'The vaccine hesitant trust us. We can change their minds'
“He got all his information from WhatsApp videos and hearsay,” explains Asifa Patel, recounting a recent phone call with a British Indian man in his 50s from West Yorkshire. “He had a lot of stories of people getting negative effects from the Covid vaccine, and didn’t want to get it himself. One of his biggest concerns was that he doesn’t trust hospitals. He thinks people get worse when they go there, and he told me stories he’d heard about people having bad experiences.
“I listened to his concerns, and reassured him about how rare malpractice is in hospitals. I gave him accurate information about Covid, and he understood everything I said. By the end, he was considering changing his mind about the vaccine.”
This is just one of the conversations that Patel, 21, has had in her volunteer role as a vaccine ambassador. The student nurse at the University of Bradford, who is British Indian, is taking part in one of many programmes across the country where local universities, councils and charities are working together to train up vaccine ambassadors to go into local black, Asian and minority ethnic (BAME) communities and encourage people to sign up for the vaccine.
It comes over concerns about a worryingly low uptake of the vaccine within BAME communities. Public health experts and MPs have called for BAME communities to be better protected, as they’re at a higher risk, with vaccines minister, Nadhim Zahawi saying: “My big worry is if 85 per cent of the adult population get vaccinated, if the 15 per cent skews heavily to the BAME community, the virus will very quickly infect that community.”
A UK Household Longitudinal Study found that while 82 per cent of people overall were likely to have the jab, 72 per cent of black people and 42 per cent of Pakistani and Bangladeshi people said they were unlikely to be vaccinated. Sage advisors have since stressed that more needs to be done to improve trust in the NHS and the vaccine for BAME communities.
“I personally know people in my community who are sceptical about the vaccine and are listening to the misinformation around it that has spread,” says Patel, who has been trained as a vaccine ambassador through a programme run by charity Neesie, which supports single mothers and their children. She is one of 20 young people of varied backgrounds who has spent the past two months learning about the vaccine from experts and professionals, and is now going into local communities to try to change people’s minds and allay fears about the virus.
“I wanted to challenge these conspiracies and misinformation and encourage my community to have the vaccine in order to improve our chances,” she says. “As a student nurse, I’ve seen first hand the health inequalities of BAME communities and wanted to research and highlight them with the aim of raising awareness, particularly knowing that BAME communities are disproportionately impacted by the virus.”
During her time as a vaccine ambassador, she has found that reluctance amongst BAME communities towards the vaccine is twofold: there are practical concerns about the safety of the vaccine and its long-term effects on things like fertility, but there is also a deep sense of mistrust towards the government and the NHS.
“With the long-term effects, it’s easier to discuss,” she says. “We use evidence-based research and scientific knowledge to explain exactly what the virus contains. We talk them through how it’s made, and that evidence shows there’s no risk of long-term effects. Most people who are affected by vaccines notice it straight away and it’s short-term. The biology of the vaccine gets out of your system in a couple of days. It copies the instructions in and then leaves.”
When it comes to the wider issue around a sense of mistrust she does what she did with the British Indian man on the phone: listens, shares her own experiences, and tells them she’s had the vaccine herself. “Hearing from someone who looks like them helps. We’re not part of the Government so they trust us more and can relate to us. I tell them this vaccine is just like all childhood vaccines we’ve had, and advise them to separate their views of the Government and focus on the hard evidence.”
Trudie Lang, professor of global health research at the University of Oxford, who works in malaria vaccine development and sat on the Ebola vaccine safety board, stresses that the vaccine is as safe as any others. “We often hear [people say] ‘It happened so quickly; they must have cut corners.’ But there were no corners cut and no lower standard. The vaccines have gone through rigorous trials in very large numbers of participants.”
Within BAME communities, there are worries the trials did not involve enough people of colour, but Lang says this is not true. “All the vaccine trials set out to recruit participants across ages, geographies and ethnic groups – and did so quite successfully. The studies were run within and across different countries. Because the scale is so big, they probably were quite representative. As the vaccine’s rolled out, it’s important they’re taken up across all communities and that will only further strengthen our evidence base.”
Esther Ikeije, 22, is a pharmacy student at the University of Bradford and also works as a vaccine ambassador, particularly within her British Nigerian community. She has found that many people she speaks to aren’t anti-vaxxers, but have deep-rooted worries about the vaccine’s safety which are linked to historical scandals that have involved drugs being trialled on black communities without proper consent.
One of those is the Tuskegee Study in the US in 1932. Black American men with syphilis were promised free medical care for being involved in the study, but were actually just given placebos. The study was meant to last six months but continued for 40 years, and none of the men were treated with penicillin despite it being widely available, meaning 128 of its participants died after being lied to and denied treatment. President Bill Clinton later called it shameful and racist.
“A lot of [black people who are wary of the Covid vaccine] have had other vaccines in the past,” explains Ikeije. “But as humans we don’t want to be the guinea pigs. We want to see how it pans out, so what they really want is reassurance about the long-term effects, especially when there’s already so much mistrust. If they’re able to get a better idea of the effects and will it bring protection from such a deadly situation, they’re happy to take it. It’s like any other vaccine in the past.”
She has also come across people who don’t believe Covid is dangerous. “There was one woman I spoke to who didn’t really believe in Covid, but through conversations, she’s starting to realise that it is real, which is a huge positive. In the beginning she felt it was a flu. There are also myths about hand sanitising making your hands fall off – we talk them through that, explaining hand sanitisers have been important even before Covid for protecting against the spread of germs. So often it’s easy to label a group of people as anti-vax and anti-Covid. But we listen to their fears without labelling them.”
Their work is already starting to pay off. Patel, who was inspired to become a vaccine ambassador partly because her own relatives were hesitant about taking the vaccine, has already noticed a change in attitude within her own family in West Yorkshire. “My dad had safety concerns about the vaccine, but since I joined this programme and learned about the vaccine, he’s changed his views. My family is slowly getting used to the idea of it, and my grandad has already had it.”
She is now encouraging her community to sign up for medical trials, as often BAME communities avoid this, which can lead to health inequality. She also believes the Government needs to do more. “We need more simple information or translated Covid information for people who don’t speak English, translated to their own languages. They also need to distribute vaccines in places people feel comfortable in, like places of worship or community centres rather than hospitals and places they don’t trust.”
Lang agrees, urging global governments to invest in taking vaccine hesitancy seriously. “I think ambassador programmes are brilliant, certainly for explaining how vaccine manufacturing works to see they’re halal, or understanding they won’t impact fertility. But what’s important is to understand the concerns of every different community, without being dismissive, so we can develop appropriate public health messages and education and engagement programmes to address them.
“Only then can we correct the detail of their hesitancy with the truth. And what we know is true is that vaccine use across humanity has been the single biggest factor on childhood survival, mitigating previous pandemics, and reducing mortality from infection. That is absolutely what we know.”
