Vaccine only part of building trust with communities, says Professor Kevin Fenton


The vaccine is only one part of building wider trust between communities and health services according to Professor Kevin Fenton.

Speaking yesterday at a discussion on the covid-19 vaccine hosted by Westminster Council, the Professor emphasised the need for trust with communities to be built, as the concerns about vaccine hesitancy have continued to grow.

“How do we build trust? It’s about having conversations. It’s about authentic listening; it’s about actually making a change.

He added, “If people are saying here’s what we need to protect ourselves in our communities, then we need to see those changes as well. The vaccine is one part of it”.

“We’ve also seen many other advances as well in terms of treatment and testing and vaccination support. There’s much more we can do to get that support to communities. I am certainly committed to doing that in London but we need to also think of how we change this.”

In addition to Professor Fenton, the discussion included contributions from Dr Sonya Abraham, Serena Simon, Dr Shelia Neogi, Eddie Nestor and was moderated by OBV CEO Lord Simon Woolley.

Among the topics discussed was the impact in which the pandemic has been having on health workers.

Dr Sonya Abraham stated the people within the health services were ‘being worn down’ and spoke frankly on the wellbeing of NHS staff at present:

“This has been going on a long time now. Colleagues have been lost - some of them forever, colleagues have been impacted and people are working hard 24/7. The NHS is wonderful. We’ve always provided 24/7 care, but the amount of care that’s needed now is way more than the actual workforce that is out there to can provide. So they’re tired and it’s having a huge impact.”

Structural issues at play

Naturally, the structural issues which resulted in people from minority backgrounds being disproportionately hit was a constant theme throughout the discussion.

Eddie Nestor was the first to emphasize this, pointing to the types of jobs people from minority communities do as having a significant impact. For Eddie, the impact that has occurred within these communities has had a distinctly political aspect to it.

Serena Simon, programme director of Regeneration and BAME Network Chair at Westminster Council mirrored this. She stated that the conditions leading to a disproportionate impact are caused by structural inequalities.

“It’s about what type of jobs our communities are in. How exposed are they to being on the frontline, in jobs where their employment is tenuous? People in the community I serve in my regeneration programme are saying to my staff that they’re fearful of going to take a test to see whether they have covid because what’s going to be the next step after that if they’re positive. Are they going to lose the tenuous employment they have that’s bringing food and money in?"

Serena Simon, programme director of Regeneration and BAME Network Chair at Westminster Council

Lack of trust and misinformation still serious issues

Ultimately, at the heart of the discussion were the issues of trust and misinformation. This was behind health officials sounding the alarm on the low takeup of vaccines within minority communities. Professor Kevin Fenton recognized longstanding historical issues that have disadvantaged communities as contributing to this.

Eddie Nestor commented that the effectiveness of the videos spreading misinformation is heavily reliant on the existing sense of distrust. “myths and hard truths circulate within a vacuum of distrust”. He added that the sentiment which had come up in conversation with a friend was essentially that of, “you disbelieve those you don’t trust and believe people that you don’t know”

Dr Sonya Abraham framed it as being a long-term issue which had existed prior to the existing pandemic: “We know that the uptake in our communities was low even before covid-19 - the flu vaccine, MMR, measles, mumps, rubella. One of my hopes is that going forward these will also be righted, and that covid is our stimulus to do this.”

Serena Simon believed that more opportunities for the community to be open about their concerns without ‘fear of being judged’ were integral to addressing the issue.

While the reasons behind the low uptake in vaccines among individuals from minority backgrounds remains a matter of discussion, recent studies suggest that vaccine hesitancy is very much real. A poll of 2000 adults at the end of last year by The Royal Society for Public Health showed that three quarters of people (76%) would willingly take a covid vaccination. However, this figure fell to 57% when only considering respondents from minority ethnic backgrounds. 

Key takeaways

GPs are still there and willing to help | Sheila Neogi spoke of how digitalizing parts of medical work due to the pandemic precluded many older Asian and Black people from accessing their GPs. The long queues she used to have at her practice may now have gone due to complying with covid-19 measures, but she stressed that people were still welcome to see their Doctors

“We can’t have people in crowds getting seen so we’ve had to do telephone, video, whatever, but we haven’t actually closed our doors and I think this is what a lot of the public need to realize. GPs are still there, you can access us and you can come in.”

Dr Shelia Neogi, Senior Partner and GP, Pimlico Health at the Marven Surgery

'Data has been peer reviewed' | Part of the hesitancy surrounding vaccines has hinged on two issues. Firstly, data from clinical trials has been absent from discourse on the virus and when it has been present, it has often focused on headline grabbing side effects which are present in the development of any drug.

Secondly, the speed at which vaccinations have been confirmed has also led to understandable anxiety. For many, this has seemed questionable because of the protracted time it usually takes for vaccines to receive authorization.

According to Dr Sonya Abraham much of the data has been published in peer-reviewed journals. She offered further perspective for listeners stating that where the first phase of trials largely focused on safety, the second phase continued to focus on safety but with greater importance placed on the efficacy of vaccines. She added that the regulator MHRA (Medicines and Healthcare products Regulatory Agency), had vigorously looked at data before making their decision to authorise any vaccine.

According to Dr Abraham the reduced time for the vaccine was also impacted by the absence of stopgaps between reviews and regulations.

Evidence provided from clinical trials is another important part of the authorization process. A lack of it can be a very big problem in clinical trials and attempts to license drugs. However, she notes that the willingness of people to involve themselves at this stage has helped to accelerate the process: “What’s been amazing with covid is that lot people have gotten up and said I will be part of the trail, so that’s allowed for a lot of acceleration.”

Professor Kevin Fenton also added that resources have been put into the manufacturing of the vaccine that ‘far exceeds anything we’ve seen before.’

Age, the big determinant | Professor Fenton addressed the view which suggested that black people were being put first for vaccination. He stressed that the government’s current strategy had been to prioritise age.

“The government has been clear that the strategy is to work by age because age is the strongest determinant of your likelihood of having the severe disease or dying from the disease. So age, as well as people who are clinically vulnerable, are the things that are being prioritised in the first phase.”

Professor Kevin Fenton, London regional director at Public Health England

On side effects | Dr Sonya Abraham assured that vaccines were ‘one of the safest therapeutic medicines’. “We know of general side effects and they occur here as well. When you have it you may have local reactions around where you had the injection - you may be a bit sore, you may get temperatures. To date, there have been no serious adverse events apart from, and I know people are probably worried about this, anaphylactic reaction. You can get this from any drug.

She added that: “if you are high risk or concerned about your medical issues [then] when you go to have the vaccine, talk because the people who are vaccinating [you] have been given the training to understand what the relative risks are”.

Mayowa Ayodele


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