“I haven’t had the vaccine yet and I’m not sure if I will,” said Sharna Marie. The 20-year-old from Birmingham, the UK’s second-largest city, has a genetic condition that makes her worried about how the jab would affect her.
“I’m not sure what’s in it, how it was made so quickly,” she said, explaining that she is a carrier of sickle cell disease, a hereditary blood disorder that largely affects the people of African and Caribbean descent.
Even after all Covid restrictions in England were lifted last month she said she would not be rushed into a decision. “Maybe I’ll get it in a couple of years, I just want more time to assess.”
Ministers have hailed the national vaccination program as a great success. But as the UK enters the next stage of the pandemic, there is urgency among health and government officials to reach out to the estimated 8.5 per cent of people aged 12 and over who remain unvaccinated.
Public health teams are trying to understand why certain pockets of the population are still reluctant to come forward, in particular pregnant women, the under-30s and some ethnic minority groups.
Since the national vaccination program began in December 2020, more than 52.6mn people in Britain, or 91.5 per cent of the population aged 12 and above, have had at least one Covid jab.
According to an Financial Times analysis, the UK vaccination campaign ranks 12th globally, measured in terms of third doses administered per 100 people. “The vaccine campaign has been an overall success but there is no room for complacency,” said one Whitehall official.
For expectant mothers, the risks of remaining unvaccinated are stark. Around 98.7 per cent of those admitted to intensive care with coronavirus between February 1 and September 30 2021 were unvaccinated, according to official data. And yet, 41.3 per cent of women giving birth have only had one dose.
Campaigners such as Joeli Brearley, founder and chief executive of Pregnant Then Screwed, a charity that supports pregnant women, have argued that initial problems with the program’s rollout have led to lasting confusion over whether to have the jab.
Pregnant women were advised in December 2020 against having the jab, only for that advice to be reversed the following April. Brearley said many expectant mothers were still struggling to get clarity.
In a survey by the charity of nearly 4,000 pregnant women, 42 per cent said speaking with a medical professional had made them question the safety of the vaccine. Others reported being turned away from vaccination centers or were told to take their concerns to their GP.
Allana-May Brelsford, 23, went for a jab in May last year but said the “panicked” response of staff when they found out she was 35-weeks pregnant with her second child put her off.
“I was looking at my daughter and my pregnant belly, thinking, ‘if I go through with this, what about the potential harm to them?'” She said, adding that she was keen to get the vaccine at some point.
In December, the Joint Committee on Vaccination and Immunization, the government advisory body, prioritized the group for the jab. Dr Bola Owolabi, director of health inequalities at NHS England, said that “measures to boost uptake among expectant mothers” would include midwife-led pop-up centers and women’s only vaccine appointments.
More generally, raising vaccine rates in big cities remained a challenge, health officials said. “Our [urban] populations tend to be younger, more ethnically diverse, have more mobile populations and face more deprivation, ”said Dr Justin Varney, director of public health for Birmingham.
In Britain’s second-largest city, under-25s make up nearly 40 per cent of the city’s 1.1mn population. “We have just over 230,000 individuals aged 18-29, but only about 130,000 people have been vaccinated,” said Varney.
Younger people in Birmingham list various reasons why their cohort was more reluctant to have the jab. “I think a lot of people are worried about fertility in women and men,” said 19-year-old Kate Mitchell. The apprentice, who is fully jabbed, said social media campaigns encouraged younger people to come forward.
Meanwhile, 18-year-old Ava Bennett-Evans, also fully vaccinated, noted that scrapping vaccine passports might have disincentivised some peers. “People sort of thought – what is the point of getting jabbed?”
Usman Khan, a 19-year-old college student who is unvaccinated, thinks that clearer medical information would encourage uptake. “The way the information has been presented makes it hard to understand,” he said.
Attempts to boost uptake rates among ethnic minority communities has proved even more challenging. According to the Office for National Statistics, 40 per cent of adults in England identifying as either black Caribbean, black African or Pakistani had received three vaccinations by the end of 2021, compared to 68 per cent of white Britons.
“One of the key issues – that has come up again and again throughout the pandemic – is the concept of trust”, said Dr Habib Naqvi, director of the NHS Race and Health Observatory.
Health leaders are working with community groups to better understand people’s safety concerns. Amin Tarbiat, who works at Moulana, an Iranian community group in Liverpool, helps to translate health materials and counter fake news about the jab. “The council knew that we were trusted more than local authorities”, the 63-year-old said.
In Londonwhich has lagged behind the country in terms of vaccination rates, officials have taken the program into unvaccinated communities.
In Westminster, where just 39 per cent of all those over 12 have been triple jabbed, the council is using a minibus as a pop-up vaccination centers. “We offer information in different languages and have stressed the fact that we can offer the jab to undocumented [people]”Damien Carmody, operations lead for the pop-up center, said.
Some believe that the vaccine rollout has demonstrated the need to rethink the interaction between health services and some communities. “What Covid – both the infection rates and immunization uptake – has highlighted is just how stark health inequalities are,” said Dr Andrew Steeden, GP borough lead for north-west London.
Steeden also reiterated the importance of not just talking to people, but collaborating with marginalized communities. “It is about really co-designing services going forward.”