ABSTRACT

Objective

COVID-19-related inequities experienced by racial and ethnic minority groups including healthcare professionals mirror wider health inequities, which risk being perpetuated by lower uptake of vaccination. We aim to better understand lower uptake among racial and ethnic minority staff groups to inform initiatives to enhance uptake.

Design

Twenty-five semi-structured interviews were conducted (October 2020–January 2021) with UK-based healthcare staff. Data were inductively and thematically analysed.

Results

Vaccine decision-making processes were underpinned by an overarching theme, ‘weighing up risks of harm against potential benefits to self and others’. Sub-themes included ‘fear of harm’, ‘moral/ethical objections’, ‘potential benefits to self and others’, ‘information and misinformation’, and ‘institutional or workplace pressure’. We identified ways in which these were weighted more heavily towards vaccine hesitancy for racial and ethnic minority staff groups influenced by perceptions about institutional and structural discrimination. This included suspicions and fear around institutional pressure to be vaccinated, racial injustices in vaccine development and testing, religious or ethical concerns, and legitimacy and accessibility of vaccine messaging and communication.

Conclusions

Drawing on a critical race perspective, we conclude that acknowledging historical and contemporary abuses of power is essential to avoid perpetuating and aggravating mistrust by de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.

中文翻译：

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种族、族裔和 COVID-19 疫苗接种：针对英国医护人员的定性研究

摘要

客观的

包括医疗保健专业人员在内的少数种族和族裔群体所经历的与 COVID-19 相关的不平等反映了更广泛的健康不平等，这种不平等有可能因疫苗接种率较低而长期存在。我们的目标是更好地了解少数种族和族裔员工群体的接受率较低，为提高接受率的举措提供信息。

设计

对英国医疗保健人员进行了 25 次半结构化访谈（2020 年 10 月至 2021 年 1 月）。对数据进行归纳和主题分析。

结果

疫苗决策过程以一个总体主题为基础，即“权衡伤害风险与对自身和他人的潜在利益”。次主题包括“害怕伤害”、“道德/伦理上的反对”、“对自己和他人的潜在利益”、“信息和错误信息”以及“机构或工作场所压力”。我们确定了受制度性和结构性歧视观念影响的少数种族和族裔工作人员群体对疫苗犹豫的影响更大的方式。这包括对疫苗接种的机构压力、疫苗开发和测试中的种族不公正、宗教或伦理问题以及疫苗信息和通信的合法性和可及性的怀疑和恐惧。

结论

从批判性的种族角度出发，我们得出的结论是，承认历史和当代的权力滥用对于通过将犹豫与影响犹豫的社会过程脱钩来避免持久和加剧不信任至关重要，从而破坏提高疫苗接种率的努力。