To vaccine or not to vaccine -- that is the question

Written by: Nkasi Stoll and the Tackling Inequalities and Discrimination Experiences in health Services (TIDES) study team

What is this study about?

We have all been affected by COVID-19.  

Research studies have shown racially and ethnically minoritised people in the UK have been affected more by COVID-19 in many areas, but particularly in terms of: admission to intensive care, infection rates, mortality rates.  

There is a huge concern for healthcare staff as they come into contact with many people as part of their job, and their job is vital for helping others stay well.  

Some people may delay taking a COVID-19 vaccine or do not accept the COVID-19 vaccination when offered one.  

Why? Well the TIDES study team want to know! 

So in summer 2020 the TIDES study team brought together different groups, representatives, people working within NHS settings, private and social care (which also included senior leaders) from across England came together to come up with topics and questions to ask other healthcare staff about their COVID-19 experiences. 

Sculpture in front of a fountain (HERON SELPh 2019 Exhibition).

How did we do the study?

In October 2020 – January 2021 researchers from the TIDES study team and collaborators spoke to 24 UK-based healthcare staff and senior management about: 

  • their thoughts, feelings and experiences about the COVID-19 vaccine 
  • access to personal protective equipment (PPE)
  • witnessing and experiencing workplace discrimination, bulling, and harassment 

The conversations were then analysed using thematic analysis. The researchers: 

  • read and re-read pages and pages of conversations
  • searched for ways to describe what the healthcare staff said
  • looked for similarities and differences between what the healthcare staff spoke about

What did we find?

Healthcare staff, including senior management, spoke about weighing up risks of harm against potential benefits to self and others: 

Fear of harm

  • Staff spoke about not trusting how the vaccine was produced, trialled and delivered; and whether the potential side effects outweigh the benefits of taking the vaccine.
  • Staff with health conditions were worried about what might happen to them after taking the vaccine.

Religious/moral/ethical objections

  • For staff who are religious, their beliefs may make them unsure or refuse to take the COVID-19 vaccine.

Potential benefits to self and others

  • Staff who took the vaccine focussed on the potential benefits including: protection from COVID-19, not spreading COVID-19 to others, wanting to return to pre-COVID life.

Information and misinformation

  • Staff who weren’t sure whether to take the COVID-19 vaccine felt there was too much social misinformation and confusing messages; and not enough clear, trustworthy information about the vaccine.

Institutional or workplace pressure

  • Staff spoke about feeling pressured and forced by employers, media and workplace rumours to take the COVID-19 vaccine.
  • Staff feared there would be punishments from employers (including losing their job, moved to non-patient facing roles) if they didn’t take the COVID-19 vaccine.

Structural discrimination

  • Staff (especially those who identified as Black and Asian) spoke about not trusting the government and pharmaceutical companies because of current and historical bad practice.
  • Putting pressure on racial and ethnic minoritised staff makes them more suspicious and less likely to want to take the COVID-19 vaccine.

What can I do with this?

I work in policy and/or public health messaging: Acknowledge and address the historical and current abuses of power that cause racially and ethnically minoritised people to refuse or delay taking the COVID-19 vaccine by: collaborating with community-based organisations to develop tailored public health messages and educational campaigns addressing vaccine concerns and mis-information.  

I work in vaccine delivery and/or public health: You can improve accessibility to COVID-19 vaccine through community and workplace-based delivery. Work with community organisations to increase individual and community trust in the COVID-19 vaccine. 

I am a researcher: You can use this study to justify conducting research on the thoughts, feelings and experiences of racially and ethnically minoritized people and religious communities about the COVID-19 vaccine. 

I am a student: You can use this study to reference in your essays or assignments. 

I am a member of the general public: Share this summary with your friends and family to raise awareness and start conversations about the COVID-19 vaccine. 

I want to know more!

Woodhead, C., Onwumere, J., Rhead, R., Bora-White, M., Chui, Z., Clifford, N., Connor, L., Gunasinghe, C., Harwood, H., Meriez, P., Mir, G., Jones Nielsen, J., Rafferty, A. M., Stanley, N., Peprah, D., & Hatch, S. L. (2021) Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff. Ethnicity & Health, DOI: 10.1080/13557858.2021.1936464

Check out other TIDES publications here