Racial discrimination, low trust in the health system and COVID-19 vaccine uptake: a longitudinal observational study of 633 UK adults from ethnic minority groups. (November 2022)

• Record Type: Journal Article
• Authors: Paul, Elise; Fancourt, Daisy; Razai, Mohammad
• Is Part Of: Journal of the Royal Society of Medicine. Volume 115:Number 11(2022)
• Page Start: 439
• Page End: 447
• Publication Date: 2022-11
• Subjects: Epidemiologic studies -- public health -- vaccination programmes; Medicine -- Periodicals; Medicine -- Great Britain -- Periodicals; Periodicals; 610.5
• DOI: 10.1177/01410768221095241
• Languages: English
• ISSNs: 0410-0768

Abstract

Objectives: To examine whether racial/ethnic discrimination predicts future COVID-19 vaccine refusal, and whether this association is explained by trust in government and the health system. Design: Longitudinal observational study of racial/ethnic discrimination occurring since the start of the first lockdown (measured in July 2020) and later COVID-19 vaccine status. Setting: UK (England, Scotland, Wales and Northern Ireland). Participants: A total of 633 adults belonging to ethnic minority groups who took part in the UCL COVID-19 Social Study. Main outcome measures: COVID-19 vaccine refusal (vs. accepted/waiting/had at least one dose) between 23 December 2020 and 14 June 2021. Results: Nearly 1 in 10 (6.69%) who had refused a COVID-19 vaccine had experienced racial/ethnic discrimination in a medical setting since the start of the pandemic and had experienced twice as many incidents of racial/ethnic discrimination than those who had accepted the vaccine. Structural equation modelling results indicated a nearly four fold (odds ratio = 3.91, 95% confidence interval = 1.40 to 10.92) total effect of racial/ethnic discrimination on refusing the vaccine which was mediated by low trust in the health system to handle the pandemic (odds ratio = 2.49, 95% confidence interval = 1.12 to 5.39). Analyses adjusted for a range of demographic and COVID-19 related factors. Conclusions: Findings underscore the importance of addressing racial/ethnic discrimination and the role the National Health Service in regaining trust from ethnic minority groups to increase COVID-19 vaccine uptake among ethnic minority adults.