Issues, barriers and perceptions about the COVID-19 vaccine among culturally and linguistically diverse communities in NSW
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Issues, barriers and
perceptions about
the COVID-19 vaccine
among culturally and
linguistically diverse
communities in NSW
Issues, barriers and
perceptions about
the COVID-19 vaccine
among culturally and
linguistically diverse
communities in NSW
ACKNOWLEDGEMENTS CONTENTS
This research, conducted by Social Equity Works, has
Rosanna Barbero from Addison Road Community
been commissioned by the New South Wales Council iii ACKNOWLEDGEMENTS
of Social Service (NCOSS) and funded by NSW Ministry Centre, Marrickville
of Health. Romana Waseem from Canterbury City
1 EXECUTIVE SUMMARY
The research team would like to thank the Community Centre (4Cs), Lakemba
following services who helped to set up the focus
groups. The research team is indebted to these ser- Marg Couch, Senior Project Officer,
Regional Development Australia (RDA)-Riverina 5 RECOMMENDATIONS
vices, who opened their doors to the research team in
a short time frame between May and June 2021 and,
Joanne Fitzpatrick from Griffith Women on Fire, Grif-
in particular, collaborated on the facilitation of focus 6 RESEARCH SUMMARY INFOGRAPHIC
fith Community Centre, Griffith
groups with their community members including sup-
porting the team with spoken and written translation Randa Goriya from the NSW Chaldean League,
and bilingual facilitation. Mt Druitt TAFE Campus, Mt Druitt 8 INTRODUCTION
Khalid Zainulabdeen from Red Cross NSW/ACT, Wol-
longong 9 METHODOLOGY
Recruitment for the focus groups 9
Sivaharani (Harani) Mayuran from STARTTS
delivered at Toongabbie Community Centre, A word about the research design 11
Toongabbie Demographics of research participants 11
Sree VithyaHarilingam, Wilma Garguath and Zaid
Naoum from SydWest Multicultural 14 FINDINGS
Community Services, Mt Druitt and Blacktown
Having the vaccine or not 14
Sofia Lema and John Paul Troiani from Illawarra Reasons for having the vaccine 17
Shoalhaven Local Health District, Wollongong delivered
at the Warrawong Community Centre Reasons for not having the vaccine 18
Vaccine refusal 20
Leissa Pitts Manager, ISLHD Multicultural Health and
Refugee Health Service Other factors considered 21
Knowing someone who has been
Talei Vulatha Community Resilience Project vaccinated 22
Officer Multicultural Communities Council Illawarra
Knowing someone who has had
We would especially like to thank the 167 people who COVID-19 23
participated in our focus groups, all of whom were Knowing where to get vaccinated 24
generous with their time and passionate, clear and
fearless in the feedback they provided to the research- Sources of information about COVID-19
ers about the COVID-19 vaccine. and the vaccine 25
29 DISCUSSION
AUTHORS NOTE RESEARCH TEAM
35 ATTACHMENTS
This report has been written by Robin Miles, Project Lead
Robin Miles ATTACHMENT 1:
Lindy Cassidy, and Audrey Bennett with input to the
Qualitative Research Team A Description of the Focus Groups 35
content and recommendations from
Dr Camilla Couch and Patricia McCormick. Dr Camilla Couch
Patricia McCormick ATTACHMENT 2:
Lindy Cassidy COVID-19 Vaccine Information in multiple
Expert Multicultural Advisor languages 39
Paula Abood
Research Assistant
Audrey Bennett
REPORT DESIGN
Cath Appleton Design
i
EXECUTIVE SUMMARY
This research was conducted between late April and early June 2021 just prior to the
FIGURES TABLES
most recent outbreak in Sydney of the Delta variant of COVID-19. Many participants
10 Figure 1: 10 Table 1:
Country of Birth Focus Group Details in our study, who were unwilling or hesitant to be vaccinated, expressed the opinion
11 Figure 2: 15 Table 2: that COVID-19 was not a ‘real and present danger’ in Australia due to the very low
Language spoken at home People in the sample already vaccinated
case numbers active at the time.
12 Figure 3: 15 Table 3:
Length of time living in Australia Vaccine refusal and hesitancy in the
sample Australia has been very successful in stemming
12 Figure 4:
Age 20 Table 4: the spread of the virus through a combination of
Vaccine refusal by country of birth and border closures, quarantine, a first-world health
13 Figure 5:
language background system and expert contact tracing. 58% of people in our
Gender
21 Table 5: sample reported that
14 Figure 6: It is possible that, were this research conducted they would be having
Reasons for not having the vaccine
Are you going to get the COVID-19 today, this hesitancy would be reduced due to the
vaccine? 22 Table 6: the vaccine.
heightened risk of contracting COVID-19 through
Who do you know who has been This included 13
15 Figure 7:
vaccinated? the more transmissible Delta variant and its pres-
COVID-19 Vaccine intention of ence in the community. people (6.4%) who
respondents by age category had already been
Regardless, the need for vaccine take-up among vaccinated, in most
16 Figure 8:
Respondents COVID-19 Vaccine intention CALD communities remains high given they can cases having had
by Country of Origin be at increased risk due to factors such as in- their first
17 Figure 9: secure high-risk employment and living in high vaccination only.
Reasons for getting vaccinated against density households; and to ensure equitable
COVID-19 public health outcomes and social, economic and
18 Figure 10: community participation for everyone.
Reasons for not getting vaccinated This was a small study of 199 people (our sam-
against COVID-19
ple), drawn from culturally-diverse communities
22 Figure 11: in metropolitan Sydney and two regional NSW lo-
Do you know someone who has been 42% reported that
cations. Community members were asked survey
vaccinated? they were unsure or
questions either online or through focus groups.
23 Figure 12: were not planning to
Separate information was also collected from
Knowing someone who has had have the vaccine.
COVID-19
intermediary organisations working with CALD
communities (via a second survey). Of these, 29% were
24 Figure 13: unsure or hesitant.
Who do you know who has had The study’s purpose was to understand issues,
COVID-19? barriers and perceptions in relation to the COV-
25 Figure 14: ID-19 vaccine among NSW’s many culturally and
Where to go to get vaccinated linguistically diverse (CALD) communities. As
25 Figure 15: such, it presents a grassroots perspective. Key
13% reported that
Sources of information about COVID-19 findings are presented below.
and the COVID-19 vaccine they would not have
the vaccine.
27 Figure 16: CALD communities have mixed
Sources of information for respondents
who were planning to have the vaccine
responses to the vaccine This compares closely to recent data published
Like the general population, our study highlights by The Age and Sydney Morning Herald that sug-
27 Figure 17:
Sources of information for respondents that NSW residents from CALD backgrounds are gests ‘about a third of Australians are hesitant
who are not planning to have the mixed in their responses to, and confidence in about getting a COVID-19 vaccine.’1
vaccine having, the COVID-19 vaccine.
28 Figure 18: 1
Stephen Duckett. Too many Australians are hesitant to get
Sources of information for respondents vaccinated. Here’s how we fix it. Sydney
who ‘don’t know’ if they will have the Morning Herald, May 19, 2021.
vaccine
1
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
EXECUTIVE SUMMARY
A range of factors appear to ■ Lack of certainty about how the vaccine works ■ Resources available on websites often rely
influence attitudes ■ Concerns that the vaccine will make you sick on a high level of English language literacy or
or change your DNA literacy in a person’s first language
Older people (65+) in the survey sample were the
■ Concern that the vaccine is a form of ■ The importance of tailoring messaging to
age group most likely to report they had had or
government control those with lower levels of health literacy who
were intending to have the vaccine, while young-
are more likely to endorse misinformed beliefs
er people (18-24) were most likely to express ■ A belief that if you are healthy, it is better to
about COVID-19 and vaccination
uncertainty or hesitancy. fight the virus and make yourself and your
immune system ‘stronger’ as a result. ■ Mass media campaigns should be utilised,
Country of birth also showed up as a possible but supplemented by decentralised
indicator for being ‘positively pre-disposed’ to- Only a small number of people in the survey
communication strategies that tap into local
wards vaccination and would be worthy of further sample reported that religious or cultural reasons
support networks
research. were a barrier to having the vaccine.
■ The need to convey information in a way
Knowing someone who had had the virus or been that is meaningful to people, using trusted
vaccinated didn’t appear to make respondents
Public health information can be
community sources and multiple channels to
more likely to get the vaccine themselves. confusing reinforce messages.
The most frequently cited reasons for getting the The focus groups highlighted that conflicting
vaccine were a mix of personal safety (‘keeping pub-lic messaging, overly-complex information Drawing on motivational factors
family/self-safe’), altruistic reasons (‘for public (even when translated), or not enough targeted is key
health’ and ‘it is the right thing to do’), and the information were factors in vaccine hesitancy,
On closer inspection, the results of our study
more motivational reason ‘to travel’. with comments including:
suggest that vaccine hesitancy is perhaps better
Across CALD communities there is a good level understood as low motivation – or a ‘wait and
of practical knowledge, but still some uncertainty Nobody knows what see’ approach. Many participants said that they
about where to access vaccinations to do. My GP doesn’t even would consider having the vaccine if there was
know what I should do, ‘more of a reason’ to do so.
Focus group participants generally indicated whether I should
familiarity with the 2 types of vaccines available Reasons given by participants that would moti-
have it or not
and the risks associated with each, particularly re- vate them to get vaccinated included:
garding Astra Zeneca – although this was notably
not the case for a group of newly-arrived
They say one thing If I was able to
refugees who had little or no knowledge of
and then they tell you travel to see my
vaccinations for the virus.
something else….it (the family.
Over 80% of respondents knew where to go to vaccine rollout) is If there was more
get vaccinated including GPs, the vaccination hub so confusing risk from COVID-19 –
for Sydney residents and local hospitals. Howev- another outbreak or
er, a concerning 19% reported that they did not concern about
know where to get vaccinated. increased
transmission.
Fears and concerns about vaccinations If I had to in order to
remain keep my job.
Despite high rates of knowledge about COVID-19
across our study sample, a range of concerns and
Many participants, even some who were the most
misconceptions – shared with the wider popula-
vaccine hesitant, said that if being fully vaccinat-
tion – were evident. These included:
ed meant the difference between being able to
■ Fear about blood clots caused by the Astra travel overseas to visit family or not, they would
Zeneca vaccine definitely roll up their sleeves and get ‘the jab.’
■ Fear about the perceived lack of ‘proper’
testing of the vaccine prior to rollout
2 33
RECOMMENDATIONS
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
Again, this aligns with other research which This research is intended to provide a useful, long-standing trust and strong relationships that
If I could get home to emphasises the importance of building motiva- grassroots perspective, from a range of CALD exist between local, place-based services and the
see my mother, I would get tional and ‘pull’ factors into the vaccine rollout communities across NSW, on issues, barriers and communities they work with – close connections
vaccinated today! strategy and accompanying messaging, in order perceptions concerning the COVID-19 vaccine. It that should be utilised to advance public health
to increase vaccine uptake among CALD com- is hoped that these findings contribute to a grow- outcomes.
munities. Involving communities in the process, ing body of knowledge regarding COVID-related
In this context, it is recommended that NSW
understanding concerns and motivational factors, issues for NSW’s culturally-diverse communities.
Health, in partnership with Multicultural NSW,
building trust and testing messaging have been
The research has highlighted that reinforcing the CALD peak bodies and community leaders, use
identified as key.
benefits of being vaccinated, rather than dwelling this research to inform ongoing efforts to encour-
on the risks, is more likely to generate behavioural age uptake of the COVID-19 vaccine among CALD
change and a positive vaccine response from both communities. The findings indicate that these
CALD communities and the general population. efforts could be supported by:
It also reminds us of the immense value of the
1 direct and early engagement with specialist local multicultural
and state-wide ethno-specific community organisations in the
development and rollout of any public health campaigns
2 strategies to ensure community involvement in, and ownership of,
any campaigns with trusted sources such as local community leaders
and peer champions
3 tailored, targeted messaging across multiple platforms and
channels, available in easy-to-read format for English and translated
versions
4 supporting health care professionals in their role as educators and
leveraging successful local programs that increase COVID-19 vaccine
literacy and informed decision making
5 further research to understand concerns, misconceptions and
motivations of priority groups.
Mother’s Group at SydWest Multicultural Community Services, Blacktown
4 55
2
Issues, barriers and perceptions about the Covid-19 vaccine among culturally and linguistically diverse communities in NSW
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
199 s
participan
t = 2 people More Influence of
11 likely to friends and
ps
focus grou get the family overseas
vaccine Almost half of the participants
This small study of 199 knew someone who had
people from a range of +65 age group contracted COVID-19 over-
cultural backgrounds in FEARS & seas. Many people spoke
metropolitan Sydney and 58% CONCERNS about the impact of COVID-19
said yes to on their immediate family
two regional locations the vaccine about the including some who had lost
found that the community
with 6.4%
vaccine loved ones.
is divided in its response Fear about
to both the safety, need previously blood clots
and efficacy of the
vaccinated caused by the HEALTH
vaccine. Astra Zeneca
vaccine INFO
Fear about
the perceived
lack of ‘proper’
testing of the Lack of
vaccine certainty
29%
about how
were
the vaccine
unsure or worked Health information from
s not hesitant
Covid i esent
Concerns online sources (low use
d pr that the vaccine of government websites)
real an I would will make you
but
danger inated if
sick or change Facebook
c your DNA
get vac as a WhatsApp
there w o. Concern
to
reason
that the vaccine
ld get
WeChat
is a form of I co u
13% government ... if see m
y
Main stream media e to
reported control hom , I would
A belief er
that they moth cinated
I would get would not
have the
that if you were
healthy, it was better
to fight the virus and
Younger group c
get va ay!
tod
vaccinated... vaccine Instagram
make yourself and
your immune system Tik Tok
‘stronger’ as
a result
... if th
e
... if I wa more re was ... if
ri
able to tr
s Covid sk from in o I had t
avel outbre – another rd o
to see m ak o kee er to
y about r concern pm
family. inc job y
transm reased .
ission.
6 7
INTRODUCTION METHODOLOGY
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
This research project has been commissioned by the New South Wales Council of A mixed-method research methodology was used for this project. However, it
Social Service (NCOSS) to look at issues, concerns, attitudes and barriers to receiving was primarily a qualitative approach that aimed to hear directly from people in
the COVID-19 vaccine in culturally and linguistically diverse (CALD) communities in the community from culturally and linguistically diverse (CALD) backgrounds. The
NSW. methodology involved:
The research was conducted over two months Emerging research indicates that misconceptions
■ 11 focus groups (including one pilot) involving ■ A second online survey was designed to elicit
from late April to late June 2021 with data col- about COVID-19 in Australia tend to be more
a total of 167 participants from CALD the views and experience of the intermediary
lected just prior to the latest COVID-19 outbreak common in groups with lower levels of health
backgrounds and 7 locations: Griffith (1), organisations in their work with CALD
in Sydney. It was undertaken with some urgency literacy, including people who speak a language
Wollongong (2), Blacktown (2), Lakemba (1), communities. It generated eight responses.
given the following factors: other than English. In addition, the varied experi-
Mt Druitt (3), Toongabbie (1) and Marrickville ■ Two interviews were undertaken with a
ence of and information about COVID-19 trans-
■ the lack of data concerning people (1). These supported participants to answer multicultural health communication expert
mission and vaccination in overseas countries
from culturally and linguistically diverse the survey questions and enabled more from the Illawarra Shoalhaven Local Health
makes this a particularly interesting issue, given
backgrounds in larger research studies 2 detailed exploration of issues and further District and an Emergency Department
that CALD community members may be having
■ the heightened concern in the community gathering of qualitative information (see Table medical practitioner.
regular discussions with relatives overseas and
about the potential side effects of, in 1 below). Identified multicultural
getting information about COVID-19 from over- ■ The online survey responses from the
particular, the Astra Zeneca vaccine which and community service organisations with
seas sources. intermediary organisations and the interviews
has led to a higher-than-usual rate of vaccine connections to CALD communities in the
with health staff have informed analysis of
hesitancy in the wider community 3 relevant locations acted as ‘intermediaries’ by
data from community members, findings and
■ the need to lift the overall vaccination rate in assisting with organising the focus groups,
recommendations.
Australia. providing bilingual facilitation of discussion
and supporting community members to In addition, the research has been informed by
undertake the survey. More information other publicly available research, including find-
on the focus groups and intermediary ings concerning vaccine hesitancy and uptake4,
organisations can be found at Attachment A. and a scan of multicultural COVID-19 health
resources available in community languages from
■ An online survey with the same questions
the Commonwealth, NSW and Victorian Govern-
as those used in the focus groups was made
ments, SBS and Ethnolink (see Attachment 2).
available. This was promoted via NCOSS
networks and the research team’s CALD
connections and completed by 32 people. The Recruitment for the focus groups
total sample size of this study was therefore Intermediary organisations and focus group
199 participants, made up of members of participants were recruited using the research
diverse CALD communities. team’s extensive connections with multicultural
■ A bilingual multicultural community and community service organisations across NSW
engagement expert was engaged throughout and drawing on key NCOSS member organisa-
the project to advise the research team, tions providing support to, and with longstanding
including in relation to the design of the relationships with, CALD communities. To a large
survey. Bilingual facilitators were used for extent, the selected locations and the services
focus groups where necessary, and guidance and supports provided by the intermediary organ-
was provided by intermediary organisation isations determined the cultural backgrounds that
2
McCaffery KJ, Dodd RH, et al. Health literacy and disparities 3
An online survey conducted by Essential Research (April representatives as required, and in one were included in the study.
in COVID-19–related knowledge, attitudes, beliefs and 2021) completed by 1090 people between 21–26 April 2021, instance the survey was translated into Arabic.
behaviours in Australia. Public Health Res Pract.2020;30(4): found just 43% of Australians think the rollout is being done Focus group members were each provided
e30342012. December 2020. First published:5 November efficiently, down from 68% in March… The slow rollout and
2020. ‘There are several limitations to our study. Although changes to the roadmap also appear to have given rise to with a $25 gift card at the end of the session
our recruited sample was large and diverse, it was not vaccine hesitancy, with one in six people (16%) saying they and a $50 gift card was donated to the
statistically representative of the Australian population. will never get vaccinated against COVID-19, up from 12% last intermediary organisation to provide some
The proportion of Australians from non-English speaking month, while 42% said they will get vaccinated, but not right
backgrounds was small (6%) since the survey was not away. The proportion of people who would be willing to get
additional resources to each group.
translated and required sufficient English skills to complete vaccinated as soon as possible, or are already vaccinated,
the questionnaire in English.’ (p. 7) also declined, down from 47% to 42%.’ Essential Report
(April 2021)
4
https://www.ncoss.org.au/COVID-19-research/
8 9
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
METHODOLOGY
Service Location Group Composition Participant
numbers
Addison Road Community Centre Marrickville Community leaders: - 26 A word about the research design
Vietnamese, Chinese, Italian, The research was carefully designed, drawing on
Greek, Indonesian, Latin
expert cultural advice on communication pro-
American and Portuguese
cesses and survey design. Focus groups included
speakers
participant consent forms, incentive vouchers and
Griffith Community Centre Griffith Indonesian and Pakistani women 6
a one-page introduction to the research for the
Multicultural Communities Wollongong Arabic-speaking group 22
intermediary organisations. Intermediary organ-
Council Illawarra
isations and preferred locations were identified
Multicultural Communities Wollongong Italian older women’s group 15
and agreed in advance with NCOSS.
Council Illawarra
Syd West Multicultural Services Mt Druitt Arabic-speaking group 10 The survey was designed in an easy-to-read
Syd West Multicultural Services Blacktown Spanish-speaking seniors’ group 16 format, using simple English. Feedback from
Syd West Multicultural Services Blacktown Mothers’ support group: - 14 the Spanish-speaking translator was that it was
Indian, Sri Lankan, Pakistani and extremely easy to translate and complete. Other
Ghanaian groups commented that they found the survey
Canterbury City Community Lakemba Pakistani, Indian and Sri Lankan 14 easy to complete and most groups displayed a
Centre (4Cs) women solid level of spoken and written English. The
Chaldean League and Western Mt Druitt Chaldean group 18 research design and conduct also leant heavily on
Sydney TAFE the expertise of the facilitators and their exten-
STARTTS - Toongabbie Toongabbie Tamil-speaking group 12 sive networks which made delivery in such a short
Community Centre time frame possible. The positive engagement
Mt Druitt TAFE – TAFE NSW Mt Druitt Work Opportunities for Women 14 and support of the intermediary organisations
group (mixed CALD backgrounds) was also a factor contributing to the successful
TOTAL 167 conduct of the research.
Table 1: Focus Group Details
Explanatory note: The focus group at Mt Druitt TAFE - comprised predominantly of CALD women
enrolled in a Certificate II entry level course - was used to pilot and refine the focus group process,
with survey responses generated by the group included in the final survey results.
35
31
30
35 32
25
30 27
20
20 25
17 21
16
15
15 20 17
Count
Count
12
15 13 12
10 8 10 11 10
7
6 6 10
4
5 5 6
5 3 3 3 2
5
1 1 1 1
2
1
2
1 1 1
2
1 1 1 1 1
2
1 1 2 2 1 1 1 2 1 1 1 1 1 1 2 1 1 1 1
0 0
Chinese…
Iran
Iraq
Egypt
China
Eritrea
Thailand
Pakistan
Sweden
Hong Kong
Ukraine
Poland
Chile
Telugu
Urdu
Spanish
Chaldean
Polish
Multiple
Farsi
Tamil
Gujarati
Hazaragi
Khmer
Tigrinya
Arabic
Italian
Persian
Mandarin
Spanglish
Hindi
Punjabi
Vietnam
El Salvador
Australia
Italy
Sri Lanka
Syria
Bolivia
Malaysia
Argentina
Cambodia
Taiwan
Japan
Peru
Sudan
Afghanistan
Indonesia
India
Ghana
Uruguay
Russia
Jordan
English
Japanese
Malay
Hausa
Vietnamese
Russian
Kurdish
Swedish
Cantonese
Thai
Figure 1: Country of Birth
Figure 2: Language spoken at home
10 11
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
METHODOLOGY
35.00% 33.16% 90.00% 84.30%
30.00% 80.00%
70.00%
25.00%
20.53% 60.00%
20.00% 16.84% 50.00%
13.16% 14.21%
15.00% 40.00%
10.00% 30.00%
5.00% 20.00% 14.53%
2.11%
10.00% 1.16%
0.00% 0.00%
Lessthat
Less than
1 1 1-2 years 22-5
- 2 years - 5 years 5 5-10 years
- 10 years 10-20
10 - 20 More
More than
than 0.00%
1 year
year years 20 years Male Female Non-binary Rather not say
Figure 3: Length of time living in Australia Figure 5: Gender
25.00% 23.56%
21.47%
20.00%
17.28% 16.75%
15.00% 13.09%
10.00% 7.85%
5.00%
0.00%
0.00%
Under 18 18-24 25-34 35-44 45-54 55-64 65+
Figure 4: Age
Chaldean Focus Group Feedback Sheet
12 13FINDINGS FINDINGS
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
Research participants were asked: 13 people (6.5%) had already been vaccinated 75 (42%) indicated a degree of vaccine hesitancy,
(at least 1 dose)6 with several commenting that with 24 participants (13%) reporting that they
If they were intending to get they had chosen or needed to be vaccinated for were not planning on getting vaccinated, while 53
vaccinated work-related reasons. Others reported that they (29%) reported they did not know if they would
had been vaccinated primarily for health reasons, get vaccinated.
The reasons why they would, or to stay well and make sure that their families
would not, choose to get vaccinated stayed well. They were also concerned about
public health and safety. One of the women in the Response Count Percent
If they knew anyone who had Lakemba groups from Sri Lanka was adamant that Not planning to have the vaccine 23 13%
the benefits outweighed the risks, spoke positive- Unsure about having the vaccine 52 29%
already been vaccinated, and if so, ly about how easy it had been to get the vaccine 75 42%
who from her local medical centre and that she had
experienced no side effects from the vaccination. Table 3: Respondents who indicated vaccine
If they knew anyone who had refusal or hesitancy
contracted COVID-19 and if so, who
Language Count Percent This level of vaccine hesitancy reflects larger stud-
If they knew where to go to get Urdu 1 ies in the Australian community. A survey of over
Italian 3 1,000 participants from across Australia conduct-
vaccinated Arabic 2
ed in April 2021 by Essential Research found hes-
Tamil 3
What sources they used to get Chaldean 1
itancy rates of 42%, including 16% who indicated
they were never going to get vaccinated.7
information about the COVID-19 Spanish 3
Total 13 6.5% of sample For our survey, responses indicated that age
vaccination Having the vaccine or not
was a factor, with 85% of respondents aged 65
Of the 199 participants, 117 (58%) reported that Table 2: Respondents already vaccinated
Basic demographic information; age, and over reporting that they would have or had
they were planning to be, or had already been,
gender, country of origin, language
vaccinated, while 78 (42%) reported that they
spoken at home and length of time were not planning to have the vaccine (13%) or
living in Australia. did not know if they would get vaccinated (29%). 40
35
30
25
Count
90.00% 84.30% 20
80.00% 15
70.00% 10
60.00% 5
50.00% 0
40.00% Under 18-24 25-34 35-44 45-54 55-64 65+
30.00% 18
20.00% 14.53%
10.00%
Yes No Don’t Know
0.00% 1.16%
0.00%
Figure 7: COVID-19 Vaccine intention of respondents by age category
Male Female Non-binary Rather not say
6
The researchers did not distinguish between whether 7
Essential Research. The Essential Report, 21 April 2021.
people had received their first and second doses of the
Figure 6: Are you going to get the COVID-19 vaccine? vaccine i.e., partially or fully vaccinated.
14 15Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
FINDINGS
I’m over 65. I have some
already had the vaccine. Those who indicated that Country of origin also seemed to play a role in Reasons for having the vaccine
they would not be having the vaccine were fairly people’s views about having the vaccine, with health issues. I think it’s
evenly distributed across age groups, with young- high vaccine pre-disposition reported by [having the vaccine] very
er people aged 18-24 being the age group with Vietnamese respondents to the online survey I don’t important to
keep safe.
the highest proportion of participants expressing and women in the Italian-speaking group. While want to
uncertainty about having the vaccine. The age participants from Iraq recorded the highest ‘yes’
group with the second highest level of hesitancy, response, this was almost matched by Iraqi die.
I want to see my family.
proportionate to other categories, were the 35-44 participants who reported that they were I usually go every year but
year olds. ‘unsure’ or ‘did not know’ whether they would now I haven’t seen them
have the vaccine. The relevance of country of Of the 117 participants who reported that they
had either already been vaccinated or were plan- because of COVID-19.
origin in this regard would be worthy of further Having it will help.
research. ning to get vaccinated, ‘keeping my family healthy
and well’ (82%) and ‘keeping myself healthy and
well’ (81%) were the two most popular reasons
for having the vaccine. This was followed by ‘for
16 I am well but my parents
public health’ (70%), ‘it is the right thing to do’
are older. It is important to
14 (62%), and in order ‘to travel’ (61%). (See Figure
keep them well.
9)
12
10
Count
8
6
90.00% 80.95% 81.90%
4
80.00% 70.48%
2
70.00% 60.95% 61.90%
0
60.00%
50.00% 45.71%
Sr rica
Au rica
an
Pa ina
n
an e
Am l y
Ea yria
Vi Iraq
m
a
n
Sw lia
ia
en
ka
E n
gh p
pa
h Ita
di
ta
er Ira
As
Af uro
na
ist
ra
an
Ch
ed
In
e
Af
Ja
th S
kis
40.00%
st
et
st
iL
n
30.00%
ut
st
ou
So
Ea
20.00%
rS
he
10.00%
Ot
0.95%
Yes intention
Figure 8: Respondents COVID-19 Vaccine No byDon't know
Country of Origin 0.00%
To stay To keep my For public To travel To work It is the Something
healthy and family health right thing else (please
well healthy and to do tell us what)
The Italian focus group held in Wollongong was an These women were motivated to stay healthy and well
older women’s social group, with all participants well, keep their family healthy and well, for public
(15) aged above 65 years. Most in fact were aged health reasons, to be able to travel, and for gen-
over 75 years, with one participant in her 90s. eral safety. Members of the group also reported Figure 9: Reasons for getting vaccinated against COVID-19
87% of the group had either been vaccinated (3) that they wanted to get vaccinated so that they
or were planning to get vaccinated (10). would be able to ‘dance’ and ‘socialise’. Other reasons that people gave for getting vacci- All but one of the focus groups were familiar with
nated included the need to continue working in the different vaccines currently available in Aus-
essential ‘front line’ employment such as security, tralia, Astra Zeneca and Pfizer. Most participants
Of course, I will get
cleaning and aged care settings. One woman in were also aware of blood clots being associated
vaccinated. It is important
the Lakemba focus group who had already had with the Astra Zeneca vaccine. One group of
to do this. It is a very bad
her first dose of the Astra Zeneca vaccine said newly-arrived refugees in Griffith had not heard
disease.
that ‘the benefits outweigh the risks’ and, as an of either the Astra Zeneca or Pfizer vaccines and
older woman, ’I do not want to die.’ had a more limited understanding of the
vaccination program in general.
16 17Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
FINDINGS
I have heard that the
vaccine changes
Reasons for not having the vaccine Issues raised in focus groups as contributing to Specific comments
increased hesitancy included: included: your DNA.
At the moment the ■ Some GPs being hesitant to recommend
situation is under control vaccination They don’t tell you what
and don’t feel the need. ■ The information being provided is conflicting chemicals are in the
Also, I have no plans to Of the 42% participants who said that they would vaccine.
■ The information is overly complex and not
travel in the near future so not have, or were hesitant to have, the vaccine,
comprehensible, regardless of whether it has
I don’t see the need. 48.65% said that they preferred to ‘wait and see’
been translated I am a mother.
before getting vaccinated.
■ The risk of blood clots I am not sure it [the
■ Perceptions that the vaccines are generally vaccine] is safe for
unsafe me when I am
■ Concerns that some people are dying after breastfeeding.
being vaccinated
60.00% ■ Not being sure about the risks associated with
48.65% If you are young and
50.00% having the vaccine and being pregnant or
35.14% breastfeeding healthy your body has the
40.00% 32.43%
■ The perception that there has been a lack of energy to fight the virus.
30.00% 27.03%
21.62% testing of the vaccines prior to rollout You don’t need to have the
18.92%
20.00% vaccine. You should just let
8.11% 10.81% ■ A lack of understanding of how vaccines work,
10.00% 5.41% your body fight it itself.
the composition of the vaccines and what
0.00% they would do to the body, including making
The The For I am I don't like For For I want to Something changes to a person’s DNA.
vaccine is vaccine is medical scared to vaccines religious cultural wait and else
not well unsafe reasons have the reasons reasons see (please
tested vaccine tell us
what)
Figure 10: Reasons for not getting vaccinated against COVID-19
The perceived ‘lack of adequate testing’ of the The discussion in the focus groups about people’s
vaccine and ‘fear of being vaccinated’ also re- hesitancy to be vaccinated focused on a number
ceived high response rates, selected by 35.14% of concerns which reflected:
and 32.43% of participants respectively. Only
■ poor communication from a number of
13.55% of respondents cited religious or cultural
trusted sources including GPs and some media
reasons as being behind their vaccine hesitancy.
sources
Open-ended responses to this question included: ■ conflicting information about the vaccine from
health authorities
The vaccine is not 100% ■ fears about vaccine safety that are shared by
working. It cannot offer the general community
100% protection. ■ misconceptions about the effectiveness of,
and how the vaccines work.
I will not have it because
make me sick.
Tamil Focus Group Feedback Sheet
18 19Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
FINDINGS
Confusion about what to do, where to go and One woman whose husband worked for a security People in this category said that they would ‘wait
the health impacts of the vaccine was a common firm said that her husband had had to be vacci- and see’ what happens with the wider rollout be-
thread in the conversations around vaccine hesi- nated in order to keep his job: fore making their final decision. This suggests that
tancy. a proportion of the ‘no’ group are in fact hesitant
rather than outright refusing to have the vaccine.
Nobody knows what to do. There were also fears expressed by focus group
He [husband] had to have it.
My GP doesn’t even know participants about the dangers of being vacci-
He didn’t have a choice. He was
what I should do, whether nated. Participants reported being afraid of the
fine [no side effects], but I’m not
I should have it or not. thinking I will have it. I don’t need health risks especially from blood clots. Some
to. I’m a mum, I’m busy. I have people distinguished clearly between Astra Zene-
to look after my children. I don’t ca and Pfizer in this regard. However, for many,
know how I feel about it, whether the distinction between the different vaccines
I am not sure what to I’m going to have it. was lost and they spoke of the vaccines generally
do. I have spoken to my being unsafe and having a range of unwanted side
GP, but they can’t tell me effects.
whether I should have the
vaccine or not while I am In several focus groups the issue of government The vaccine has been
breastfeeding control was also raised. A number of people re- rushed out. It has not been
ported strongly that they feared that the vaccine properly tested.
was ‘a means that the government was using to
They say one thing control people’.
and then they tell you Reason for not having the vaccine Percent Count
something else… it [the The vaccine is not well tested 54.55% 12
vaccine rollout] is so I want to wait and see 54.55% 12
confusing The vaccine is unsafe 36.36% 8
For medical reasons 31.82% 7
I am scared to have the vaccine 31.82% 7
I don't like vaccines 13.64% 3
Vaccine refusal Country of Birth Language Background Count For religious reasons 13.64% 3
Pakistan Urdu 4 For cultural reasons 9.09% 2
China, Taiwan Chinese 4 Something else (please tell us what) 9.09% 2
I never get sick. It is the (Mandarin/Cantonese)
same for all my family. We Sri Lanka, India Tamil 3 Table 5: Reasons for not having the vaccine
have always been strong
Chile Spanish and English 2
and healthy so I will be
Italy Italian 2
saying no to the vaccine.
Iraq, Syria Arabic 2
Iraq Chaldean 1 Other factors considered
Iran Farsi 1
In addition to the broader questions of why peo- ■ Knowing someone who had been
Only a small number of participants (24 Greece Macedonian 1
ple would or would not choose to get vaccinated, vaccinated
or 13%), said they would not get vacci- Poland Polish 1 the research team used the focus group discus- ■ Knowing someone who had contracted
nated. Of this group, 21 were women Pakistan Punjabi 1 sions to explore whether the following factors COVID-19
and 2 were men8. Respondents were Sweden Swedish 1 had any impact on a person’s likelihood of being
born in ten different countries with a ■ Knowing where to go to get vaccinated
Vietnam Vietnamese 1 vaccine pre-disposed or hesitant:
diverse range of language backgrounds. ■ The sources people turn to for information
Table 4: Vaccine refusal by country of birth and about COVID-19 and COVID-19 vaccines.
language background
8
This reflects the overall sample bias towards women. The
majority of focus group participants were women X with Y
participants being men.
20 21Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
FINDINGS
My friend works
as a COVID-19 cleaner
Knowing someone who has been When this issue was teased out further in focus
and they all had to [get
vaccinated group discussions, a range of reasons were
vaccinated].
revealed including:
Of those who responded to this question 125 or
70% knew someone who had already had the My husband works in
vaccine. security and he had My brother in the UK is a
to get it. doctor and he got it and
his wife.
My family overseas have My son needs to travel for
already been vaccinated. work so he is getting it.
80.00%
69.83%
70.00%
60.00%
50.00%
40.00% Knowing someone who has had
30.00% 25.70% COVID-19
20.00% Almost half of the participants knew someone
who had contracted COVID-19 overseas. Some
10.00% 4.47% reported that all the members of their family or
0.00% many members of their extended family had
con-tracted COVID-19. In the older Italian group,
Yes No Don't know 10 of the 15 women knew someone in Italy who
had contracted COVID-19.
Figure 11: Do you know someone who has been vaccinated?
Among the 125 participants who knew someone Who Count Percent
who had already been vaccinated, 100 identified Other family member 41 31.3%
‘immediate family members’ (parents, children, Sister 24 18.32% 50.00% 47.16% 46.59%
siblings and partners). Some focus group partic- Community member 23 17.56%
ipants reported that all of their family members 40.00%
Brother 18 13.74%
overseas had been vaccinated. Others reported
Father 17 12.98%
that their relatives had been vaccinated as a 30.00%
Mother 16 12.21%
requirement of their employment.
Work colleague 14 10.69%
20.00%
Husband or wife 11 8.4%
Son or daughter 10 7.63% 10.00% 6.25%
Partner 4 3.05%
Someone else 45 34.35% 0.00%
Total respondents 131 Yes No Not sure
Table 6: Who do you know who has been
vaccinated?
Figure 12: Knowing someone who has had COVID-19
22 23Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
FINDINGS
50.00%
43.59%
45.00%
40.00%
35.00%
30.00% 26.92% 90.00% 79.58%
25.00% 20.51% 80.00%
20.00% 15.38% 14.10% 70.00%
15.00% 10.26%
6.41% 5.13% 60.00%
10.00% 3.85% 3.85% 3.85%
5.00% 0.00%
50.00%
0.00% 40.00% 29.58%
30.00% 22.54%
r
nd
)
er
r
r
r
r
er
e
ife
r
ho
be
he
ne
be
he
te
gu
ht
th
20.00%
w
ie
Sis
sw
ot
ot
am art
em
em
a
Fa
ug
Fr
lle
or
Br
M
5.63%
P
m
m
ll u
da
10.00% 2.82%
co
d
an
ty
ily
te
or
k
ni
or
sb
0.00%
e
n
u
as
W
Hu
So
m
rf
le
m
he
(p
Co GP/Doctor Vaccine Hospital Work place Somewhere
Ot
se
centre else (please
el
ne tell us where)
eo
m
So
Figure 13: Who do you know who has had COVID-19? Figure 14: Where to go to get vaccinated
From the sample (n=199) GPs were the most Sources of information about COVID-19
commonly identified place to go to get vaccinat- and the vaccine
Four people in the focus groups knew someone Surprisingly, knowing people who had contracted ed, followed by the vaccine centre at Homebush
Bay and then hospitals. Other places identified The largest single source of information about
who had died of COVID-19. COVID-19 did not seem to influence focus group
included medical centres and pharmacies. COVID-19 and the vaccine was Facebook (41.7%).
participants’ predisposition towards either having
the vaccine or being vaccine hesitant. However,
Facebook. I get my
All my family back home the older Italian women’s group spoke about the
information from
[Pakistan] got it [COVID-19] but impact that COVID-19 had had in Italy in the early
Facebook. But if I want to
they are all fine now, apart from my father. stages of the pandemic and how this had affected 45.00% 41.71% check it, I watch the news
He died. But he was really sick before he them deeply. 13 of the 15 women in this group 40.00% 37.14%
34.86% 34.29% on 7 [Channel 7].
got it. He had lots of underlying conditions. would have, or had already had, the vaccine. 35.00% 30.86%
Medical conditions, so he was really unwell 30.00% 27.43% 26.86% 25.71%
before he got COVID-19. But everyone else, Knowing where to get vaccinated 25.00% 22.29% 22.86%
they are fine now. They were sick but 20.00%
they got better… 115 people (81%) who responded to this question 15.00% 13.14%
10.86% 10.86% 9.71%
If you are well and healthy (n=142) knew where to go to get the vaccine. 34 10.00%
you can fight this off. people (19%) reported that they did not know. 5.00%
This included 15 respondents from Iraq, 3 re- 0.00%
spondents from India, 2 respondents from China,
)
sw e
Ne r TV
e
M per
Au s
lia
V
Ot adio
ia
o
Fa as
Ot o
cia ok
re
nd
2 respondents from Pakistan and one respondent
ic
un rvic
di
i
ST
ed
ad
se
ra
r s ebo
he
rv
ra
pa
rie
he
lm
SB
er
r
st
rr
se
se
S
ity
from each of the following countries; China, Eri-
ws
yf
c
ov
he
SB
y
ity
un
ll u
t
ily
n
ni
o
trea, Italy, Sri Lanka, Sweden, Syria and Vietnam.
i
m
u
te
am
ily
m
m
m
he
am
e
m
m
yf
Co
These people were also less sure about whether
as
Ot
o
co
M
yf
le
rc
(p
is
M
or not they would have the vaccine. It is possible
he
Th
se
ew not
el
that their lack of knowledge about where to go to
A
re
he
get vaccinated was related to their general level
m
of vaccine hesitancy.
So
Figure 15: Sources of information about COVID-19 and the COVID-19 vaccine
24 25Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
FINDINGS
The second largest source of information for Italian radio (3 women) and ABC TV (3 women).
people in the sample was ‘other forms of social Only two women used the internet and none of 45.00% 41.41%
media’ (37%), followed by SBS television (35%), the women reported using Facebook or social 40.00% 37.37%37.37%
my friends (34%) and other television (31%). Oth- media as a source of their information. Several 35.00% 32.32%
er sources of information people reported that mentioned that they got their information from 30.00% 26.26% 28.28%28.28% 28.28%
they used were the NSW Health website, nightly their GP or specialist doctor and one partici- 24.24%
25.00%
television news including Channel 7, Channel 9 pant said ’I don’t listen to anyone’. In the Span- 20.00% 18.18%
and Channel 10 followed by the ABC, the Austral- ish-speaking focus group a comment was made 14.14%
15.00% 11.11% 12.12%
10.10%
ian government health website, their GP, local that seemed to reflect many of the other focus 10.00%
Medical Centres and the Red Cross. group discussions: 5.00%
0.00%
In the Lakemba focus group, predominantly made
up of women from Pakistan, there was an ani- There is so much confusion
)
io
k
ice
V
ice
r
Au s
lia
V
o
ia
o
as
re
pe
d
oo
di
di
rT
ST
ed
ad
se
about it [the vaccine] that
en
tra
he
rv
rv
ra
ra
pa
eb
mated discussion about Facebook which was the
he
lm
rr
SB
er
se
fri
se
s
sw
S
ity
ws
c
ov
Ot
he
SB
I think my GP is the best
Fa
ia
y
ity
ity
un
Ne
M
ll u
major source of information, along with Google
Ot
oc
ily
in
un
un
m
rs
te
am
ily
place to go.
m
m
m
searches and community and friendship-based
he
am
e
m
m
yf
Co
as
Ot
co
co
M
yf
le
WhatsApp groups. There was a general consensus
(p
er
is
M
Th
th
se
from most in the group that these were their pre-
no
el
A
re
he
ferred or most common sources of information When ‘sources of information’ is correlated with
ew
and news. However, if they wanted to ‘fact check’ the group who said they would have the vaccine
m
So
what they were hearing they would watch the (n=104), there is a shift from Facebook being the
nightly news on Channel 7 or Channel 9 to verify preferred source of information to ‘SBS TV’ being Figure 16: Sources of information for respondents who were planning to have the vaccine9
what they perceived could sometimes be unrelia- the preferred source. The ‘vaccine-predisposed’
ble sources. group also had the lowest rate of relying on Face-
In the Mt Druitt focus group several of the wom- book as a source of information about COVID-19,
50.00%
en with well-developed digital literacy and gener- though it was still high. The graph below high- 42.86%42.86% 42.86%
45.00%
al literacy skills used health and fitness websites lights how other ‘preferred sources’ play out for 38.10%
40.00%
and social media sites as their source of infor- those intending to have, or who have already had, 33.33%
the vaccine. 35.00%
mation about ‘all things health related’, including 30.00%
28.57% 28.57%
COVID-19. These women also spoke positively For those participants who indicated that they 23.81% 23.81%23.81%
25.00%
about the information and support they got from would not, or were not planning to, have the
20.00%
the staff at Canterbury Council Community Centre vaccine, ‘Facebook’, ‘my friends’ and ‘my family’ 14.29%
15.00%
(4Cs) who they could rely on to find out things were the sources of information about COVID-19 9.52% 9.52% 9.52%
10.00%
that they identified they needed to know more that were equally most frequently cited, followed
5.00%
about. closely by ‘my family overseas’. ‘SBS radio’ and
0.00%
In the smaller focus group in Griffith with ‘SBS TV’ as sources of information received the
lowest mentions from this group. (See Figure 16)
el com nity dia
)
recently-arrived refugee women who had low
o
ok
er
io
ov ia
Ot io
s w ce
ty ice
un S TV
V
y f n Au ds
Fa as
re
Ot radi
Ne r T
ily tral
ad
ad
ap
se
i
n
so bo
he
te serv
(p mu serv
e
ily frie
he
levels of English language literacy, there was little
he the mm al m
SB
rr
er
Sr
The vaccine-hesitant group were the group who
sp
ce
s
i ty
he
w
SB
am M y
knowledge about the vaccines, no awareness of
ci
ll u
identified ‘Facebook’ as their most frequent
ni
i
m
u
am
the different types of vaccines and little know-
m
source of information about COVID-19. ‘Face-
er
e
Co
h
as
Ot
o
ledge about where to go to get vaccinated or find book’ was followed by ‘other social media’ and
yf
M
le
c
is
r
M
Th
out more about COVID-19 in general. The ‘my friends’ as the next most frequent sources.
se
ew no
community service staff and volunteers present
A
re
‘This community service provider’ (the interme-
at the group were working hard to assist these
diary organisation where the focus group was
women to improve their English language skills
m
conducted) was identified by 26% of respondents
So
and support them with translated information.
as a source of information regardless of their
Figure 17: Sources of information for respondents who were not planning to have the vaccine
In the older Italian women focus group in Wollon- intention to get vaccinated or not. The fact that
gong, participants reported getting their infor- both the ‘vaccine hesitant’ and those who indi- 9
This group of the research sample included a small number
mation from slightly different sources – family in cated they wouldn’t be getting the vaccine sought of people who had already been vaccinated.
Australia (10 women), Channel 9 (7 women), information from this source suggests that rolling
26 27DISCUSSION
Issues, barriers and perceptions about the COVID-19 vaccine among CALD communities in NSW
60.00%
49.02%
50.00%
43.14% 41.18%
40.00%
31.37%
30.00% 25.49% 25.49% 23.53%
21.57% 21.57%
20.00%
9.80% 9.80% 11.76% 9.80%
10.00% 3.92%
0.00%
e
e
r
s
lia
TV
)
o
ia
o
as
io
k
V
re
pe
nd
oo
vic
vic
di
di
rT
ed
ad
se
ra
he
ra
ra
S
pa
rie
eb
er
er
he
lm
SB
er
t
rr
us
sw
S
ity
ws
s
s
yf
c
ov
Ot
he
SB
Fa
ia
A
ity
ity
un
Ne
M
ll u
Ot
oc
ily
in
un
un
m
rs
am
te
ily
m
m
m
he
am
e
m
m
yf
Co
as
Ot
co
co
M
yf
le
(p
er
is
M
Th
th
se
no
el
A
re
he
ew
m
So
Figure 18: Sources of information for respondents who ‘don’t know’ if they will have the vaccine
out positive messaging through trusted
community service organisations could be an
effective way of shifting people from vaccine
hesitancy to deciding to have the vaccine.
28 29Issues, barriers
Issues, barriers and
and perceptions
perceptions about
about the
the COVID-19
COVID-19 vaccine
vaccine among
among CALD
CALD communities
communities in
in NSW
NSW DISCUSSION
translated materials and information about the their circumstances. However, the sources of in- The Hub has ‘been working in partnership with
vaccines to be tailored to the needs of people in formation that people most rely upon or trust are key stakeholder groups to guide communications
these newly-emerging community groups. critical to the dissemination of accurate and clear to meet the health literacy, and culturally and
messaging to dispel the fear surrounding events linguistically diverse (CALD) needs of its pop-
It was reported that in Wollongong there can
such as blood clotting and the misconceptions ulation. Structured working groups have been
sometimes be four generations of family mem-
raised in the focus groups. With so many partici- created to prioritise communications to vulner-
bers from newly-arrived refugee groups living in
pants in this study getting their information from able youth, CALD groups, the elderly, itinerate
the one house. Most of these family members
Facebook and other social media sites, it is vital workers, asylum seekers and refugees. The aims
generally have limited English language literacy
that these channels are used to promote simple are to test messaging and build trust with priority
which increases their risk of not receiving key
positive messages and for any future community populations, to ensure effective communication
health messages and, therefore, increasing the
awareness campaigns. of the need to sustain physical distancing meas-
potential impact of COVID-19 - in particular, the
ures in the absence of a vaccine. Similar efforts
Delta strain which has proven highly infectious
Effective communication are now needed nationally and should start at the
amongst household members.
time of disease outbreaks in the future, alongside
Confusion and misconceptions about the vac- planned mass media and health communication
Vaccine uptake cine’s efficacy, availability and safety were all is- campaigns.’
sues that were raised in the focus groups. Finding
Not dissimilar to the wider community, more In the article by Dodd et al. they reinforce the
ways to effectively communicate with people with
people in our study were planning to have the importance of using communication formats
lower English language literacy and health literacy
vaccine than not, and a number had already been which are ‘suitable for people with low health
is an important way to address the confusion
vaccinated. In a recent Lancet article (February literacy and education, and which are appropriate
and misconceptions about the vaccine, as has
2021) 'Concerns and motivations about COVID-19 for culturally and linguistically diverse groups and
been discussed in a number of recent Australian
vaccination', findings from two surveys from an Indigenous populations.’ The article argues that it
studies.
Australian longitudinal study conducted in June is important to look at motivations and concerns
and July 2020 included that ‘the top three rea- A study14 by McCaffery et al. (2020) concluded about vaccines when shaping messaging. It also
sons for agreeing to vaccinate were ‘to protect that there are ‘important disparities in COVID-19- points out that primary care doctors are a trust-
themselves and others’ … ‘belief in vaccination related knowledge, attitudes and behaviours ed source and as such should be supported in
and science’ …and ‘to help stop the virus spread’. according to people’s health literacy and delivering information about the vaccines and ad-
Even among those willing to vaccinate there was language.’ One of the findings was that ‘people dressing community concerns. The article states,
some hesitancy about the safety of the vaccine. with lower health literacy were also more likely ‘We need to understand and address citizen’s
The Lancet article noted that ‘willingness to to endorse misinformed beliefs about COVID-19 concerns that can prevent optimal uptake, build
vaccinate differed by both age and education.’ For and vaccinations (in general) than those with motivations into messaging, and prioritise public
those who were indifferent or said they would adequate health literacy. The same pattern of trust by informing and involving the community
not get the vaccine the top reasons across the results was observed among people who primar- in the process. Supporting health-care profession-
two surveys were ‘concern about the safety of the ily speak a language other than English at home.’ als in their role as educators will ensure people
vaccine in its development’ and ‘potential side The McCaffery study highlights the importance have adequate and accessible information from
effects’.12 of tailoring health messages to those with lower a trusted source, to optimise vaccine uptake and
health literacy and culturally and linguistically ultimately reduce community transmission of
Older people in our study who comprised 23%
diverse communities. It points out that there are COVID-19.’15
of the total sample (n=199) were the group most
examples of effective management of diverse
likely to say that they wanted to get the vaccine. Recent research by Associate Professor Holly
community needs that use tailored health mes-
85% of those over 65 said they would have, or Seale16 with UNSW Medicine’s School of Public
sages and cites the Western Sydney Local Health
had already had, the vaccine. Vaccine predispo- Health and Deputy Chair for the Collaboration on
District Health Literacy Hub.
sition was, however, also strong across other age Social Science and Immunisation found there is a
need to ‘decentralise’ communications by tapping
13
The Essential Report - an online survey conducted by
12
R H Dodd, K Pickles, B Nickel, E Cvejic, J Ayre, C Batcup, C Essential Research completed by 1090 people
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