Up to a quarter of British healthcare workers have expressed hesitancy towards Covid-19 vaccines, the first comprehensive study of NHS and care staff suggests. Conspiracy beliefs, a paucity of black and ethnic minority participants in vaccine trials, or assuming immunity to Covid-19 because of previous infection were some of the key reasons cited. “Understanding these drivers is important, because without this understanding you can’t implement any interventions,” said Dr Manish Pareek, associate clinical professor in infectious diseases at the University of Leicester who led the study. Pareek and his colleagues previously identified lower rates of vaccine uptake among black and south Asian health staff, workers under 30, and those living in more deprived areas. To better understand the reasons for this hesitancy, they recruited 11,584 clinical and non-clinical staff working for the NHS and other health providers, such as dental practices and pharmacies. As well as completing detailed questionnaires about their attitudes to Covid-19 vaccination, some of the participants were interviewed more extensively to better understand their concerns. The research, which has not yet been peer reviewed, found that 23% of health staff, were hesitant about Covid-19 vaccines, and that hesitancy was more common among BAME health workers, particularly those from black Caribbean groups. However, some white healthcare workers were also hesitant, particularly those in white other ethnic groups. Younger staff, pregnant women and those who had not taken up the flu vaccine were also more hesitant – as were those who had previously tested positive for Covid-19. “A lot of healthcare workers became infected over the last 12 months, and many will feel that they’ve already got immunity,” Pareek said. Other leading reasons for hesitancy included concerns about how safe the vaccine was due to the speed of development and – particularly for black African and Caribbean health workers – the lack of ethnic diversity in vaccine studies. Experiences of discrimination and structural inequalities also contributed to hesitancy among these groups. Addressing this misinformation and mistrust could play an important role in helping to tackle hesitancy among healthcare workers, said Dr Katherine Woolf, associate professor in medical education at University College London, who co-authored the report: “We urgently need strategies to build trust and dispel myths surrounding the Covid-19 vaccine, particularly within communities where there are greater levels of hesitancy. Public health communications should be inclusive, non-stigmatising and use trusted networks.”