COVID-19 vaccine decision-making and the role of institutions across the pandemic in UK Black African and Black Caribbean communities.

INTRODUCTION

In the UK, individuals from Black African and Black Caribbean backgrounds show particularly low rates of COVID-19 vaccination uptake. Initial research highlighted institutional mistrust as a prevalent influencing factor in COVID-19 vaccine decision-making, but most data were obtained from un-differentiated minority ethnic samples. This study explored the role of institutional mistrust across the entire COVID-19 vaccination rollout period, focusing on Black African and Black Caribbean communities.

METHODS

Purposive sampling resulted in 13 participants (7 = male, 6 = female; M = 52 years), who expressed uncertainty about one or more of the menu of COVID-19 vaccinations. An in-person focus group and online semi-structured interviews were conducted to explore COVID-19 vaccination views and institutional influences. Data were analysed thematically.

RESULTS

Three overarching themes were identified, each with constituent sub-themes, mapping onto the chronological sequence of the vaccination rollout: (1) 'mistrust during initial vaccine decision-making' (e.g., highlighting historical racial inequities and biased news exposure), (2) 'negative experiences of institutions during the pandemic' (e.g., highlighting systemic pressures to vaccination and perceptions of deception), and (3) 'vaccination attitudes post-pandemic' (e.g., highlighting varied views and concerns about booster vaccinations).

CONCLUSIONS

Findings emphasize the enduring influence of institutions on COVID-19 vaccination attitudes of UK individuals from Black African and Black Caribbean backgrounds. Initial vaccination adherence through perceived coercive governmental strategies appeared counterproductive for ongoing willingness to vaccinate. Instead, co-producing campaigns and providing opportunities to discuss concerns with trusted healthcare professionals in the community are recommended. These findings can be applied to future vaccination campaigns against COVID-19 and other similar health threats.