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Vaccine hesitancy: UK booster campaign must reach out to pregnant women and people in ethnic minority groups

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With booster jabs forming the backbone of the UK’s omicron efforts, it’s more important than ever to reach out to pregnant women and people from ethnic minority groups who may be more likely to have concerns over vaccination



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| Analysis

24 December 2021

A mass vaccination hub at Stamford Bridge stadium in London on 18 December

WIktor Szymanowicz/NurPhoto/Shutterstock

The UK is one of the least vaccine hesitant countries in the world, with close to 90 per cent of over-12s in the UK having received at least one coronavirus vaccine jab. But with the country relying heavily on a booster campaign in its efforts to fight the omicron variant, it is more important than ever to reach out to communities where concerns over vaccination are more common, such as pregnant women and some ethnic groups.

Studies suggest that people from ethnic minority groups are more likely to be vaccine hesitant due to historical racism and a lack of trust in the government and medical establishment. About 95 per cent of white over-50s in the UK had received two doses of a coronavirus vaccine by the end of November, compared with just 65 per cent of people in the UK aged over-50 who are of Black Caribbean descent.

When it comes to the booster roll out, the latest UK information collated from GP records up to 15 December suggest that 93 per cent of white over-80s who were due to get a booster had received one. This figure is 75 per cent for Black over-80s and 79 per cent for South Asian over-80s.

Winston Morgan at the University of East London says that communication around the booster campaign needs to be clearer. “Rolling out a huge booster without explaining the difference between the initial vaccination and a booster will cause confusion in many,” he says. “It will reinforce a lot of fears.”

Morgan says a similar lack of nuance slowed down the roll out of the first jab. “The original campaign didn’t really assume that there’d be a large number of people who didn’t take the vaccine,” he says. “It wasn’t very sophisticated.”

Doubts about efficacy

The booster roll out will require similar or even stronger efforts. “I keep getting patients who mention that they have serious doubts about the efficacy of the vaccines because it seems like it doesn’t prevent the spread of infection,” says Mohammad Razai at St Georges, University of London. “They ask – if it doesn’t prevent the spread of infection, why would I take it?” he says.

Early studies suggest that two doses of a coronavirus vaccine provide substantially less protection against infection with the omicron variant, but a third dose may largely rectify this. It is thought that two doses probably still offers some protection against severe disease.

Mixed government messaging may also be a problem. “Telling everyone in the summer to remove their face masks and essentially saying that the pandemic is over… and now saying that everyone needs a booster – it erodes trust,” says Razai.

Another group where vaccination uptake is low has been pregnant people. In October, NHS England and the Royal College of Obstetricians and Gynaecologists called for pregnant women to get vaccinated, following the release of data that showed that nearly 20 per cent of the most ill covid-19 patients were unvaccinated pregnant women.

Coronavirus vaccines were not offered to pregnant people who would otherwise be eligible in the UK until April 2021, once it had become clear that the vaccines are safe for use in pregnancy. The UK’s Joint Committee on Vaccination and Immunisation (JCVI) then advised that covid-19 vaccines should be offered during pregnancy, but while this cleared the way to offering the vaccine, much official guidance stopped short of explicitly recommending it.

“I think that pregnant women very rightly question what they’re putting into their bodies, such as alcohol and caffeine,” says Sarah Hillman, a GP and a clinical lecturer at Warwick University in the UK. “It makes sense why they may be hesitant about a vaccine.”

On 17 December, the JCVI put pregnant women on the priority list for booster jabs. “Even though it came as the government essentially started offering everyone the jab, it means patients have another trusted source of information saying that the vaccine is safe,” says Hillman. “It’s important.”

While the reasons for vaccine hesitancy in people from ethnic minority groups or who are pregnant differ, the methods to combat it are largely the same when it comes to the booster campaign.

Trusted messengers

During pregnancy, people need to be hearing the same message repeatedly from those that they trust, says Hillman. “We need better messaging for healthcare professionals,” she says. “So that pregnant women feel safe because they’ve been told by the midwife and then by the GP, and when you’re hearing the same message over and over – hopefully that will make a difference.”

Razai agrees that GPs have a key role to play in reaching out to those who are most hesitant. “GPs know patients and know their families,” he says. “They can have discussions around the vaccine based on trust.” Walk-in vaccination sites are convenient, says Razai, but “convenience is not a major issue for vaccine hesitant people”.

Walk-ins also don’t work for the large group of people who live in digital poverty, says Razai. “The only way to reach these people is via telephone or post,” he says.

When it comes to those most fearful about the vaccine, giving up on them isn’t an option, says Liz Carnelley at Near Neighbours, a charity that has been working with the government to help vaccinate people from minority groups.

Tens of thousands of people are currently getting their first doses of vaccine, says Carnelley. “We’re still putting in the work to convince people.”

“There’s always more we can do,” she says. “But I think the gradual drip, drip, drip and engaging with people who’ve got reasonable questions is the best way to persuade people.”

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Solar storms may cause up to 5500 heart-related deaths in a given year

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In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart



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17 June 2022

A solar storm

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Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus

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Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer

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Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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