A qualitative study of factors influencing COVID-19 vaccine hesitancy among South Asians in London

OBJECTIVES: This qualitative study sought to elicit the views and experiences of patients and health-care professionals to identify the factors associated with COVID-19 vaccine hesitancy among South Asians in London. DESIGN: In-depth semi-structured telephone and virtual interviews. SETTING: UK. PARTICIPANTS: Convenience and purposive sample of 12 individuals including patients, clinicians, and a medical receptionist. MAIN OUTCOME MEASURES: Our dataset identifies and explains the reasons for distinguishing between those individuals who are COVID-19 vaccine-hesitant, and those who are COVID-19 vaccine-anxious. RESULTS: COVID-19 vaccine hesitancy and the decision on whether to - or not to – vaccinate against COVID-19 involves ongoing and unresolved inner conflict about COVID-19 vaccines. Our findings therefore suggest that some individuals may be existing in a state of inbetweeness; where they are neither pro nor anti vaccination, while simultaneously questioning the many ‘truths’ surrounding COVID-19 and not just one truth such as the safety of COVID-19 vaccines. We argue that this in-between state is intensified by technology and social media; culminating in the Rashomon Effect, whereby a combination of truths, fractured truths, subjective realities, and unreliable or contradictory sources impact on our perceptions of COVID-19. CONCLUSIONS: Given the complexities arising from the multiple factors influencing vaccine hesitancy and scepticism, ‘quick fixes’ and ‘one size fits all’ solutions to address COVID-19 vaccine hesitancy will be ineffective. Therefore, promoting trust and prioritising good after-care as well as on-going care as a response to the effects of the pandemic is vital.