Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.

<h4>Background</h4>Older adults from minority ethnic backgrounds are at increased risk of contracting COVID-19 and developing severe infection and have increased risk of mortality. Whilst an age-based vaccination approach prioritising older groups is being implemented worldwide, vaccine...

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Autores principales:	Cini Bhanu, Dipesh P Gopal, Kate Walters, Umar A R Chaudhry
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/9cce32a2e5404ed3b8b31520c2ee6150
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spelling	oai:doaj.org-article:9cce32a2e5404ed3b8b31520c2ee61502021-12-02T19:55:59ZVaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.1549-12771549-167610.1371/journal.pmed.1003826https://doaj.org/article/9cce32a2e5404ed3b8b31520c2ee61502021-11-01T00:00:00Zhttps://doi.org/10.1371/journal.pmed.1003826https://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Older adults from minority ethnic backgrounds are at increased risk of contracting COVID-19 and developing severe infection and have increased risk of mortality. Whilst an age-based vaccination approach prioritising older groups is being implemented worldwide, vaccine hesitancy is high amongst minority ethnic groups.<h4>Methods and findings</h4>We conducted a systematic review and convergent synthesis to systematically examine perceptions of vaccinations amongst older adults from minority ethnic backgrounds. We included studies that reported on perceptions, beliefs, and attitudes towards vaccinations in older adults aged ≥65 years from a minority ethnic background. We excluded studies of vaccinations in investigation or development, studies focused on specific medical conditions, studies where ethnic background or age group was unidentifiable, systematic reviews, editorials, and conference abstracts. We searched MEDLINE, Embase, Virtual Health Library, Web of Science, Cochrane Library, medRxiv, and PROSPERO databases from inception to 15 July 2021. Risk of bias for studies was assessed using the Mixed Methods Appraisal Tool. The quality of evidence of collective outcomes was estimated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) framework. A total of 28 eligible studies conducted between 1997 and 2020 were included in the final analysis (17 quantitative surveys, 8 focus group or interview studies, 2 mixed methods studies, and 1 case-control study). The majority were US studies in English or Spanish, except for 6 studies set in Hong Kong, 2 studies in Japan, 1 study in Brazil, and 1 multi-centre study (including China, Indonesia, Turkey, South Korea, Greece, UK, Brazil, and Nigeria). In total, 28,262 individuals with an estimated mean age of 69.8 years were included, 63.2% of whom were female. We summarised the common concepts and themes across studies and populations using a convergent synthesis analysis. Thirteen themes categorised as barriers or facilitators were identified and grouped into structural factors-healthcare provider and system related, patient related, and policy and operational-and were analysed by minority ethnic group. The main limitation of the study was the predominance of studies from the US and East Asia.<h4>Conclusions</h4>In this systematic review, we found that factors influencing vaccination uptake involve healthcare provider and system, patient-related, and governance-level factors that are specific to the older ethnic minority community being served. The evidence included in this review is supported by high or moderate certainty and can be translated to practice and policy. A tailored, multi-level approach combining increased education, access, and culturally competent discussions with trusted healthcare professionals to address health beliefs can maximise the potential impact of widespread vaccination policies.Cini BhanuDipesh P GopalKate WaltersUmar A R ChaudhryPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 18, Iss 11, p e1003826 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Cini Bhanu Dipesh P Gopal Kate Walters Umar A R Chaudhry Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.
description	<h4>Background</h4>Older adults from minority ethnic backgrounds are at increased risk of contracting COVID-19 and developing severe infection and have increased risk of mortality. Whilst an age-based vaccination approach prioritising older groups is being implemented worldwide, vaccine hesitancy is high amongst minority ethnic groups.<h4>Methods and findings</h4>We conducted a systematic review and convergent synthesis to systematically examine perceptions of vaccinations amongst older adults from minority ethnic backgrounds. We included studies that reported on perceptions, beliefs, and attitudes towards vaccinations in older adults aged ≥65 years from a minority ethnic background. We excluded studies of vaccinations in investigation or development, studies focused on specific medical conditions, studies where ethnic background or age group was unidentifiable, systematic reviews, editorials, and conference abstracts. We searched MEDLINE, Embase, Virtual Health Library, Web of Science, Cochrane Library, medRxiv, and PROSPERO databases from inception to 15 July 2021. Risk of bias for studies was assessed using the Mixed Methods Appraisal Tool. The quality of evidence of collective outcomes was estimated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) framework. A total of 28 eligible studies conducted between 1997 and 2020 were included in the final analysis (17 quantitative surveys, 8 focus group or interview studies, 2 mixed methods studies, and 1 case-control study). The majority were US studies in English or Spanish, except for 6 studies set in Hong Kong, 2 studies in Japan, 1 study in Brazil, and 1 multi-centre study (including China, Indonesia, Turkey, South Korea, Greece, UK, Brazil, and Nigeria). In total, 28,262 individuals with an estimated mean age of 69.8 years were included, 63.2% of whom were female. We summarised the common concepts and themes across studies and populations using a convergent synthesis analysis. Thirteen themes categorised as barriers or facilitators were identified and grouped into structural factors-healthcare provider and system related, patient related, and policy and operational-and were analysed by minority ethnic group. The main limitation of the study was the predominance of studies from the US and East Asia.<h4>Conclusions</h4>In this systematic review, we found that factors influencing vaccination uptake involve healthcare provider and system, patient-related, and governance-level factors that are specific to the older ethnic minority community being served. The evidence included in this review is supported by high or moderate certainty and can be translated to practice and policy. A tailored, multi-level approach combining increased education, access, and culturally competent discussions with trusted healthcare professionals to address health beliefs can maximise the potential impact of widespread vaccination policies.
format	article
author	Cini Bhanu Dipesh P Gopal Kate Walters Umar A R Chaudhry
author_facet	Cini Bhanu Dipesh P Gopal Kate Walters Umar A R Chaudhry
author_sort	Cini Bhanu
title	Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.
title_short	Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.
title_full	Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.
title_fullStr	Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.
title_full_unstemmed	Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.
title_sort	vaccination uptake amongst older adults from minority ethnic backgrounds: a systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/9cce32a2e5404ed3b8b31520c2ee6150
work_keys_str_mv	AT cinibhanu vaccinationuptakeamongstolderadultsfromminorityethnicbackgroundsasystematicreview AT dipeshpgopal vaccinationuptakeamongstolderadultsfromminorityethnicbackgroundsasystematicreview AT katewalters vaccinationuptakeamongstolderadultsfromminorityethnicbackgroundsasystematicreview AT umararchaudhry vaccinationuptakeamongstolderadultsfromminorityethnicbackgroundsasystematicreview
_version_	1718375855741206528

Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review.

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