COVID-19 vaccine hesitancy – debunking the myths using a community engagement approach underpinned by NICE guidance

1). To reduce COVID-19 vaccine hesitancy amongst BAME population by debunking the myths about COVID vaccines by organising webinars, virtual group talks, podcasts, videos in other languages and dialects.

2). To increase COVID-19 vaccine uptake by engaging with the BAME communities, informing and educating the target groups about COVID-19 vaccines using multi-platform approach including social media, print and press etc.

3). To support and work in collaboration with faith and community leaders in the BAME communities in ensuring an improved BAME COVID-19 vaccine uptake.

There has been some reluctance and hesitance in the Black, Asian and Minority Ethnic (BAME) communities about the COVID-19 vaccine uptake due to myths about the vaccines and historical misgivings.

Disturbing headlines like ‘New poll finds BAME groups less likely to want COVID vaccine’ started emerging in late 2020. By the time the MHRA approved the Pfizer vaccine in December 2020, the scepticism of the COVID-19 vaccine amongst BAME groups had hit the air waves and became a national concern.

A poll commissioned by the Royal Society of Public Health published in December 2020 found that only 57% of respondents from BAME backgrounds (199 respondents) were likely to accept a COVID-19 vaccine, compared to 79% of white respondents.

The encouraging information from this particular survey was that the BAME respondents who were not willing to be vaccinated were especially receptive to offers of further health information from their GP. Over one third (35%) said they would likely change their minds and get the jab if given more information by their GP about how effective it is – almost twice as many as the 18% of white people who were initially unwilling.

In another survey, 27% of ethnic minorities who participated say they suspect that “reporters, scientists, and government officials are involved in a conspiracy to cover up important information about coronavirus” – almost twice as high as the 14% of people from white ethnic groups who say they suspect the same.

People from BAME groups (25%) are also twice as likely as white people (13%) to report believing “the only reason a coronavirus vaccine is being developed is to make money for pharmaceutical companies”. These kinds of beliefs may be contributing to uncertainty about getting a coronavirus vaccine among some BAME people.

As an organisation, BWIH, felt there was an urgent need for strategic intervention to reach out to the BAME communities.

NICE guideline (NG44) Community engagement: improving health and wellbeing and reducing health inequalities – published in 2016 made the following relevant recommendations in addressing the type of situation:

Recommendation 1.5.1 Work with local communities and community and voluntary organisations to:

• Identify barriers to involvement, particularly for vulnerable groups and recently established communities.
• Decide which types of communication would get people interested and involved. Include ways of communicating that reflect the needs of: vulnerable or isolated groups, recently established communities, those with low literacy or learning difficulties, and people who do not use digital or social media.

Recommendation 1.5.2 Provide the support people need to get involved.

This includes:

• Involving community members in the initiative's recruitment process (see section 1.3).
• Offering to phone, write, email, use social media or call round to see people.
• Providing information in plain English and locally spoken languages for non-English speakers. This could include encouraging members of the community who speak a community language to get involved in translating it.
• Ensuring the timing of events meets people's needs.

We embarked on various COVID-19 vaccine outreach programmes to engage, inform and educate various BAME groups; we actively supported and collaborated with community groups and leaders of BAME to promote COVID-19 vaccine uptake. Specifically,

- We featured the photos of leading doctors and nurses from black background receiving COVID vaccine and holding their vaccination card on social media to encourage people from BAME communities to participate.

- We engaged (and continue to engage) with the people from BAME communities on social media platforms, challenging and dispelling misinformation and amplifying the positive messages of the COVID vaccine literally and dramatically.

- We produced podcast and videos in English and English-based Pidgin encouraging people to accept the vaccine and to shun the myths

- We organised an open webinar on debunking the myths about the COVID-19 vaccine with the emphasis on using the ‘4 As plus’ approach:

• Acknowledge concern
• Address the problem
• Answer: get answer from reliable source
• Act on information you get plus
• Verify before you amplify

This virtual seminar on Zoom had panelists including seniors doctors, nurses, pharmacists, faith leaders and a trial recipient from the BAME community to help address the concerns.

Webinar / Zoom Community meeting (Virtual)

- This two-hour event was attended by over 150 participants from the BAME community.

- In the pre-event survey completed by 44 people, 66% of the respondents said they would take the COVID-19 vaccine when offered.

- The post-event poll showed much improvement as almost 90% of those who completed the survey said they would take the vaccine whenever they were offered it.

This survey was completed by 33 people, 27 of whom were affirmative, two were likely to accept the vaccine in future but their current circumstances were debarring them; only one respondent said they were yet to be convinced that the vaccine was the right way forward.

Videos in other languages

 - These have made remarkable impacts; the COVID-19 vaccine message broadcast in English-based Pidgin have been viewed more than 8,000 times across social media platforms

- There were numerous positive comments and the majority favourably disposed to taking the vaccine whenever it is offered to them

- This result has been achieved in line with the NICE guideline NG44 1:5:2 ‘Providing information in plain English and locally spoken languages for non-English speakers’.

We observed that myths, misconceptions and outright fallacies were the barriers to engagement in the COVID-19 vaccine programme amongst the BAME community.

- Engagement with various BAME groups using local languages by trusted health and faith leaders from their community helped in debunking the myths, dispelling the misconceptions and correcting the false misrepresentations about the vaccines and the approval processes.

- Using different social media platforms allowed the message to be passed to thousands of the BAME community in their preferred languages and in their own environments.

 - We intend to continue community engagement programme until the end of the pandemic, expanding the scheme and finding ways to engage the hard-to-reach people in the BAME communities.

- Going forward, the same principles should be applied to improving health promotion for other medical conditions and chronic diseases, this will help reduce disparities and health inequalities in the BAME communities, which will in the long run save the NHS money.

- Educating people empowers them to make healthier decisions.