Tackling Covid - Vaccine Hesitancy in Underserved at-Risk Populations Including Persons with BAME Background

Currently, four efficient and safe vaccines against COVID-19 have gained MHRA approval for use in the UK. At the current trajectory, most individuals in the UK will have been offered vaccination by autumn 2021. Similar to other immunization programmes, vaccination coverage is lower among migrants and persons with ethnic minority (EM) background, and associated with socioeconomic, cultural, linguistic and healthcare utilisation factors. Improving uptake of vaccination in these groups mitigates individual vulnerability and avoids increased transmission and future COVID-19 waves from under-vaccinated groups. Research exploring the sociocultural, public trust and healthcare related barriers and enablers for vaccine uptake in migrant and EM populations is limited, as are effective co-designed interventions.

This evidence gap is relevant in East London with its high proportion of vulnerable and at-risk communities. Our research aims to address pockets of under-vaccination after the routine vaccination programme, alongside the likely need for boosters mitigating against waning immunity and/or emergence of COVID-19 mutations.

Lessons are likely applicable to other vaccination programmes including measles and influenza, and health promotion interventions, like screening. Our 24-monthsresearch has three work packages (WP). A qualitative study will explore social and cultural concepts, perceptions, and attitudes regarding vaccines for and beliefs regarding COVID-19 alongside other vaccination programmes, and the acceptability of interventions to promote uptake of vaccination through in-depth interviews and focus groups with individuals from migrant and EM communities. (WP1) Through a series of participatory workshops, we intend to co-design a two-way SMS public engagement tool (PET) and examine the viability of culturally adapted educational support, including content, design, mode and timing of delivery of messages. (WP2) A cluster randomized feasibility study will act as a pilot to evaluate feasibility and implementation aspects of a subsequent large trial to evaluate if the PET increases COVID-19 vaccination uptake in our target population. (WP3)