背景:边缘化群体的COVID-19疫苗接种率存在明显的不平等,一些少数民族和宗教团体的税率较低,年轻人,那些生活在更贫困地区的人,社会经济地位较低。现有的研究侧重于影响疫苗摄取的心理和社会经济因素,没有探索更广泛的社会和历史背景。了解COVID-19疫苗摄取的不平等需要对以下因素的驱动因素进行严格检查,和障碍,疫苗接种。
方法:我们介绍了在COVID-19大流行期间进行的一项共同设计的定性研究的结果。焦点小组和访谈用于检查大曼彻斯特对COVID-19疫苗接种反应的背景,特别关注边缘化的经历。使用专题框架分析来分析数据。
结果:我们发现,公众对COVID-19疫苗接种计划的反应与机构不信任和剥夺公民权的长期历史交织在一起,源于边缘化和社会不平等的经历。COVID-19大流行对少数族裔群体的不成比例的影响进一步加剧了这种情况,年轻人,以及那些有现有健康状况的人。
结论:少数群体经历的结构性不平等的历史引发了对疫苗接种背后机构动机的怀疑和怀疑。这凸显了对疫苗态度的情境分析的必要性,考虑到先前存在的不平等,这可能与概念化公众对疫苗接种计划的反应特别相关。最后,我们的研究显示了公众(非)信任可以影响公共卫生政策的重要方式。我们建议将其纳入对未来公共卫生危机的应对措施中。
BACKGROUND: There are clear inequalities in COVID - 19 vaccination rates amongst marginalised groups, with lower rates for some minoritised ethnic and religious groups, younger people, those living in more deprived areas, and with lower socio-economic status. Existing research focuses on psychological and socio-economic factors that influence vaccine uptake and does not explore broader social and historical contexts. Understanding inequalities in COVID-19 vaccine uptake requires a critical examination of the drivers of, and barriers to, vaccination.
METHODS: We present findings from a co-designed qualitative research study undertaken during the COVID-19 pandemic. Focus groups and interviews were used to examine the context underpinning responses to the COVID-19 vaccination in Greater Manchester, particularly focussing on experiences of
marginalisation. Thematic framework analysis was used to analyse the data.
RESULTS: We found that the public\'s responses to the COVID-19 vaccination programme are intertwined with a longstanding history of institutional distrust and disenfranchisement, resulting from experiences of
marginalisation and social inequalities. This was exacerbated further by the disproportionate impacts of the COVID-19 pandemic on minoritised ethnic groups, younger people, and those with existing health conditions.
CONCLUSIONS: Histories of structural inequalities experienced by minoritised groups invoked feelings of suspicion and scepticism at the motivations of the agencies behind the vaccination rollout. This highlights the need for a contextualised analysis of attitudes to vaccines, considering pre-existing inequalities, which may be especially relevant for conceptualising public responses to the vaccination programme. Finally, our study shows the important ways in which public (dis)trust can impact public health policies. We recommend this should be incorporated into responses to future public health crises.