Vaani Kaur* from Newcastle, doesn’t want the coronavirus vaccine. Kaur has heard on the grapevine, mainly via Whatsapp forwards and social media, that there are risks to women regarding their future fertility. The information, she says, began spreading in her digital circles in December and now is cited in conversations with family and friends, as well as online.
The 30-year-old is from a Sikh family and says there are “huge pressures” on her to have children, especially boys, making it her priority when considering any decision. “I cannot afford to risk my chances of pregnancy if this vaccine is dangerous for women who want children,” Kaur told The Independent. As a result she does not plan to take the jab.
The government and NHS say there are no such known risks or danger to fertility, or to pregnancies. But it is currently not vaccinating pregnant women because there have not yet been specific clinical trials on them. The World Health Organisation (WHO) also warned against pregnant women having the Moderna vaccine, again because of lack of data (trials are pegged to start after the first quarter of 2021) not because they anticipate problems. It is usual practice not to recommend until clinical data is available.
The evidence that is available, from the Pfizer vaccine, was reviewed by the Medicines and Healthcare products Regulatory Agency (MHRA) and separately by WHO, and regulatory bodies in the USA, Canada and Europe, and has raised no concerns about safety in pregnancy.
On 27 January, Professor Jonathan Van Tam, deputy chief medical officer, told Channel 4 News that the coronavirus vaccine having an impact on fertility was an “unfounded rumour” and there was no basis he knew of in vaccine evidence. The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists (RCOG) issued a joint statement to confirm there is “no evidence to suggest that Covid-19 vaccines will affect fertility” and that such claims were “speculative” and “not based on data”. But the message isn’t filtering down.
Like Kaur, Deana Uppal, 31, from London also says she doesn’t feel enough testing has been done to feel safe taking the jab. “I need reassurance from the government that the vaccine is safe and can in no way affect future fertility,” she says. “The fake news and myths haven’t helped and have caused tremendous doubt and fear in my mind.”
All three vaccines – Pfizer, Oxford, and Moderna – that are available as part of the NHS rollout have been extensively tested (the Pfizer trial included over 43,000 people, 24,000 for Oxford and 30,000 for Moderna). The Vaccine Knowledge Project also shared the extensive steps, and number of official bodies, that vaccines have to go through in order to be rolled out. It has also provided an explanation for the historically unprecedented speed of this vaccine: money, pre-existing technology, high numbers of volunteers and collective interest (experts have said that in other trials there are often long waits or periods “of nothing” between trials, time spent applying for grants or working with manufacturers).
Despite this explanation and evidence of the vaccine’s safety, almost one-fifth (19 per cent) of Black and Asian people polled by the 1928 Institute – a think tank led by academics from the University of Oxford – said they were unsure about taking a vaccine, or would decline it. Other polling by the Royal Society of Public Health found BAME groups are less likely to want the vaccine than white counterparts. More than 76 per cent of the population as a whole would take the jab, but this drops to 57 per cent in minority ethnic communities. And just 55 per cent in Asian respondents. British Indians are the largest ethnic minority group in the UK.
And this is now playing out in real time. A study released on 28 January, from Oxford University and the London School of Hygiene found black people over the age of 80 were half as likely as their white peers to have been vaccinated against Covid by 13 January. This is despite being four times more likely to die from Covid-19 than their white peers. The problem could be even worse in some areas: a study by the Mile End Institute at Queen Mary University found only 39 per cent of ethnic minority Londoners were likely to take the jab.
Some say they are concerned that the jab is not vegetarian or halal, and some would rather it went to someone in more need, according to the 1928 Institute. But we also cannot ignore the long history of medical racism that has built a climate of distrust in these communities. NHS doctor Dr Ranj Singh explains: “One reason for not taking the vaccine is because of how BAME people have been treated in the past.”
Modern examples of this include black women being four times more likely to die in childbirth than white women. And black men are 40 per cent more likely to access mental health treatment through the police or criminal justice route, with white people twice as likely to be given mental health treatment. Kiran Kaur Manku, research fellow in global health at the University of Oxford, told The Independent: “Often, [people] feel as though their symptoms aren’t taken seriously, and so they need to exaggerate and self-advocate. One [person] mentioned [their] Lupus went undiagnosed for a long time as their symptoms did not manifest as written in textbooks.”
It is this legacy of poor treatment, as well as modern healthcare discrimination, that makes BAME people hesitant around new medical offers, says Dr Winston Morgan, an academic from the University of East London. “For the black community in particular, when the vaccine was first proposed, hesitancy was primarily based on genuine reservations triggered not just by knowledge of historical events, but by people’s current experiences with medical and health services around poor treatment,” he says. “If you remember, there were lots of suggestions that BAME groups should be the first to get this new vaccine and that is worrying as these groups tended to be at the bottom of the list for medical treatment and outcomes.”
Dr Nikita Ved, cofounder of the 1928 Institute and research fellow at Oxford University, says that it isn’t just the past that is clouding some people’s judgement – they are also dealing with modern misinformation, spread rapidly via technology. She says: “This [reluctance] is partly because of a flurry of misinformation being spread. The community has been specifically targeted through social media, texts and WhatsApp.
“It seems that the Indian/South Asian population have been really falling prey to [misinformation] through things like WhatsApp forwards. And a lot of it seems to be directed at fertility, which is, I think, very interesting because there is no evidence to suggest that the vaccine causes fertility issues. There’s nothing to say that at all. This has not been proven. And so, it’s just preying on people’s fears and insecurities because of course, again, not just within the Indian community but across many communities, infertility is still somewhat stigmatised.”
Jade Ria Talsania, 27, from Watford is also scared of taking the vaccine. “We do not know what is in the vaccine and what it may do to our bodies,” she said. “It scares the life out of me. I’m petrified of what it could do to my body. Will it stop me from having children in the future?”
The World Health Organisation (WHO) explains the vaccine “[works] by training and preparing the body’s natural defences – the immune system – to recognise and fight off the viruses and bacteria they target. If the body is exposed to those disease-causing germs later, the body is ready to destroy them, preventing illness”. The only side-effects one can expect of the vaccine are a heavy arm, feeling tired and achey. The vaccine is safe even if you have immune system problems and you cannot catch coronavirus from the vaccine.
Talsania did emphasise that she finds it harder to trust the government because of other areas of coronavirus policy. “It’s hard to trust the government completely. They haven’t shut down borders, they created Eat Out To Help Out, it’s a shambles,” she says. Professor Sophie Harman, Professor of International Politics and Global Health Expert at Queen Mary University of London, said: “Vaccine hesitancy can be influenced by a whole range of factors. Where someone gets their news sources, trust in government or authority, discrimination in society and the health sector, and historical legacies of medical science.”
In a bid to address this issue, Dr Ved says there needs to be a public health campaign to dispel the myths, particularly misinformation around pregnancy and fertility. This would include messaging in different languages and co-produced with community leaders. Some celebrities, including Adil Ray, Meera Syal, Ranvir Singh, comedian Romesh Ranganathan, Sadiq Khan and others teamed up on a public health video they called: “If you could save someone’s life”.
Of course there are people who are happy to get the vaccine. Ola Odu, 23, from Bedfordshire, recently lost her uncle to Covid-19. “I can’t wait! It’s so important that we all get this vaccine as soon as possible,” she said. “I’ve seen the strain it’s had on my loved ones who work in healthcare and have sadly lost family members to Covid. The benefits far outweigh the risks.”
And 80-year-old Gurdial Singh Sadra from Redbridge already had his vaccination in December. “I had the Pfizer vaccine last month and wasn’t worried about having it,” the 80-year-old said. “People should take the vaccine as it’s there to protect us and save lives.”
Ultimately the experts believe that getting this right is all about the messaging to these vulnerable communities. Dr Morgan is optimistic that the tide could be turned with a proactive effort to do so: “I still believe that if we get the messaging right and get the right people to deliver it, then the vast majority will say yes.”
Minister for Covid vaccine deployment Nadhim Zahawi said that in a bid to combat misinformation the NHS is “working closely” with these communities. “To support those receiving a vaccine and help anyone who may have questions about the vaccination process.” As part of this they are engaging faith and community leaders to give them advice and information about the universal benefits of vaccination.
It is clear that the lower number of people in these communities wanting to get the coronavirus vaccine should be a cause for public health concern, not only as it leaves people unprotected but fails to address the existing evidence that black and Asian minority ethnic people are dying in higher numbers. But with a legacy of medical racism and lack of effective public health messaging reaching out to rebuke myths and misinformation, it is an uphill battle, and any successes might come too late.
*Some names have been changed
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