VACCINE HESITANCY V5a amended title.pdf

VACCINE HESITANCY V5a amended title.pdf - page 1/28 - Understanding vaccine hesitancy through …

Understanding vaccine hesitancy through communities of place

VACCINE HESITANCY V5a amended title.pdf - page 2/28 - Introduction

Introduction

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VACCINE HESITANCY V5a amended title.pdf - page 4/28 - Glossary of terms

Glossary of terms

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VACCINE HESITANCY V5a amended title.pdf - page 6/28 - pharmaceutical companies to the chequere…

pharmaceutical companies to the chequered history of institutional racism and sexism embedded in medicines clinical and research practices, to the troubled politics of American and British healthcare, and even to the place of each of these countries in the world.

VACCINE HESITANCY V5a amended title.pdf - page 7/28 - evidenced as a factor in vaccine hesitan…

evidenced as a factor in vaccine hesitancy and acceptance by those working with communities around the development of vaccines for HIV, Ebola and Poliovirus. This third factor is dominant in hesitancy concerns for a third group, which also incorporates elements of the first two: those who have been racially or otherwise minoritised, persecuted and stigmatised by majority and dominant groups, and by systems and structural inequalities. Thus `Fear as a factor within vaccine hesitancy often incorporates elements of the other two factors for these groups.

VACCINE HESITANCY V5a amended title.pdf - page 8/28 - The knowledge base: strengths and gaps

The knowledge base: strengths and gaps

VACCINE HESITANCY V5a amended title.pdf - page 9/28 - How these negative messages are diffused…

How these negative messages are diffused through social media networks and how they are challenged or cemented by relations in place, is a subject that would value further research and a significant gap in the evidence. Personal connections, too, with those an individual may know offline, can play a key role, and may aid in debunking some of the myths related to the effectiveness and side-effects of vaccination. As such, while study of social media dynamics is crucial for understanding the intra-community spread of misinformation, given the important limitations of supracommunity directed informational campaigns as described above, it is equally as important to understand the dynamics of this type of information once it begins to circulate within a given local community.

VACCINE HESITANCY V5a amended title.pdf - page 10/28 - Bottom-up: an emerging community engagem…

Bottom-up: an emerging community engagement model for addressing vaccine hesitancy

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VACCINE HESITANCY V5a amended title.pdf - page 12/28 - Generalisable findings

Generalisable findings

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VACCINE HESITANCY V5a amended title.pdf - page 14/28 - There was a marked need to pay attention…

There was a marked need to pay attention to place-based community factors and to codesigning the interventions and solutions for the communities, in enable greater accessibility to the vaccine. The rigid structures governing local health commissioning limited the first stages of rollout, with vaccination only led by local governments and health providers and only accessible in clinical sites. As the inequities in uptake of vaccination showed strong disparities between different communities, the need for commissioning local groups who held high trust and strong participation routes to marginalised and/or hesitant community residents and groups, became clear.

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VACCINE HESITANCY V5a amended title.pdf - page 16/28 - previously disenfranchised from the civi…

previously disenfranchised from the civil society landscape, but how the pandemic had brought them into forums and working groups with secular and public service organisations, through the shared commitment to address the challenge to reaching hesitant communities. In the UK and the US, for reasons discussed above, hesitancy related factors often - but certainly not exclusively mapped onto faith groups, and many described the lack of interfaith structures within local UK communities in particular as a missed opportunity to inform and share relevant and accessible information and knowledge through faith structures and to integrate local faith networks and their members - some of whom would turn out to be hesitancy groups- in the vaccine engagement campaigns from early on, before hesitant-narratives had a chance to amplify and circulate.

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VACCINE HESITANCY V5a amended title.pdf - page 18/28 - Corroborating the findings in the eviden…

Corroborating the findings in the evidence review about the role of historical injustice in building vaccine hesitancy, communities in the US and the UK sites referenced past - and recent - injustices in health and broader policies around welfare in their reasons for distrust of the vaccine or scepticism. Specific examples of previous scandals; personal experiences of racism or poor medical experiences; or simply limited or compromised access to health services, all contributed to vaccine hesitancy and resistance. In Tower Hamlets, consistent issues with access to GPs over the last ten years was referenced frequently as a contributor to why communities were distrustful of medical intervention as they perceived the sudden engagement of local health services, trying to persuade them to get the vaccine, as a conspiracy or as `one-sided, negating the benefit to them.

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VACCINE HESITANCY V5a amended title.pdf - page 20/28 - challenges have their own distinctive ro…

challenges have their own distinctive roots in the historic and current lived experience of the different South Asian communities which tend to stem from the UKs colonial legacy and historical and more recent Islamophobia. There is a need to distinguish between different racialised minorities in the development of vaccine engagement programmes and for research teams to ensure much finer granularity and representation in conducting research about the potential solutions to vaccine hesitancy, in order to account for the high specificity of lived experiences of discrimination or alienation. Through the lens of vaccine hesitancy the cases demonstrated the distinct political relationship of different racialised minority communities in different places to authority-led health agendas, which could not be accounted for through the limited number of largely `top-down approaches and required tailored, and locally informed, engagement.

VACCINE HESITANCY V5a amended title.pdf - page 21/28 - Section D

Section D

VACCINE HESITANCY V5a amended title.pdf - page 22/28 - The evidence review for this study consi…

The evidence review for this study considered the SAGE model of vaccine hesitancy (the 3Cs) as the most established understanding of reasons for vaccine hesitancy to occur and employed it in considering the experience of the four case studies of delivering the vaccine programme. The case studies revealed gaps in the existing understanding of vaccine hesitancy, especially the lack of local community-level approaches - or robust `bottom up approaches to vaccine engagement, and an appraisal of the community and place dimensions that mediate vaccine uptake.

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VACCINE HESITANCY V5a amended title.pdf - page 24/28 - In addition, and aligned with this prior…

In addition, and aligned with this priority, the following areas of further research would be beneficial.

VACCINE HESITANCY V5a amended title.pdf - page 25/28 - Appendix 1

Appendix 1

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Appendix 2

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VACCINE HESITANCY V5a amended title.pdf - page 28/28 - This research is funded by the British A…

This research is funded by the British Academy, the Social Science Research Council and the UKs Science & Innovation Network in the USA.