Coronavirus (COVID-19): highest risk – interviews report – August 2021

Results from qualitative Scottish Government interviews conducted in August 2021 with people at highest clinical risk from COVID-19.

Impact of the vaccine

Around 94% of those on the high risk list were fully vaccinated and vaccination rates in the general population were also very high. For some participants, this has affected how they understand their risk, although many acknowledged that vaccination is not considered a fail-safe way of being protected from COVID-19.

Reasons why people are not fully vaccinated

Two participants explained why they have decided not to be fully vaccinated. We spoke to the parent of a higher risk young adult whose daughter had a bad reaction to the first dose of the vaccine. While the participant acknowledged that they could not be certain that their daughter's ill-health was linked to her vaccine, they felt it was too risky for their daughter to have the second dose until they received further information from the consultants about whether it was safe to go ahead.

She's frightened to go for her second jag. After the first time, her kidney function dropped. If that happens again [with the second dose], you're talking about her kidney dropping to about 20% - is that a risk we're going to take? We're waiting on the hospital to give us an update on whether it's safe to take a second jag (Participant 2)

Another participant had chosen not to receive either dose of the vaccine because they were concerned about reacting badly because they are immunocompromised. They also disclosed that they live rurally and believed that the risk of contracting the virus was relatively low and because they did not believe that the vaccine has been adequately tested with people with compromised immune systems. The participant said they would prefer to wait until there were more 'peer-reviewed medical journals' which evidenced how the vaccine may react with their condition before deciding to get the vaccine.

My immune system is not functioning properly. There is not enough evidence of the benefit compared to the risk for me. I don't want to put something in my body when I don't know how it will react. I read that it's been tested on humans and people died. (Participant 12)

Vaccination made some participants feel more confident

Some participants felt that their risk of catching or becoming seriously ill from COVID-19 had reduced since having their second dose of the vaccine and that this had allowed them to feel more confident to do things again. While there were questions about the efficacy of the vaccine for those with compromised immune systems, some felt that vaccines had offered a degree of protection:

I felt the risk had decreased [after vaccination] - not eliminated but decreased. I know the risk of severe disease goes down once vaccinated. (Participant 5)

More information about the efficacy of the vaccine is needed

Many participants said that they were looking for more information about how well the vaccine has worked and about the difference between different vaccines but they found it difficult to find conclusive answers:

We don't know what effect the vaccine will have on people who are immunosuppressed. You read data one day that says it works, other days, that it doesn't – I've still got no idea. If I can get the data, then I can assess if I feel happy going out as other people seem to be doing at the moment. (Participant 10)

Some participants felt that having condition-specific information on the efficacy of the vaccine would give them more confidence to manage their own risk and allow them to start meeting more people from outside their household again. Along with this, some participants questioned what role booster vaccines may play in the future, depending on the effectiveness of the vaccine for those who are immunocompromised:

When I went for my second vaccination, the nurse said they didn't know if the vaccinations would be as effective from my group but I heard there might be a booster? (Participant 9)

Information about vaccine efficacy should come from a healthcare professional

Vaccines had changed the way that many participants thought about their risk and the impact that COVID-19 may have if they caught it. However, there were many questions from participants about how the vaccine may interact with a medical condition or medication. Participants told us that having condition-specific information from a trusted source would allow them to better manage their own risk and may give them more confidence to make decisions:

...this made me feel a lot better. Since speaking to the consultant, I feel a lot more chill about my risk. (Participant 3).

For those who were still looking for more information or reassurance, many suggested that they would feel more confident if this information came from a medical professional:

I feel slightly more protected after double dose but I know it's not possible to tell exactly how much protection I have, given that I'm immuno-compromised. I'd have trust in my doctor to give me that information, rather than just looking on Google. (Participant 4).



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