Despite a huge drive urging people to get the jab to protect themselves against Covid many remain unconvinced. Experts on the frontline explain why some are so reluctant
The New Year, our second during the pandemic, got started with an appeal to the unvaccinated. Chief Medical Officer Dr Michael McBride took to the airwaves again to urge those who had not yet received their booster jab to do so as soon as possible.
After a post-holiday period during which more than 30,000 new cases of Covid-19 and a further 15 deaths were reported, it felt more like a New Year’s-esque Groundhog Day, when the excesses of the holidays — going out for a meal, visiting a pub or hugging a loved one — finally caught up with us.
Health professionals have said the rate of boosters being administrated has stalled with under 900,000 given out so far.
Of vaccinations overall, the Department of Health’s own figures show that of the over-60 age group, 100% are vaccinated while the percentage dwindles when we reach the 30-39 age group.
At time of writing, the vaccinated cohort in that group sits at 83.57% while for the 18 to 29-year-olds, it’s 78.8%. Of those who are unvaccinated, some are described as “anti-vaxxers” and others are the “vaccine hesitant” — a minority group but one which nevertheless commands attention.
The Department of Health’s dashboard reflects the recorded dates of those vaccinated along with the NISRA population estimates for mid-2020, an approach also taken in other parts of the UK. On the dashboard, it’s possible to see a breakdown of the number of vaccines given out overall in each postcode in Northern Ireland.
Along with mass vaccination centres, GPs such as Dr Joe McEvoy are at the frontline of the vaccine rollout. He is one of two doctors at Londonderry’s Bayview Medical and said he frequently meets people who haven’t had the Covid-19 vaccine “for a wide range of reasons” in the course of his work.
“Some of them are quoting friends or relatives who have become ill after the vaccine, others are saying they’ve seen information online, especially on social media, saying the vaccine is dangerous,” he said.
“Some others say they don’t like being told what to do — they kick against it if there’s any kind of authority telling them what to do, it makes them naturally reluctant to get it.”
Derry postcodes such as BT47 and BT48 have repeatedly recorded the high numbers of positive cases over a number of months and collectively recorded more than 3,000 positives over the first full week of January. Many of those sceptical have “valid concerns”, said Dr McEvoy, which makes it ever more important to present statistics and to explain on a personal level the importance of vaccinating.
“It’s good to arm them with information if possible but to do it in such a way that they’re not made to feel that they’re being told what to do, or their concerns are stupid, or there’s an authority trying to force them into something they don’t want to do,” he said.
The Covid-19 vaccine is a medication and as such “it doesn’t work for everyone”, says Dr McEvoy.
“There have been people who have had problems with it. I explain that I’ve had the vaccine; after looking at the information I strongly feel that it’s better to get the vaccine and reduce the possibility of complications.”
Much of the reluctance has to do with a mistrust of authority figures which hasn’t been helped by political events in England, he said, which bleeds into society in Northern Ireland.
“[There is] a lack of trust in governments at the minute. The sort of things we see now, where it’s one rule for the rulers and another rule for us, that really does undermine people’s trust, especially when it comes to information that’s being passed to them by scientific authorities under the say so of the government.”
Paul Gallagher is an independent councillor in Derry and Strabane District Council who has met many constituents who haven’t received a Covid-19 vaccine.
“For some, it’s a conspiracy and that’s their only thought process. There are others who have linked vaccines to other things that have happened to them and their children, like autism and unexplained issues,” he said.
“One man who had 11 children told me the first number weren’t vaccinated and the younger ones were, and he could see a marked difference in them. He wouldn’t have anything to do with vaccines.”
The vaccines that have been authorised have been through three stages of clinical trials and have been tested on tens of thousands of people around the world, according to the UK government.
The estimated population of Strabane Local Government District in June 2020 according to NISRA was 40,375. At time of writing, 52,588 vaccines have been given.
Mr Gallagher, who is vaccinated, said he also understands the fears being expressed by others about reports of people who have experienced blood clots after receiving the vaccine.
“There is blame getting put on anti-vaxxers and it’s being said our health service is collapsing because of anti-vaxxers and that’s just not true. When it’s said that 50% of people who are in hospitals are unvaccinated, that’s not enough to blame that group. What about the other half?
“The officials don’t take into consideration anything other than vaccines — not age, people having COPD.
"There’s a big drive for vaccines to be the answer but people are not convinced.”
Mr Gallagher also hit out at Covid passports, which he said, “are not worth the paper they’re written on”.
“Passports had no impact on addressing Covid, it’s just about economics. If Covid is as bad as they say it is, Covid doesn’t care about economics.”
As a result, the two-tier society he said already existed between the haves and have-nots has expanded further to create a two-tier society within the group of “working-class” people he represents for whom “life choices would be limited compared to others who have an advantage”.
“In Strabane, there’s higher deprivation, a low-wage economy, people on benefits, poverty. A two-tier society is being created within that of people who have vaccines and people who don’t. That’s not the answer,” he said.
People who haven’t taken the vaccine are not unintelligent, he added. “The powers-that-be want to give this perception that people who don’t have the vaccine and are refusing to can’t make decisions for themselves, [that] we need to make decisions for them. People who pile onto that and who have got a vaccine and have got boosters seem to think they have authority.”
Instead of “blaming the unvaccinated”, governments should instead be looking to the underfunding of the health service.
“The governments who have been to the forefront of making cuts are now looking to the public and saying you need to protect what we have and putting the responsibility and blame on them.
“We need to draw a line and turn a fresh blank page on how we’re going to deal with Covid and accept the people who aren’t going to take the vaccine, won’t take it and move forward.”
A spokesperson for the Department of Health said: “Social deprivation is one factor contributing to reduced vaccine uptake. This is by no means unique to Northern Ireland. As an essential part of monitoring the rollout of the programme, the Department remains in close and regular contact with Health Trusts, GPs and Community Pharmacy to identify areas and population groups where vaccine uptake is lower.
"In particular, the deployment of the programme through community pharmacy and mobile vaccination clinics is enhancing both availability and uptake of vaccine in communities across Northern Ireland.”
Dr Laurence Dorman is the chair of the Royal College of General Practitioners and practices in Kilkeel in Co Down.
“If you remember back to the very first vaccine this time last year when general practice was rolling out AstraZeneca, we did that by age and it was quite funny because when people said they were housebound and were told they’d have to wait, all of a sudden there was this squealing of wheels and people were doing anything to come in with their sticks and Zimmer frames,” he said. “But you really saw as you went down the age groups the increased suspicion, whether that’s coming from social media, or information from peers.”
Medical professionals are beginning to become frustrated by the reluctance of some to get vaccinated, he said.
“A lot of my colleagues are starting to get a bit despondent because we pride ourselves on doing the best for our patients. To turn around and imply that we’re doing something that’s not in their best interest, that we have a secret agenda, it’s starting to get hurtful.
“Some people do come to us and say it hasn’t had enough testing and we do challenge that by telling them that what happened is that the government threw everything they could at it, a huge amount of money. If you want to build a house, you can build it in six months, but if you give a builder £2 million, he’ll build it a heck of a lot quicker, and it will still be done right.”
His practice in Kilkeel wouldn’t see people on a lower income as being more reluctant to have the vaccine.
“That’s the case more so in big cities, whereas we don’t have that issue in my practice.”
Dr Dorman said doctors are aware of which patients have not been vaccinated and said, as a GP with 20 years’ experience, more needs to be done.
“We need people who are influencers to speak to people, especially those who are trained to do so. I’m a doctor but people still go on social media and challenge me. I wouldn’t tell a builder how to do his job or an accountant because I don’t have those skills. Celebrities, sports stars, those people with influence should do so.”
In Derry, Dr McEvoy said hardline anti-vaxxers are difficult to reach.
“The views become entrenched and they’re very difficult to address, I think we just have to repeat the message. There are people who maybe can’t decide if they want to get the vaccine or not. It’s the maybes who we need to get the information to.
“The Department of Health here has been widely seen among health professionals as doing a good job. There is much more of a feeling of all in this together than there is across the water.
“We still have to offer the help to those people who are hardcore — and as people become sick, maybe some hardliners would question their own feelings and approach us for the vaccine, that has happened in a few cases but not very many.
“I have had somebody come to me yesterday and say they’d like their vaccine and how would they go about it. The vaccine should be available to all, even at a late stage.”
The Department of Health has been asked for a response.