The social lives of the SARS-CoV-2 vaccines: A qualitative study of vaccine understandings and decision-making among people of Black ethnicities in London, UK

Abstract

Background

In the first two years of the COVID-19 pandemic, people of Black African and Black Caribbean ethnicities were among the groups most likely to acquire COVID-19, and to develop serious infection, but were also the least likely to have received a SARS-CoV-2 vaccine. Our aim was to explore SARS-CoV-2 vaccine understandings and decision-making among people of Black ethnicities in order to understand the complex drivers of vaccination disparities.

Methods

We conducted six online and face-to-face focus group discussions with thirty-six participants of Black ethnicities in London, UK. Topic guides were developed with our community partners and covered impact on daily lives, experiences of COVID-19, knowledge and beliefs (including about prevention measures), and healthcare seeking behaviour and perceptions.

Results

Participants described how their relationships with SARS-CoV-2 vaccines were entangled with their belonging to religious communities; how painful histories of medical experimentation on Black people had reemerged in the context of concerns regarding vaccine safety; and how present realities of medical racism and global vaccine inequity shaped their understandings of the vaccines.

Conclusion

Our account problematises “vaccine hesitancy” and the hegemonic belief that this is a direct consequence of a lack of knowledge or education. Instead, by engaging with “social lives” of the SARS-Cov-2 vaccines, we trace the rich meanings ascribed to vaccination, and complex and active negotiations around vaccination, among participants. Public health practitioners and policymakers should move beyond conceptualising vaccine hesitancy as irrational or ill informed, and instead acknowledge how such decisions are situated within a wider social, historical and political landscape.