Black communities are at risk of bearing the brunt of the UK’s third wave of Covid infections, according to senior doctors who said efforts to vaccinate the most vulnerable people in certain ethnic groups must be redoubled to improve their protection.
The success of the NHS vaccine rollout is central to the government’s decision to move ahead with further easing of Covid restrictions on 19 July. But headline figures which show at least 90% of over-65s in England have had two doses of vaccine mask the fact that some ethnic groups have far lower levels of protection.
The latest tracking by researchers from the University of Oxford using the OpenSafely health records platform reveals vaccine coverage in black communities is at least 20 percentage points lower than in white groups. The disparity exists in the most vulnerable over-80s and appears to widen further in younger groups. Vaccine coverage among south Asians is roughly halfway between that seen in the black and white populations.
While some early gaps in vaccine coverage have narrowed over time, for example among people with learning disabilities, and Bangladeshi groups, coverage has remained stubbornly low among black groups.
“The key issue is that particularly in black ethnic populations, the vaccination coverage has been lower and we need to do as much as possible to try and increase that,” said Kamlesh Khunti, a member of the government’s Scientific Advisory Group for Emergencies (Sage) and professor of primary care diabetes and vascular medicine at the University of Leicester.
“We’ve done a great job on vaccinations, but there are pockets of difference particularly among deprived populations and black communities. We really have to be cautious. We could certainly end up widening the inequalities we’ve already seen.”
Throughout the Covid crisis, doctors have warned that the pandemic has been more deadly for people from black and Asian backgrounds than white people, with the Office for National Statistics naming jobs and living arrangements as major factors. Low vaccine coverage among the most vulnerable people in those communities now threatens to exacerbate the danger.
“We saw in the first wave, before vaccines, some very marked ethnic disparities in the impact of major disease. That was bad enough, but to see those very groups that have the most to gain from vaccination – because they have the highest risk of severe disease – being the groups with lower vaccination coverage is very disturbing,” said Liam Smeeth, a GP and professor of clinical epidemiology who next month becomes the new director of the London School of Hygiene & Tropical Medicine.
“We need to redouble our efforts to ensure that people really are being offered slots for vaccines at times they can easily get to, in places they can easily get to, to make sure people really are given every opportunity to opt in and get the vaccine,” he said.
While two doses of the Oxford/AstraZeneca or Pfizer vaccines provide more than 90% protection against hospitalisation from Covid, the vaccines do far less to prevent infections, so as England loosens its restrictions cases are expected to surge into the summer.
Khunti said people who made a conscious decision not to get vaccinated should have clear instructions on how to reduce their risk of disease in other ways, through the continued use of face coverings, social distancing and other measures.
Dr Chaand Nagpaul, the chair of the council of the British Medical Association, said it was important “not to get lost in the statistics” and forget there are large numbers of unvaccinated and vulnerable people in some ethnic groups, such as the black population.
“In the coming months, given the government’s approach, if we are to see infection rates go from 35,000 to 100,000 per day, the risks to those who are the most vulnerable in society gets greater,” he said. “As you start to see infection rates rising, it will be the most vulnerable who will be hit hardest, and that will include those who are unvaccinated.”