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COVID-19: UK’s colour-blind vaccine allocation strategy putting ethnic minorities at higher risk of illness and death

Omitting ethnic minorities from the vaccine priority list is putting these groups at a significantly higher risk of COVID-19 illness and death. Public health doctors, writing in a commentary published by the Journal of the Royal Society of Medicine, say that the UK’s colour-blind vaccination model disregards the unequal impact of the pandemic on minority ethnic groups and is worsening the racial inequalities that the pandemic and the wider governmental and societal response have harshly exposed and amplified.

The commentary describes how COVID-19 has disproportionately affected Black, Asian and Minority Ethnic (BAME) groups, resulting in higher rates of infection, hospitalisation and death. People from minority ethnic groups are more likely to live in crowded and multi-generational households where there may be increased risk of transmission. They also comprise a higher proportion of the high-risk and low-paid essential workers, especially in urban areas, thereby increasing their risk of exposure to COVID-19.

Calling for targeted vaccination of all high-risk groups, the lead author of the commentary, Professor Azeem Majeed, of the Department of Primary Care & Public Health at Imperial College London, said: “Prioritising essential workers for vaccination will preserve the healthcare system, accelerate re-opening of society, help revive the economy and enable the operation of essential community services.”

He continued: “If insufficient numbers of individuals from BAME communities are vaccinated, the virus will continue to spread amongst these groups, putting the general population at risk.”

The authors say that ineffective vaccine allocation strategies are likely to play a role in the high levels of vaccine hesitancy observed across ethnic minorities. The UK Government’s Scientific Advisory Group for Emergencies (SAGE) has highlighted the significant risk of low COVID-19 vaccine uptake in ethnic minorities, advising better understanding of the barriers that contribute to low uptake.

Prof Majeed said: “Lack of trust in some ethnic minority communities as a result of cultural and structural racism, low confidence in the safety and efficacy of the vaccines, and limited endorsement from trusted providers and community leaders are likely to be key factors.” He went onto describe lack of vaccines, transport access and inconvenience of appointments as other factors hindering vaccine uptake in these communities.

Prof Majeed concluded: “Dismissing the racial and socioeconomic disadvantages that ethnic groups face may result in devastating impact lasting far beyond the end of the pandemic. Controlling further outbreaks and, ultimately, ending the pandemic will require implementation of approaches that target ethnic minorities as well as ensuring vaccine allocation strategies are effective, fair and justifiable for all.”

Notes to editors

COVID-19 vaccine allocation: addressing the United Kingdom’s colour-blind strategy (DOI: 10.1177/01410768211001581) by Tasnime Osama, Mohammad S Razai and Azeem Majeed, will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Wednesday 10 March 2021.

The link for the full text of the paper when published will be:

For further information or a copy of the paper please contact:

Rosalind Dewar
Media Office, Royal Society of Medicine
DL: +44 (0) 1580 764713
M: +44 (0) 7785 182732

The Journal of the Royal Society of Medicine (JRSM) is a leading voice in the UK and internationally for medicine and healthcare. Published continuously since 1809, JRSM features scholarly comment and clinical research. JRSM is editorially independent from the Royal Society of Medicine, and its editor is Dr Kamran Abbasi.

JRSM is a journal of the Royal Society of Medicine and it is published by SAGE Publishing.

Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company’s continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne.

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