Racism is ‘fundamental cause’ of COVID-19 vaccine hesitancy among ethnic minorities

Racism is the “fundamental cause” for the withholding of COVID-19 vaccinations among ethnic minorities, according to a newly released briefing from the Runnymede Trust and the University of Manchester’s Center on the Dynamics of Ethnicity.

During the rollout of the COVID-19 immunization program in the UK, explanations for lower vaccination coverage among people from minority ethnic groups focused on differences in concerns about side effects and a lack of confidence in vaccine development and effectiveness.

The authors of the new briefing argue that by the time people decided whether to get vaccinated, the conditions that led to lower vaccination coverage among ethnic minorities were already in place. By ignoring the impact of structural and institutional racism on immunization rates, “vaccination hesitancy” is misunderstood — and most importantly, an opportunity to address inequalities is missed.

The briefing uses data from the UK Household Longitudinal Study to show that institutional and community-level factors, driven by structural and institutional racism, explain the vast majority of racial inequalities in vaccination coverage.

Vaccination hesitation rates vary between ethnic groups, with over half of the black group reluctant to receive the COVID vaccine compared to just over 10% of the white British group.

Comparing vaccination hesitancy in the minority ethnic groups with the white British group, institutional factors – including financial situation, car use, ability to travel to vaccination centers, home ownership and educational attainment – explain 41.6% of the difference for people in Pakistan or Bangladesh, while factors at community level such as neighborhood diversity, cohesion, political effectiveness and racism over 30%.

For Blacks, community-level factors had the greatest impact, with institutional-level factors explaining 12.9% of the difference.

These results suggest that if policies address institutional and community-level factors shaped by structural and institutional racism, significant success in reducing ethnic inequalities could be achieved.

“Vaccination hesitancy places blame on individuals rather than addressing the historic and persistent racism that has contributed to the societal inequalities that have led to racial inequalities in vaccine distribution and uptake,” said one of the briefing’s authors, Professor Laia Bécares King’s College London.

The briefing was also given by Professor James Nazroo and Dr. Patricia Irizar from the University of Manchester and Dr. Richard Shaw of the University of Glasgow. It draws on a longer article published in SSM—Population Health and is part of a series of briefings from the Runnymede Trust and the Center on the Dynamics of Ethnicity (CoDE) on the impact of COVID-19 on people from minority ethnic groups .