Pakistani and Bangladeshi ethnicities often cited concerns about vaccine side effects (35.4% v 8.6%).14 Some reports indicate a rise in vaccine hesitancy following the AstraZeneca vaccine safety scare across Europe and Africa.2425 Historical precedents show that widely publicised safety scares can have profound and long-lasting effects on vaccine confidence.26 Box 1 Causes and drivers of low confidence in covid-19 vaccines5791123 Socioeconomic and healthcare inequalities and inequities Structural racism and previously unethical research involving some ethnic minority groups Social disadvantages including lower levels of education and poor access to accurate information Misinformation, disinformation, rumours, and conspiracy theories, in particular through social media Lack of effective public health messages or targeted campaigns Barriers to access, including vaccine delivery time, location, and cost related to socioeconomic inequalities and marginalisation How to approach covid-19 vaccine hesitancy Approaching vaccine hesitancy is complex, and therefore no single intervention can address this entirely, especially in the context of covid-19 where evidence for effective strategies to address it is currently limited.27 When considering the most effective methods to increase vaccine uptake, we advocate comprehensive multi-component approaches tailored to the local population, combined with good communication at an individual level.27 At a broader national level, a multifaceted, non-stigmatising approach is needed to share communication (in a variety of mediums) from trusted sources.11 This includes traditional media channels (for example, television, radio, public transport advertising, and internet) to engage different groups regarding public health policies and counter any misinformation.2829 Recognising barriers to uptake (box 2) helps to inform appropriate interventions to address them (box 3). Box 2 Stated reasons for low uptake of covid-19 vaccines among the public213031 Concerns about long term effects, side effects, and unknown future effects on health Previous side effects to other routine vaccines such as influenza vaccine Low confidence in vaccines, including their importance, safety, and efficacy Lack of trust in the manufacturing and country of production of vaccines, vaccine technology, the pharmaceutical industry, government, and public health bodies Concerns about the speed of development of covid-19 vaccines Concerns about vaccines’ incompatibility with religious beliefs Previously negative experiences of healthcare, including racial discrimination Lower risk and perception of lower risk of covid-19 (especially among younger age groups) Lack of communication from trusted providers and community leaders Practical concerns such as inconvenient vaccine delivery time and location Not offered vaccine because of inaccurate patient contact information Direct and indirect costs of vaccine (in some low and middle income countries) Apprehensions surrounding fertility, pregnancy, and breastfeeding Belief in conspiracy theories such as covid-19 not being real, or that vaccines modify DNA Recent covid-19 infection Box 3 Summary of strategies for interventions to increase vaccination uptake112732 Offer tailored communication from trusted sources such as community representatives, healthcare providers, and local authorities that is culturally relevant and accessible in multiple languages.
Editor: England: British Medical Journal Publishing Group
Idioma: Inglês

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Covid-19 vaccination hesitancy

Razai, Mohammad S ; Chaudhry, Umar A R ; Doerholt, Katja ; Bauld, Linda ; Majeed, Azeem

England: British Medical Journal Publishing Group

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