This guest blog presents early findings from a major new University of Glasgow-led study (Prof. Wright, Dr Gawlewicz, Dr Trevena) (with Dr Narkowicz, Middlesex University and Dr Piekut, University of Sheffield) on the impacts of COVID-19 on migrant essential workers. The UKRI/ESRC-funded research surveyed over 1,100 Poles living in the UK (including 368 in Scotland) and interviewed 10 stakeholders and 40 migrant essential workers. The blog also draws on work scoping attitudes towards vaccination amongst 20,000 Poles in the UK, conducted as part of a targeted vaccine information campaign by Feniks, an Edinburgh-based mental health charity.
The analysis and conclusions are made by the author. As with all guest blogs, what follows are the views of the author, not those of SPICe or the Scottish Parliament.
Ethnic minorities have stronger negative attitudes towards COVID-19 vaccination which are reflected in lower levels of vaccine uptake than in the general population. This is also true for Poles, the largest migrant group in Scotland, with near 100,000 nationals. Vaccine confidence was already lower amongst Poles pre-Covid, with high refusal rates of in-school influenza and the HPV vaccines. Understanding specific reasons for low vaccine confidence in marginalised groups is key to addressing vaccine distrust. Improving migrants’ confidence in the COVID-19 vaccine offers benefits for the whole population.
Our survey shows a mainly positive picture – most Polish respondents in Scotland were vaccinated or planned to be. However, more than a third (35.1%) out of the 368 respondents expressed negative attitudes or hesitancy towards COVID-19 vaccination, 18.1%, were not willing to take the vaccine and 17.0% were unsure, as shown in the chart below.
What are the key reasons behind vaccine hesitancy in the Polish community?
Health fears, ‘natural immunity’ and not being NHS-registered
Fears about the safety and possible side-effects of COVID-19 vaccines were central to hesitancy amongst Polish people, as for the wider population. Some saw new vaccines as a risky ‘medical experiment’ with untested long-term side-effects that may only become known in the future. These fears were fuelled by mistrust towards ‘Big Pharma’, the government, the Medicines and Healthcare products Regulatory Agency (MHRA) and the NHS. Lack of choice over type of vaccine was perceived negatively too, with some people refusing vaccination on this basis.
Vaccine effectiveness was questioned by some respondents who felt vaccination was ‘pointless’ if it did not provide full protection from contracting or passing on COVID-19. Some feared it may be ineffective on the Delta variant.
However, COVID-19 was not perceived as a health risk by some younger healthy Poles, who believed that their natural immunity was strong.
“[I won’t get vaccinated] because I don’t feel such a need, I feel healthy. And you know, I hope my immune system is strong enough to manage it somehow. I really try to take good care of myself.”Woman, 42 yrs, multiple low-skilled jobs
Some Poles were unregistered with a GP so were not automatically included in the vaccination programme.
Language is a barrier to Polish people who cannot access formal information sources, such as the NHS or Scottish Government websites. While some information is available in Polish e.g. on the NHS Inform website, the document names are in English so are not returned by web searches using Polish key words. Those with limited English turn to Polish information sources instead, including Polish TV, social media, and family or friends. This can harden hesitancy because vaccine confidence in Poland is low compared with other European countries. There is also a strong anti-vaccination movement in Poland, supported by some political leaders and official media.
Some Polish people who did want to be vaccinated fell through the net because they did not know where to turn for support:
“I got my blue letter with an invitation for the vaccine appointment, but I was in quarantine and I did not go. I do not speak English well enough to call and explain and the deadline passed me by. I am 67 years old, I am after four strokes. And in January I had surgery to remove an abdominal aortic aneurysm. I want to be vaccinated but not with AstraZeneca. What should I do?”
Some Polish people in low-paid employment were deterred by fears over taking time off work for vaccination or if they got side-effects. Research participants reported that taking time off work to self-isolate delayed or cut their pay. Such practices put people on the minimum wage in a highly precarious financial and livelihood position.
Overcoming vaccine hesitancy
Those who got vaccinated despite hesitancy were persuaded by political leaders, role models, access to reliable and unbiased information and seeing clear benefits to vaccination. Many respondents were keen to see family in Poland and deterred by potentially expensive and confusing travel requirements such as tests, staying in COVID hotels on return and having to quarantine (which were required at the time of speaking to our interviewees in April-August 2021), especially for those on low pay.
Ease of international travel, or making vaccination compulsory for travel, was pivotal as a motivator:
“If I could travel [to Poland] without a quarantine and tests, then I would think about it [getting vaccinated].”Man, 35 yrs, manager in food processing company
Many Poles are still hesitating about vaccination. Some of the ways of addressing this issue include:
- Carrying out a targeted vaccine information campaign in Polish, as successfully pioneered by Feniks;
- Supporting primary care to target those in the community who haven’t been able to access services or information, e.g. by establishing Polish ‘NHS navigators’ within communities;
- Providing unbiased information on vaccination online in Polish and using Polish document names for vaccine factsheets and videos so they show in web searches;
- Promoting the travel benefits of vaccination and its protection from long Covid;
- Providing information on employee rights and support to those in employment who face barriers to vaccination.
Vaccination uptake has traditionally been lower in marginalised groups, including migrant populations. This has become a pressing issue under the COVID-19 vaccination programme. Addressing vaccine hesitancy among marginalised groups now will have broader benefits for public health in the future. For further information on the wider research please see the homepage for the University of Glasgow-led research.
Dr Paulina Trevena, School of Social and Political Sciences, University of Glasgow and Magdalena Grzymkowska, Campaign Coordinator at Feniks Counselling, Personal Development and Support Services Ltd.