With Herculean vaccination efforts underway in the UK, the ‘hesitancy’ of ethnic minorities to vaccinate, particularly those working in health and caring professions, has become a key narrative within public discourse – especially in terms of its potential to curtail the road to so-called ‘herd immunity’. Vaccination uptake has been low amongst communities of colour in the UK health care sector, and there has been political chatter around NHS trusts making vaccination compulsory for all healthcare workers, as well as care home staff.

Vaccination is essential to combating the coronavirus, maintaining a functional economy and National Health Service, as well as saving people’s lives. However, we also need to closely examine news narratives around vaccine hesitancy amongst ethnic minorities in the UK, and to consider how these might strengthen stereotypes that ‘other-ise’ communities of colour, particularly women, who form the majority of health and care workers.

Vaccine hesitancy isn’t an issue unique to those often referred to through the category ‘BAME’. However, in their framings of the vaccine hesitancy debate, news media have nevertheless tended to focus on ethnic minorities at the expense of other groups opting out of the jab (from traditional anti-vaxxers, to those worried about the vaccine’s impact on fertility). The more prevalent circulation of these narratives is cause for concern, as they have the potential to fuel the demonisation of certain groups in society, at a time of increased racial tension globally, and at a moment when social, political and economic institutions (including journalism) are grappling with their own deeply rooted racism.

News narratives tend to focus primarily on stereotypical tropes involving purported cultural or religious reasons that make different communities hesitant to either take part in trials or get the vaccine – for example, through an emphasis on the halal status of vaccines). Central to this is the deeply problematic notion that ethnic minorities – those who are effectively other-ised under the label ‘BAME’ – form an homogenous group. But even more concerning is the fact that these news narratives come at the expense of an examination of important structural inequalities within healthcare itself, particularly in relation to women of colour, that impact upon vaccine uptake. Black women, for example, are four times more likely to die in the UK from childbirth, while women from Asian backgrounds face twice the risk of white women.

A focus on ‘cultural’ explanations also overlooks the issue of pain bias: women, in general, have to wait much longer to be seen than men in emergency departments and are less likely to be given effective pain killers, and this can often intersect with forms of racial discrimination. As a brown, Arab woman, for instance, I have had a white male doctor attribute my physical pain to ‘’cultural practices’’. This included lifting children from the ground; a“cultural practice” which seemed to him, unique to Arab women (the fact that I don’t have any children seemed beside the point). Another incident stands out: in A&E, a male nurse asked me about my pain level on a scale of one to ten. I replied with a seven, which he brushed off with “you look more like a three”. Within the broader landscape of pain bias and ethnic minorities, this might seem a relatively minor example, but it highlights how gendered, racial discrimination can become a personal, daily, and almost casual, assault on women of colour in their experiences of the healthcare system.

This persistent dismissal of pain is joined by the larger issue of lack of research into women’s health issues compared to men: disparities even more greatly magnified for women of colour, and black women in particular. This background environment of neglect helps to breed mistrust towards health institutions, and by implication, new forms of vaccination. We also need to see this in the context of a greatly elevated mortality rate for people of colour infected by Covid, who are also far more likely to be working in ‘essential’ roles that heighten their exposure to the virus. This is particularly the case for women in the health and social care sector, where ethnic minorities are massively overrepresented.

All this is taking place within the context of an increased conversation around racism in the UK, as well as the recent controversies following the publication of the Sewell Report, with its galling conclusions on the non-existence of institutional racism. We’ve already seen that such discrimination definitely exists in healthcare. But it also continues in newsrooms, where only 0.2 per cent of journalists are Black and only 0.4 per cent are Muslim. Recent news media narratives surrounding the low uptake of vaccinations within communities of colour arguably reflect this fact, and work towards increasing hostility and mistrust towards workers in caring professions, particularly women of colour.

The way that journalists frame social issues is key to their audience’s understanding and attribution of responsibility. Media scholars often make a distinction between two different ways of framing issues. The first is ‘episodic’ and focuses on individual case studies and events, without contextualisation or evaluation. The second is ‘thematic’ and places a wide-angle lens on coverage by focusing on trends over time, for example, and highlighting contexts and environments. These different ways of framing can have huge impacts on how audiences view a problem and whether they come to see it as requiring a broad, institutional solution that evaluates structural shortcomings.

When it comes to news representations of ethnic minorities in the UK and their reluctance to vaccinate, framing across the news, but particularly within more right leaning media, is consistently ‘episodic’ rather than ‘thematic’, tending to focus on a simple story of ‘refusal’ at the expense of an examination of the structural racism within healthcare that promotes this mistrust in the first place.

Other prevalent frames in the news have focused on national efforts to encourage ethnic minorities to vaccinate, but have stopped short of properly evaluating why these communities might hesitate, and as a result, have reproduced a narrative that blames communities of colour, rather than the broader institutions that marginalise and fail them. This episodic framing only enhances difference and fuels animosity towards ethnic minorities, particularly those working in the health and caring sectors. This all comes at a moment when journalism, as an institution, should be holding a mirror up to itself: not only regarding its own lack of diversity, but also to explore how it could be circumventing prevalent racist narratives in our society, rather than amplifying them. Right now, journalism needs to recognise its responsibility in creating a news media landscape that is inclusive – and fair – in its representation of ethnic minorities, at a critical moment for race relations in Britain.

Dr Sumaya Alnahed is an academic and researcher based at the University of West London, where she teaches Journalism. She is particularly interested in how news media frame socio-political issues and events, and her work includes analysis of protest movements and social change, representations of diversity and inclusion in the media, and most recently, coverage of the Covid pandemic.