From David Vincent in Shrewsbury, UK: Going to the races

Ludlow races

February 6. On Tuesday evening we drove down to Ludlow race course for our covid vaccination.  No horses, no riders, no vets, just teams of volunteers in a couple of marquees, remarkably cheerful towards the end of what I was told had been a twelve-hour day checking identities and administering jabs.

We waited in lines of spaced seating.  None of us in our first youth, and all of us, it now strikes me, white. This was rural Shropshire, and should come as no surprise.  A county which voted decisively for Brexit immigration controls has in fact very few migrants.

But with the new finding that white over-eighties are twice as likely to have been vaccinated as black, there is a fresh concern that the BAME community is not participating in the vaccination programme.*  There are similar worries about medical staff who have been offered the vaccine.  The Health Service Journal reports that at the Guy’s and St Thomas’ Foundation Trust in London there has been “substantially lower covid vaccine uptake among its black African, black Caribbean and Filipino staff so far.”** Challenged about these discrepancies, the minister in charge, Nadhim Zahawi, took a glass 85%-full line, stressing the large numbers who had taken the vaccine, and admitting that the Government was not fully recording those who had not done so.

Since the pandemic began there has been opinion-poll evidence from many countries about the scale of what are now politely described as “vaccine hesitants.” The latest survey finds that nearly 40% of the French and 23% of Germans say they will definitely or probably refuse a vaccination***  I have always been cautious about these reports.  No one ever died of giving a negative response to a pollster.  It’s easy enough to unload grievances against politicians, health services, big pharma, when, as is still the case in Germany and France, the issue is largely hypothetical. 

One positive consequence of these widely-reported figures is that they have provoked governments, health providers, community leaders and celebrities into launching educational programmes to counter on-line anti-vax propaganda. The British government has set aside £23m for this purpose. Unfortunately, according the Centre for Countering Digital Hate, anti-vax social media in the UK have also redoubled their efforts now that the choice has become real.****  

It comes down to a question of speed. 

There is a large body of literature on the centuries-old anti-vaccination movements, and on the pervasive presence of malign channels of communication.  But we do not have the time to continue debating the excessive individualism of the modern world.  The current higher BAME mortality rate is going to increase dramatically if we have to wait for generations of folk remedies to be challenged, or for the community’s mistrust of the NHS and agencies of authority such as the police to be overcome.  Equally it is a fantasy to suppose that the main digital platforms are going to deny themselves the advertising revenue generated by alternative covid cures any time soon.

This is why the most effective response to the present dilemma may be that adopted by doctors in Liverpool. They are treating vaccine resistance by BAME groups as an immediate practical matter.  It’s no good, they argue, depending solely on large-scale venues which, like Ludlow race course, can be a long way from where people live (though to be fair the race course had organised a special bus service).  Instead they have started pop-up vaccination centres in local neighbourhoods.  Rather than waging war against social media in general, they have engaged with channels of communication up and down particular streets.  And if particular groups do not trust representatives of white society, alternatives have been sought. 

According to a newspaper report, “Dr Cait Taylor, a GP who is joint clinical director of the Central Liverpool primary care network, decided she and other white medics would not be giving the inoculations. Instead, they put a call out for medical students from BAME backgrounds, offering £10.21 an hour for Urdu and Arabic speakers. ‘We wanted to inspire confidence’ she said. ‘People felt more comfortable there than at a GP surgery where you might be met with a white receptionist, or a white vaccinator, or a doctor who doesn’t explain things to you properly, or doesn’t know your language.’”*****

 Cait Taylor concludes, “the message we’ve got loud and clear from local communities is: come to us and we’d love to take the vaccine, thank you very much.”  As should have been the case from the outset with the test and trace system, as much of the delivery as possible should be left in the hands of health professionals who know and are known by the neighbourhoods they are seeking to assist. 

 *https://www.theguardian.com/world/2021/feb/04/black-over-80s-in-england-half-as-likely-to-have-had-covid-vaccine?CMP=share_btn_link

**https://www.hsj.co.uk/acute-care/exclusive-fewer-black-and-filipino-nhs-staff-vaccinated-amidhesitancy-concern/7029397.article

***https://www.theguardian.com/world/2021/feb/04/covid-vaccine-refuse-france-germany-us-quarter?CMP=share_btn_link

**** https://www.bma.org.uk/news-and-opinion/pushing-back-tackling-the-anti-vax-movement

*****https://www.theguardian.com/world/2021/feb/04/inspiring-confidence-liverpool-gps-tackle-the-vaccine-race-gap

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