• Trust’s board told around a quarter of black staff have received vaccine, compared with 80pc in total
  • Guy’s and St Thomas’ FT told uptake lowest among Filipino staff
  • RCN boss says some BAME staff have “particular concerns” about vaccine

The largest hospital trust in England has reported substantially lower covid vaccine uptake among its black African, black Caribbean and Filipino staff so far, citing ‘vaccine hesitancy’.

Other London trust directors have also reported to HSJ a disparity in the take-up of the vaccine between different ethnic groups.

Guy’s and St Thomas’ Foundation Trust’s board heard yesterday that while overall 80 per cent of its staff had been vaccinated, the rate was around a quarter among black-African and black-Caribbean staff, and lower still for Filipino staff. The trust confirmed that of Asian staff groups, Bangladeshi employees were least vaccinated so far.

Trust chair Sir Hugh Taylor said there were “hard to reach” staff groups who were “hesitant about the vaccine for a number of reasons”.

Director of workforce Daniel Waldron told the meeting: “Black-African and black-Caribbean staff are showing more vaccine hesitancy. The numbers are quite dramatically different. Filipino staff are actually the lowest group [in terms of uptake].”

There are thousands of Filipino staff working in the NHS after heavy recruitment campaigns in recent years. In June, Nursing Times reported they had seen a disproportionately high death rate.

The meeting was told the trust would be sending a survey to staff to try to find out why they had not had the vaccine.

Several other trust chief executives in London told HSJ they had encountered similar issues.

One said: “Most of our white staff have been vaccinated and few of our BAME staff have. This is a real concern given that the majority of our hands-on clinical staff are black.”

Another in north London said: “I remain worried that the very groups who we’d want to have the jab are those refusing, both staff and patients. The reticence in the black community is real and deep and I worry health inequalities could grow.”

In August, Public Health England research found the risk of dying among those diagnosed with covid-19 was higher in several ethnic groups than among white British.

Royal College of Nursing general secretary and chief executive Dame Donna Kinnair said: “BAME health and care workers are doing all they can to keep their patients safe while facing a disproportionate risk from covid-19 themselves.

“As a member of the NHS Race and Health Observatory board, I am aware that some BAME staff have particular concerns in relation to the vaccine.

“While this isn’t the only reason take-up is lower than it should be, it is important that trusted clinicians take a community approach to discuss the mistrust that is targeting our communities.

Dame Donna added: “I’m proud the RCN is collaborating with other clinical leaders to support our communities. We are also working with the London School of Hygiene and Tropical Medicine on a comprehensive study to understand the views of frontline BAME health and social care workers.

“There can’t be any barriers to receiving the vaccine. It must be easy to access and available throughout the working day if we want to effectively protect health workers from this virus.”

Some have argued that a failure to prioritise black, Asian and other minority ethnic groups, and accessibility of the vaccine to them, is to blame for low uptake, as much as “hesitancy”.

In August, Reuters reported nearly a fifth of the people in the US trial of the Pfizer/BioNTech vaccine were black or Latino. Distrust factors in the US are thought to be linked to scandals like the Tuskegee Syphilis Study and the Henrietta Lacks case.

In October, UK researchers urged more people from BAME communities to volunteer for vaccine trials, with equalities minister Kemi Badenoch volunteering to be vaccinated. The BBC reported that of the 270,000 people enrolled in trials at that point only 7 per cent were BAME.

Yesterday the NHS Race and Health Observatory, a body hosted by the NHS Confederation, wrote to the Joint Committee on Vaccines and Immunisation calling for action on its demand for “accurate, live ethnicity data on vaccine uptake”.

In a statement today the observatory’s director Habib Naqvi said: “Black and minority ethnic staff in the NHS are some of the most at risk and vulnerable groups so we are concerned to hear of potentially low vaccine uptake levels.

“The NHS Race and Health Observatory is collaborating with the London School of Hygiene and Tropical Medicine, Public Health England and the Royal College of Nursing to urgently understand perceptions and experiences of vaccine uptake amongst the health and social care frontline workforce.”

NHS Employers, which represents NHS trusts and CCGs, said members were working to tackle the problem.

Managing director Rebecca Smith said: “NHS organisations are aware that some people from the black, Asian and minority ethnic community are hesitant about having the vaccine, and this includes some NHS staff groups.

“It’s vital to tackle misinformation head on, and the best advocates for vaccination will be staff who have had the jab themselves. Too many frontline staff and people from BME communities have already been disproportionately affected by the covid emergency and we must help spread the message that the vaccine is safe.”

British Medical Association council chair Chaand Nagpaul said where lower numbers of BAME staff are being vaccinated it was important for employers to look into why this is happening and take action to resolve it. He said we should ”not make the assumption that this is about vaccination hesitancy, but may be more about systems and communication.”

Unison’s head of health Sara Gorton said: ”NHS staff get information from many sources, so it’s important the vaccine communication plan reaches all the places they use.

“Health workers also need to be given time to ask vaccination teams about their concerns, talk to those who’ve had the jab and think things through. It can’t just be a use-it-or-lose-it opportunity.”

HSJ reported earlier this month Guy’s hospital was offering vaccination “on demand” to individuals, some of whom were not in eligible priority groups, for several weeks. It said in the board meeting this was down to the contact phone number being circulated in south east London.

Wol Kolade, chair of the Guy’s and St Thomas’s Charity and a member of the NHS Improvement board, spoke at NHSI’s joint board meeting with NHSE about work by the charity investigating uptake among different ethnicities so far, among the general population rather than NHS staff.

He said they found one barrier was trust of the NHS, including specifically “of local systems which is disappointing”.

He said who is “delivering the message” was important, including that “celebrity endorsers work up to a point, but not necessarily a full point”. Another problem was young people judging it was not “worth the risk” for them.

“We’ve got quite a challenge here,” he said and added: “Let’s be honest, the health service has not necessarily been a friend to many communities.”

Meanwhile, NHSE chief Sir Simon Stevens said it was not useful when looking at vaccine uptake to use “BAME” as a “single explanatory category”.

“There are different degrees of vaccine hesitancy and trust of public services among different communities,” he said. He said data with a full breakdown by ethnicities would be published today and was being shared with local authorities, and different ethnic groups needed to be considered separately, rather than as one.

NHSE’s vaccine programme director Emily Lawson said the service was “doing everything we can to make ‘access’ not ‘the issue’” in holding back covid vaccination rates especially among potentially excluded groups.