Ethnic minority communities are being put at higher risk of falling ill and dying with coronavirus by the UK’s “colour-blind” vaccine distribution strategy, doctors have warned.
Writing in the Journal of the Royal Society of Medicine, they say the current prioritisation “disregards the unequal impact of the pandemic on minority ethnic groups” and is worsening racial inequalities that the pandemic has exposed.
The Joint Committee on Vaccination and Immunisation (JCVI) has largely recommended an age-based approach, saying age is the single biggest risk factor for Covid-19.
It recently considered but rejected a move to prioritise people in higher-risk occupations, saying this may slow down the rollout.
Prioritising essential workers for vaccination will preserve the healthcare system, accelerate reopening of society, help revive the economy and enable the operation of essential community servicesProfessor Azeem Majeed, lead author
Different ethnic groups are not specifically mentioned in this list but the JCVI said there should be “flexibility” at a local level, with attention to “mitigating health inequalities, such as might occur in relation to access to healthcare and ethnicity”.
People from minority ethnic communities are more likely to live in multigenerational, crowded households, where transmission may be higher.
They also make up a higher proportion of those working in high-risk, low-paid occupations.
These workers are less likely to be able to work from home and are exposed to more people, meaning they have a higher risk of infection.
The authors write: “The invisibility of these vulnerable groups from the priority list and the worsening healthcare inequities and inequalities are putting ethnic minorities at a significantly higher risk of Covid-19 illness and death.
“The UK’s colour-blind vaccination model disregards the unequal impact of the pandemic on minority ethnic groups, rendering it an enabler of structures that are known to systematically disadvantage BAME (Black, Asian and Minority Ethnic) communities.”
Lead author Professor Azeem Majeed, of the Department of Primary Care and Public Health at Imperial College London, said: “Prioritising essential workers for vaccination will preserve the healthcare system, accelerate reopening of society, help revive the economy and enable the operation of essential community services.”
The authors say ineffective vaccine allocation strategies “likely play a role in the high levels of vaccine hesitancy observed across ethnic minorities”.
Figures from the Office for National Statistics published this week show 44% of black or black British people reported vaccine hesitancy.
The impact of the virus on BME communities has been disproportionate and bleakDr Habib Naqvi, NHS Race and Health Observatory
All respondents from minority ethnic backgrounds were more hesitant than white adults, with the odds of hesitancy six times as high in black or black British adults compared with white adults after adjusting for other factors.
The authors note that probable key factors include a lack of trust in some communities due to racism, low confidence in the safety or efficacy of the vaccine, and limited endorsements from trusted community leaders.
Strategies that could alleviate barriers to getting the vaccine could include ensuring people do not experience financial loss by taking time off work and travelling to get a jab, and administering the vaccine in easily accessible community settings.
Prof Majeed added: “Dismissing the racial and socioeconomic disadvantages that ethnic groups face may result in devastating impacts lasting far beyond the end of the pandemic.
“Controlling further outbreaks and, ultimately, ending the pandemic will require implementation of approaches that target ethnic minorities as well as ensuring vaccine allocation strategies are effective, fair and justifiable for all.”
Dr Habib Naqvi, director of the NHS Race and Health Observatory, said: “We have sadly witnessed the consequence of not acting on early evidence presented into Covid-19 ethnicity and health inequalities.
“The impact of the virus on BME communities has been disproportionate and bleak.
“Now is the time to urgently learn from recent lessons, and act on improved granular data, including a clear focus on localised approaches with resources and support which both engage and tackle lower levels of trust and confidence in the vaccine programme across diverse communities.”
A Department of Health and Social Care spokesperson said: “The independent JCVI’s advice on Covid-19 vaccine prioritisation was developed with the aim of preventing as many deaths as possible, with older age being the single greatest risk of death. We are following the JCVI recommendations so that we save lives.
“We have invested millions into research into ethnic disparities and Covid-19 and established a new NHS Race and Health Observatory to tackle the specific health challenges facing people from ethnic minority backgrounds.”