IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i21p7008-d1272527.html
   My bibliography  Save this article

Beyond Information Provision: Analysis of the Roles of Structure and Agency in COVID-19 Vaccine Confidence in Ethnic Minority Communities

Author

Listed:
  • Shoba Poduval

    (UCL Research Department of Primary Care & Population Health, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK)

  • Atiya Kamal

    (School of Social Sciences, Birmingham City University, 4 Cardigan Street, Birmingham B4 7BD, UK)

  • Sam Martin

    (Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London (UCL), Charles Bell House, 43–45 Foley Street, London W1W 7TY, UK
    Vaccines and Society Unit, Oxford Vaccine Group, Oxford University, Oxford OX3 7LE, UK)

  • Amin Islam

    (Patient and Public Involvement Authors, UCL Research Department of Primary Care & Population Health, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK)

  • Chandrika Kaviraj

    (Patient and Public Involvement Authors, UCL Research Department of Primary Care & Population Health, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK)

  • Paramjit Gill

    (Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK)

Abstract

People from Black and Asian backgrounds are more likely to die from COVID-19 but less likely to be vaccinated, threatening to exacerbate health inequalities already experienced by ethnic minority groups. The literature suggests that mistrust rooted in structural inequality (including socioeconomic position and experience of racism) may be a key barrier to COVID-19 vaccine uptake. Understanding and addressing structural inequality is likely to lead to longer-term impacts than information alone. The aim of this study is to draw on health and sociological theories of structure and agency to inform our understanding of how structural factors influence vaccine confidence. We conducted qualitative interviews and focus groups with 22 people from London and the surrounding areas from December 2021 to March 2022. Fourteen participants were members of the public from ethnic minority backgrounds, and seven were professionals working with the public to address concerns and encourage vaccine uptake. Our findings suggest that people from ethnic minority backgrounds make decisions regarding COVID-19 vaccination based on a combination of how they experience external social structures (including lack of credibility and clarity from political authority, neglect by health services, and structural racism) and internal processes (weighing up COVID-19 vaccine harms and benefits and concerns about vaccine development and deployment). We may be able to support knowledge accumulation through the provision of reliable and accessible information, particularly through primary and community care, but we recommend a number of changes to research, policy and practice that address structural inequalities. These include working with communities to improve ethnicity data collection, increasing funding allocation to health conditions where ethnic minority communities experience poorer outcomes, greater transparency and public engagement in the vaccine development process, and culturally adapted research recruitment processes.

Suggested Citation

  • Shoba Poduval & Atiya Kamal & Sam Martin & Amin Islam & Chandrika Kaviraj & Paramjit Gill, 2023. "Beyond Information Provision: Analysis of the Roles of Structure and Agency in COVID-19 Vaccine Confidence in Ethnic Minority Communities," IJERPH, MDPI, vol. 20(21), pages 1-16, November.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:21:p:7008-:d:1272527
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/21/7008/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/20/21/7008/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Opel, D.J. & Mangione-Smith, R. & Robinson, J.D. & Heritage, J. & DeVere, V. & Salas, H.S. & Zhou, C. & Taylor, J.A., 2015. "The influence of provider communication behaviors on parental vaccine acceptance and visit experience," American Journal of Public Health, American Public Health Association, vol. 105(10), pages 1998-2004.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ginger Zhe Jin & Thomas G. Koch, 2018. "Learning by Suffering? Patterns in Flu Shot Take-up," NBER Working Papers 25272, National Bureau of Economic Research, Inc.
    2. Marta Fadda & Emiliano Albanese & L. Suzanne Suggs, 0. "When a COVID-19 vaccine is ready, will we all be ready for it?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 0, pages 1-2.
    3. Toerien, Merran, 2021. "When do patients exercise their right to refuse treatment? A conversation analytic study of decision-making trajectories in UK neurology outpatient consultations," Social Science & Medicine, Elsevier, vol. 290(C).
    4. Moss, Jennifer L. & Reiter, Paul L. & Rimer, Barbara K. & Brewer, Noel T., 2016. "Collaborative patient-provider communication and uptake of adolescent vaccines," Social Science & Medicine, Elsevier, vol. 159(C), pages 100-107.
    5. Lauren E. Latella & Robert J. McAuley & Mitchell Rabinowitz, 2018. "Beliefs about Vaccinations: Comparing a Sample from a Medical School to That from the General Population," IJERPH, MDPI, vol. 15(4), pages 1-13, March.
    6. Marta Fadda & Emiliano Albanese & L. Suzanne Suggs, 2020. "When a COVID-19 vaccine is ready, will we all be ready for it?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(6), pages 711-712, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2023:i:21:p:7008-:d:1272527. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.