Intended for healthcare professionals


Covid-19: Ethnicity vaccination gap narrows in England, but concerns remain

BMJ 2021; 372 doi: (Published 19 February 2021) Cite this as: BMJ 2021;372:n505

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  1. Shaun Griffin
  1. London

The gap between the number of black people and white people vaccinated against covid-19 in England has slightly narrowed in the past few weeks, although it is still a concern and requires attention, say experts.

As of 13 January, data from the OpenSAFELY platform showed that twice as many white people aged over 80 (43%) had been vaccinated as black people (21%).1 By 11 February, when 91% of this age group had been vaccinated, 91% of white people had been vaccinated, compared with only 58% of black people and 72% of people from South Asian backgrounds.2

The latest dataset also looked at vaccine coverage among 70-79 year olds and showed that 85% of this age group (1.76 million) had been vaccinated by 11 February. A similar trend was seen with ethnicity, as 66% of white people in this cohort had been vaccinated, compared with 46% of black people and 62% of people of South Asian ethnicity.

Further analysis showed that vaccine coverage was lowest among people who described their ethnicity as African (49% of over 80s and 41% aged 70-79), followed by those of Bangladeshi and British Bangladeshi ethnicity (59% over 80 and 54% aged 70-79) and those of Caribbean ethnicity (61% and 49%).

Building trust

OpenSAFELY is an analytics platform for electronic NHS records, created to deliver urgent results during the global covid-19 emergency. For the studies researchers from the University of Oxford and the London School of Hygiene and Tropical Medicine examined GP records, although the analysis has not yet been peer reviewed.

The study authors noted that the variations observed should not be misinterpreted as a criticism of the NHS’s vaccination campaign, adding that “further research is needed to understand and address the observed lower coverage among people from more deprived areas, and the striking disparity between ethnic groups.”

Low vaccination rates among people with severe mental illness and learning disabilities are also of concern, said the authors, who suggested that these rates “may reflect challenges around access, including for those currently living in institutional settings.”

They noted that the dataset may not be fully representative, as only 17% of general practices in London used the software, records of ethnicity were missing for 28% of people over 80, and difficulties arose in conducting large scale studies of care home residents.

Stephen Evans, one of the project’s lead researchers, told The BMJ, “The rate of rollout of the vaccination is very rapid indeed, so it is important not to draw too strong conclusions about apparent differences, since the picture is changing on a daily basis. The pattern in the first few weeks was quite different to the later data.”

Gurch Randhawa, director of the Institute for Health Research at the University of Bedfordshire and coauthor of a recent BMJ opinion piece,3 said, ”Building trust and confidence between public and government is not something that can become the norm overnight. It requires meaningful and sustained engagement and partnership working at all levels—nationally via faith leaders, role models, celebrities, etc, and at local level with trusted community organisations.”

The latest update of data coincided with the launch of a television campaign encouraging vaccination among minority ethnic communities. A five minute video coordinated by Adil Ray, creator of the BBC comedy Citizen Khan, features appearances from celebrities and politicians and dispels several circulating myths. It appeared on ITV, Channel 4, and other UK commercial channels on 18 February.

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