BAME uptake of vaccination

[randomer]

I am reading that the BAME community is disproporionately affected by Covid and the uptake of offers of vaccines is less than non BAME.

I wonder if its true and also why.

I apologise for the clumsy term "BAME" but I can't think how else to word it.

I'd be interested in the uptake of vaccine against age groups, older people are still of the generation that view doctors almost like gods, don't question medication or treatment where younger generations do their own research & ask more questions.

I can’t find the link now but surveys in the US have shown women are less likely to take the vaccine as men. When you see that pregnant and breastfeeding women were excluded from the trials that makes some sense.

There’s a long history of medical treatment being calibrated for a generic white male patient. For example mothers of mixed race babies being suspected of abuse by midwives because of Mongolian blue spots, which are thought to be bruises.

I live in Asia and many local people here say they want Chinese vaccines, not because they think they are better but that they’ve been trialed on Asians vs Pfizer etc which were mainly trialed on white people.

The AZ vaccine was trialled in South Africa, Brazil and UK.

Are BAME people biologically different to say white Europeans then?
I’ve always assumed we’re all pretty much the same, whatever our outward appearance, ie a species of mammal.

Yes. Due to melanin in their dark skin they are deficient in vitamin D which means their immunity is low. That means they are far more susceptible to catching covid, and more likely to need ICU, and to die, than fair-skinned people. I said this in my earlier post.

Most of the evidence that vitamin D seems to be beneficial is not from controlled trials, therefore NICE wont pay as much attention to it. That is because of things like thalidomide happening in the best, they want good quality research before recommending it. There are larger trials going on but not completed. Clinical trials are often slow to enroll people and to write up.

There is a considerable difference between saying those with low levels of vitamin D do badly and supplementation will change that and be safe. Most scientists would agree with the first, be more dubious about the second.

This is absolute nonsense. Vitamin D is not some new, untested drug. It is actually a hormone which is developed naturally, and completely harmless, even in huge doses. There is absolutely no risk in prescribing calcifediol in doses of 20,000 iu, for people who are already infected, which is what all the highly successful trials are doing. Instead, NICE recommends 400iu, which is ridiculous.

And yes, there are scores and scores of studies on its almost miraculous effect when given to covid patients: things like a 96% reduction of ICU intake. This is being kept from the public.

Since it is really harmless even in high doses, wouldn't it be of benefit to prescribe it anyway, as was done in Andalucía, with spectacular results? Or would that make the whole rush to vaccines look silly? Think about it.

The Andalucía doctors concluded that a trial would be a waste of time and involve far too much burocracy and paperwork and organisation, so they just went ahead, gave the patients high calcifediol doses, and look what happened! A miracle.

sorry, I should have said, NICE recommends 400iu, for bones and muscles, which is so ridiculous it is almost a mockery, which makes their motives highly suspicious.

@Grannycurls
And yes, there are scores and scores of studies on its almost miraculous effect when given to covid patients: things like a 96% reduction of ICU intake. This is being kept from the public.

Can you put a link to where you read this?

The racism was what I mentioned upthread. I was in hospital a lot due to complications and overheard midwives being vile about black and Muslim women. Mimicking accents and using stereotypes.

God, this gives me the rage! I’m sick of people acting like our NHS is some kind of godlike entity that can do no wrong. It really isn’t and some people (myself included) have really terrible experiences.

Yes. Due to melanin in their dark skin they are deficient in vitamin D which means their immunity is low. That means they are far more susceptible to catching covid, and more likely to need ICU, and to die, than fair-skinned people. I said this in my earlier post.

@Grannycurls you ought to clarify that dark skinned people only tend to have Vit D deficiency in regions with less sunlight. It is not inherently the case that dark skinned have this problem. There’s no indication of higher death rates in India vs Europe due to Covid for example.

@Grannycurls you ought to clarify that dark skinned people only tend to have Vit D deficiency in regions with less sunlight. It is not inherently the case that dark skinned have this problem. There’s no indication of higher death rates in India vs Europe due to Covid for example.

Yes, sorry, I should have mentioned that little detail.

[quote PinkyParrot]@Grannycurls
And yes, there are scores and scores of studies on its almost miraculous effect when given to covid patients: things like a 96% reduction of ICU intake. This is being kept from the public.

Can you put a link to where you read this?[/quote]
I read a comprehensive list about two weeks ago and I need time to find it. It was a list easily understood by laypeople so very useful.
In the meantime, here's another link I found on the fly:

c19study.com/d

On topic of ethnic minorities & vaccines, what is the roll out strategy for Irish travellers or gypsies/Roma on the continent?

Do Irish travellers tend to registered with doctors in UK or RoI or registered with no GP surgery?

I am finding nothing at all online about these (quite marginalised disadvantaged) communities getting vaccie, other than a tiny number of stories in the Irish media.

Are BAME people biologically different to say white Europeans then
I’ve always assumed we’re all pretty much the same, whatever our outward appearance, ie a species of mammal

There are genetic differences between all peoples (including amongst white skinned and dark skinned people)

For example, white populations from the Mediterranean have genetic differences from Scandinavian populations, for instance

That's why I think it's important that trials include people from as many backgrounds as possible

Moving away from Vit D for a minute and returning to the original question...An interesting deep dive from The Guardian, if anyone has 30mins to spare.

https://www.theguardian.com/news/audio/2021/jan/26/vaccine-hesitancy-what-is-behind-the-fears-circulating-in-bame-communities-podcast?CMP=ShareiOSAppp_Other

Encouraging to hear towards the end that community leaders have some confidence that the tide may be turning.

I'd be interested in the uptake of vaccine against age groups, older people are still of the generation that view doctors almost like gods, don't question medication or treatment where younger generations do their own research & ask more questions

Remembering that it's not all of either group, that's actually an interesting point - but I doubt in a position to know yet, since vaccination's focused on seniors so far with younger people really only involved if they're CEV

As you say though, it would be good to know

This has also popped up for me from this morning:

https://www.theguardian.com/society/2021/feb/07/faith-leaders-join-to-counter-fears-over-vaccine-among-bame-communities?CMP=ShareiOSAppp_Other

However I do agree with a previous poster who says there is little to be found in the press about Roma communities.

Most of the evidence that vitamin D seems to be beneficial is not from controlled trials, therefore NICE wont pay as much attention to it. That is because of things like thalidomide happening in the best, they want good quality research before recommending it. There are larger trials going on but not completed. Clinical trials are often slow to enroll people and to write up.

Sorry to hark on about this but if the argument is going to be about "better research is needed" then it would surely be the vaccine against Covid that is lacking research!!!! What might be the side affects after six months, a year, two years, five? We don't know! Where is the long-term research on these vaccines? Non-existent!

And yet they are arguing that Vitamin D, with proven successful trials, a supplement harmless even in huge doses and not a new untrialed chemical substance introduced into the body, "needs more research".

The hypocrisy is stunning.

@Nat6999

I'd be interested in the uptake of vaccine against age groups, older people are still of the generation that view doctors almost like gods, don't question medication or treatment where younger generations do their own research & ask more questions.

The data is in OPENSafely which has been mentioned a couple of times upthread.

There are decent graphs reproduced in this news item for both age and ethnicity:

www.dailymail.co.uk/news/article-9227355/White-80s-TWICE-likely-jab-elderly-black-Britons-report-reveals.html

Are BAME people biologically different to say white Europeans then
…
I’ve always assumed we’re all pretty much the same, whatever our outward appearance, ie a species of mammal

With very few exceptions, race/ethnicity is a social construct. Angela Saini is good on this:

www.theguardian.com/lifeandstyle/2020/aug/13/angela-saini-understanding-history-reminds-us-race-is-a-social-construct

A few allegedly known facts such as eGFR differences are now also being revised as they lack evidence and had been harming the black people to whom these differential lab values had been applied.

Researchers noticed that Black participants had, on average, higher creatinine than white ones. This could be explained by the fact that a higher proportion of Black study participants may have already had end-stage kidney disease. But instead the study assumed that Black individuals had higher muscle mass, and thus higher creatinine, than white ones. To prevent these supposedly elevated creatinine levels from skewing test results, researchers multiplied Black people’s eGFR scores by a factor of 1.2. Ten years later, a larger study led to the development of a more accurate eGFR equation called the chronic kidney disease epidemiology collaboration, or CKD-EPI—but it still contains a correction factor for Black patients.

This could have fatal consequences. In order to qualify for a kidney transplant, a patient’s eGFR score has to be low enough to be considered end-stage kidney disease. Because a Black person’s score is bumped up by the correction factor, they might have to wait until their kidney disease reaches a later, more severe stage before they qualify for treatment.

www.scientificamerican.com/article/how-to-take-racial-bias-out-of-kidney-tests/

There are some remaining validated differences in prevalence such as rhesus negative in Chinese populations but this is likely to change with travel and mixing over time. (Relevant for rhesus negative pregnancies and the difficulty of obtaining rhesus negative in China.)

www.rhesusnegative.net/themission/bloodtypefrequencies/

There are genetic differences between populations - see e.g. www.genesandhealth.org/genes-your-health/genetics-south-asian-populations

A lot of health differences, however, are due to diet, so people who start to adopt a western diet can suffer more ill health as a result, western diets are often unhealthy.

Vitamin D has been studied a lot and there is a long history of showing that supplementation doesnt work. Hence the need for scientists, rather than peddlers of supplements, to want clinical trials. I looked at the link posted above - largely observational studies, correlation studies and retrospective analysis. Vitamin D may not be considered a drug but it is a biologically active product which impacts on the body and would be little use if it was not. It has risks - I quote

"Vitamin D toxicity, also called hypervitaminosis D, is a rare but potentially serious condition that occurs when you have excessive amounts of vitamin D in your body.

Vitamin D toxicity is usually caused by large doses of vitamin D supplements — not by diet or sun exposure. That's because your body regulates the amount of vitamin D produced by sun exposure, and even fortified foods don't contain large amounts of vitamin D.

The main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause nausea and vomiting, weakness, and frequent urination. Vitamin D toxicity might progress to bone pain and kidney problems, such as the formation of calcium stones."

Taking vitamin D once you already have covid is different to taking it long term as a precaution.

As I've said I encourage people to take more than the NICE recommendation. They went as far as they felt they could in the absence of proper data, because however good it would be to have the data it isnt there.

@OverTheRainbow88
Yes thank God that those with such white privilege stepped up and were brave 🙄

Really don't understand your comment they wanted volunteers from all walks off life . There was smaller response from some groups nothing to do with privledge it was there choice

@GetOffYourHighHorse

It would seem ironic that those from the BAME community would complain they were underrepresented in trials. If they didn't come forward then what is the solution? www.bbc.co.uk/news/health-54512175

Thank god for all the thousands that did volunteer.

You're missing the fact that trials are always made up of higher proportions of educated people of higher SES who tend to not be ethnic minorities.

Huge number of factors including not having advertisements targeted towards them so being less likely to hear about them and participate, not being able to afford to take time off work, and having co-morbidities that would make them ineligible. Health inequality and racism play a huge role in all of this.

And the reason I mention genetic differences is that scientists are finding some genes relevant to covid risk - but I have no idea if there are differences between populations on this. www.phgfoundation.org/blog/further-genetic-clues-to-severe-covid-19

Vitamin D has been studied a lot and there is a long history of showing that supplementation doesnt work.
The opposite is true.
Hence the need for scientists, rather than peddlers of supplements, to want clinical trials.The studies I have seen have exclusively been from scientists, and I have seen hundreds of scientists/doctors recommending it.

Vitamin D toxicity, also called hypervitaminosis D, is a rare but potentially serious condition that occurs when you have excessive amounts of vitamin D in your body.

Yes, I have seen this. Do you know what counts as an excessive amount? Something like 30000 iu per day. Nobody has recommended that, and the recommended dose of 4000 per day doesn't come close.

I recommend the following website which summarises the NICE assessment thus; see the last paragraph.

www.linkedin.com/pulse/why-vitamin-d-key-ending-covid19-dr-gareth-davies-gruff-/?fbclid=IwAR0ZNiO_xti92ChpGCDWiLA18k4Z2M5_IPHPhhz6hwI3wuVygxqhgZVkM4k

NICE - who failed completely to see any of the errors in the Hastie study and actually praised it for making some of those errors and suggested that other studies should have made them - recommends adults to take 400 IU (10mcg) of vitamin D per day to prevent bone loss and rickets.
NICE is worried about the risk of hypercalcaemia yet the only studies that help us understand hypercalcaemia risk in healthy adults suggest that it only occurs in daily doses in excess of 30,000 IU per day.

Huge number of factors including not having advertisements targeted towards them so being less likely to hear about them and participate, not being able to afford to take time off work, and having co-morbidities that would make them ineligible. Health inequality and racism play a huge role in all of this

Agreed. It's increasingly problematic to recruit people who don't have digital health literacy or lack digital access and both of these intersect with socio-economic categories and minoritised ethnicities.

As for the covid vaccines, clinical trials are run in many countries and in some the associated out of pocket expenses can be prohibitive.