‘Colour-blind’ coronavirus vaccine distribution is putting ethnic minorities at risk

A syringe and a bottle of vaccine
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Doctors have warned that the UK’s “colour-blind” vaccine distribution strategy is putting ethnic minority communities at higher risk of falling ill and dying with coronavirus (Covid-19).

“Unequal impact”

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 it’s 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 coronavirus. It recently considered but rejected a move to prioritise people in higher-risk occupations, saying this may slow down the rollout.

Different ethnic groups are not specifically mentioned in this list. But the JCVI said there should be “flexibility” at a local level. And attention should be given to “mitigating health inequalities, such as might occur in relation to access to healthcare and ethnicity”.

Higher risk

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.

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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.

A targeted approach

The authors say ineffective vaccine allocation strategies “likely play a role in the high levels of vaccine hesitancy observed across ethnic minorities”. 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.

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.

Disparities

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.

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