Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.
Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.
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DOI：
10.1016/j.lanepe.2021.100180
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发表时间：
2021-10
期刊：
影响因子：
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通讯作者：
UK-REACH Study Collaborative Group
中科院分区：
文献类型：
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作者：
Woolf K;McManus IC;Martin CA;Nellums LB;Guyatt AL;Melbourne C;Bryant L;Gogoi M;Wobi F;Al-Oraibi A;Hassan O;Gupta A;John C;Tobin MD;Carr S;Simpson S;Gregary B;Aujayeb A;Zingwe S;Reza R;Gray LJ;Khunti K;Pareek M;UK-REACH Study Collaborative Group
在大多数国家，由于医护人员感染COVID-19的风险较高，并可能导致SARS-CoV-2的院内传播，因此医护人员是接种SARS-CoV-2疫苗的优先群体。有人担心，来自少数民族群体的医护人员比白色种族的医护人员更可能对疫苗犹豫不决（世界卫生组织定义为拒绝或推迟接种疫苗），但关于英国医护人员对SARS-CoV-2疫苗犹豫不决及其预测因素的数据有限。在临床和非临床英国HCW的多种族队列中进行的全国前瞻性队列研究和定性研究。我们分析了SARS-CoV-2疫苗犹豫的种族差异，调整了人口统计学，疫苗信任和COVID-19的感知风险。我们使用框架分析探讨了定性数据犹豫的原因。11，584名HCW被纳入队列分析。23%（2704例）报告了疫苗犹豫。与白色英国HCW（21.3%犹豫不决）相比，来自加勒比黑人（54.2%）、加勒比白色和黑人混合（38.1%）、非洲黑人（34.4%）、中国人（33.1%）、巴基斯坦人（30.4%）和白色其他族裔（28.7%）的HCW更有可能犹豫不决。在调整后的分析中，加勒比黑人（aOR 3.37，95% CI 2.11 - 5.37）、非洲黑人（aOR 2.05，95% CI 1.49 - 2.82）、白色和其他种族群体（aOR 1.48，95% CI 1.19 - 1.84）更可能出现犹豫。犹豫的其他独立预测因素包括年龄较小，女性，COVID-19阴谋信念量表得分较高，对雇主的信任度较低，上一季缺乏流感疫苗接种，先前的COVID-19和怀孕。99名参与者的定性数据确定了以下导致犹豫的因素：对政府和雇主缺乏信任、疫苗开发速度导致的安全问题、疫苗研究缺乏种族多样性以及令人困惑和相互矛盾的信息。与会者认为，通过包容性的沟通，让卫生工作者参与疫苗的推广，并通过可信的网络促进疫苗接种，可以提高少数民族社区的接种率。尽管感染COVID-19的风险增加，但来自一些少数民族群体的HCW比他们的白色英国同事更有可能对疫苗犹豫不决。迫切需要在这些社区建立信任和消除围绕COVID-19疫苗的神话的战略。应强调在怀孕期间和既往患有COVID-19的患者中接种SARS-CoV-2疫苗的安全性和益处。公共卫生传播应具有包容性、非污名化，并利用可信的网络。UKRI-MRC和NIHR。
In most countries, healthcare workers (HCWs) represent a priority group for vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) due to their elevated risk of COVID-19 and potential contribution to nosocomial SARS-CoV-2 transmission. Concerns have been raised that HCWs from ethnic minority groups are more likely to be vaccine hesitant (defined by the World Health Organisation as refusing or delaying a vaccination) than those of White ethnicity, but there are limited data on SARS-CoV-2 vaccine hesitancy and its predictors in UK HCWs. Nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK HCWs. We analysed ethnic differences in SARS-CoV-2 vaccine hesitancy adjusting for demographics, vaccine trust, and perceived risk of COVID-19. We explored reasons for hesitancy in qualitative data using a framework analysis. 11,584 HCWs were included in the cohort analysis. 23% (2704) reported vaccine hesitancy. Compared to White British HCWs (21.3% hesitant), HCWs from Black Caribbean (54.2%), Mixed White and Black Caribbean (38.1%), Black African (34.4%), Chinese (33.1%), Pakistani (30.4%), and White Other (28.7%) ethnic groups were significantly more likely to be hesitant. In adjusted analysis, Black Caribbean (aOR 3.37, 95% CI 2.11 - 5.37), Black African (aOR 2.05, 95% CI 1.49 - 2.82), White Other ethnic groups (aOR 1.48, 95% CI 1.19 - 1.84) were significantly more likely to be hesitant. Other independent predictors of hesitancy were younger age, female sex, higher score on a COVID-19 conspiracy beliefs scale, lower trust in employer, lack of influenza vaccine uptake in the previous season, previous COVID-19, and pregnancy. Qualitative data from 99 participants identified the following contributors to hesitancy: lack of trust in government and employers, safety concerns due to the speed of vaccine development, lack of ethnic diversity in vaccine studies, and confusing and conflicting information. Participants felt uptake in ethnic minority communities might be improved through inclusive communication, involving HCWs in the vaccine rollout, and promoting vaccination through trusted networks. Despite increased risk of COVID-19, HCWs from some ethnic minority groups are more likely to be vaccine hesitant than their White British colleagues. Strategies to build trust and dispel myths surrounding the COVID-19 vaccine in these communities are urgently required. Emphasis should be placed on the safety and benefit of SARS-CoV-2 vaccination in pregnancy and in those with previous COVID-19. Public health communications should be inclusive, non-stigmatising and utilise trusted networks. UKRI-MRC and NIHR.