Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; College of Business, Arts and Social Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex UB8 3PH, United Kingdom.
Vaccine. 2023 Jun 13;41(26):3891-3897. doi: 10.1016/j.vaccine.2023.04.080. Epub 2023 May 1.
Many people refuse vaccination and it is important to understand why. Here we explore the experiences of individuals from Gypsy, Roma, and Traveller groups in England to understand how and why they decided to take up or to avoid COVID-19 vaccinations.
We used a participatory, qualitative design, including wide consultations, in-depth interviews with 45 individuals from Gypsy, Roma, and Traveller, communities (32 female, 13 male), dialogue sessions, and observations, in five locations across England between October 2021 and February 2022.
Vaccination decisions overall were affected by distrust of health services and government, which stemmed from prior discrimination and barriers to healthcare which persisted or worsened during the pandemic. We found the situation was not adequately characterised by the standard concept of "vaccine hesitancy". Most participants had received at least one COVID-19 vaccine dose, usually motivated by concerns for their own and others' health. However, many participants felt coerced into vaccination by medical professionals, employers, and government messaging. Some worried about vaccine safety, for example possible impacts on fertility. Their concerns were inadequately addressed or even dismissed by healthcare staff.
A standard "vaccine hesitancy" model is of limited use in understanding vaccine uptake in these populations, where authorities and health services have been experienced as untrustworthy in the past (with little improvement during the pandemic). Providing more information may improve vaccine uptake somewhat; however, improved trustworthiness of health services for GRT communities is essential to increase vaccine coverage.
This paper reports on independent research commissioned and funded by the National Institute for Health Research (NIHR) Policy Research Programme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or its arm's length bodies, and other Government Departments.
许多人拒绝接种疫苗，因此了解他们拒绝接种的原因非常重要。在这里，我们探讨了英国吉普赛、罗姆和游民群体中个体的经历，以了解他们是如何以及为何决定接种或避免 COVID-19 疫苗。
我们采用了参与式、定性设计，包括广泛的咨询、对来自英国五个地点的 45 名吉普赛、罗姆和游民社区的个体进行深入访谈（32 名女性，13 名男性）、对话会议和观察，时间为 2021 年 10 月至 2022 年 2 月。
总体而言，疫苗接种决定受到对卫生服务和政府的不信任的影响，这种不信任源于先前的歧视以及在大流行期间持续存在或恶化的医疗保健障碍。我们发现，这种情况不能用标准的“疫苗犹豫”概念来充分描述。大多数参与者至少接种了一剂 COVID-19 疫苗，通常是出于对自己和他人健康的担忧。然而，许多参与者感到被医疗专业人员、雇主和政府的信息强行接种疫苗。一些人担心疫苗的安全性，例如对生育能力的可能影响。他们的担忧没有得到医疗保健人员的充分关注，甚至被忽视。
在过去，权威机构和卫生服务部门被认为是不可信的（在大流行期间几乎没有改善），因此，标准的“疫苗犹豫”模式在理解这些人群的疫苗接种率方面用处有限。提供更多信息可能会在一定程度上提高疫苗接种率；然而，提高 GRT 社区对卫生服务部门的信任度对于提高疫苗覆盖率至关重要。
本文报道了由英国国家卫生研究所（NIHR）政策研究计划委托和资助的独立研究。本文中表达的观点是作者的观点，不一定代表 NHS、NIHR、英国卫生部和社会关怀部或其附属机构以及其他政府部门的观点。
