COVID-19 Vaccine Hesitancy, Medical Mistrust, and Mattering in Ethnically Diverse Communities

Objectives: Uptake of the COVID-19 vaccine continues to be lower in ethnically diverse communities in the UK even though they are disproportionally affected by the negative effects of the virus. To better understand why uptake is lower, we explored factors that may underpin vaccine hesitancy and intention to vaccinate in these communities with an emphasis on medical mistrust and feelings of mattering.

Design: One hundred and sixty-one adults from ethnically diverse backgrounds who had not had a COVID-19 vaccination completed an online questionnaire that contained closed (quantitative) and open (qualitative) questions.

Results: Analyses of quantitative questions revealed that medical mistrust, but not feelings of mattering, was related to COVID-19 hesitancy and likelihood of getting a COVID-19 vaccination. Of the three components of medical mistrust, suspicion was the only unique predictor and was related to higher hesitancy towards the COVID-19 vaccine and lower likelihood of getting a COVID-19 vaccine. Analyses of the responses to the qualitative questions were organised into four themes: (1) Beliefs that taking the vaccine is an important social responsibility; (2) Experiences of pressure to take the vaccine and limited choice; (3) General mistrust linked to personal experiences and the health system; (4) Being concerned about social/medical restrictions if not vaccinated.

Conclusion: The findings suggest that medical mistrust may partly explain why uptake of the COVID-19 vaccine is lower in ethnically diverse communities in the UK and appears to play a role in how people weigh a sense of responsibility and pressure against health and social concerns in making the decision to be vaccinated.