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Research in coal-mining communities reveals how local histories shape vaccination uptake

Published: 12 May 2022

People living in areas with a strong coal mining tradition are more likely to have negative attitudes towards COVID-19 vaccinations and lockdown measures to those in areas without this history, according to a team of researchers from Wales and the United States. 

Take up of the vaccine was high despite this, particularly in Wales, and feeling part of a strong local community made people more likely to accept the offer of vaccination.

Researchers affiliated with Bangor University, Cardiff Metropolitan University, Public Health Wales and the University of Kentucky conducted surveys and interviews asking 9,000 people living in Wales and Central Appalachia about vaccination status and views on COVID-19, economic status, social lives, and political preferences. Their findings are published in a new report, Covid and the Coalfield: Vaccine hesitance in Wales and Appalachia

The project was funded by the British Academy, the UK’s national academy of the humanities and social sciences and is part of an in-depth research programme to examine the underlying factors behind COVID-19 vaccine confidence and hesitancy in different communities. 

The researchers found that people living in coalfield areas were more sceptical about vaccines and more suspicious of official accounts of the pandemic, compared to non-coalfield areas. In Appalachia, these attitudes were mirrored by lower vaccination uptake among those living in coalfield areas, but in Wales vaccination rates were similar in coalfield and non-coalfield areas.

In both countries, people who were socially isolated were less likely to be vaccinated, as were people who had experienced economic hardship during the pandemic.

Those who were unvaccinated were more likely to have voted for the Brexit Party or Green Party in Wales and for Donald Trump in the US. In Wales, being unvaccinated was also associated with more negative views towards Welsh devolution. In both countries, people who did not vote were less likely to be vaccinated. 

Dr. Christopher Saville, Clinical Lecturer at Bangor University and a member of the research team, said:

“Coalfield regions in South Wales and Central Appalachia share experiences of industrialisation and deindustrialisation which have left a legacy of health, social and economic inequalities that endure to the present day. More positively, people living in these areas have a strong sense of community and solidarity with one another. Understanding the role these factors play in vaccination is critical as our decisions around vaccination are informed by a desire to protect people around us, as well as ourselves.” 

“Taking part in activities – like sports clubs, trade unions, social clubs and community organisations, or indeed voting – that strengthen the social fabric appears to have a role in positive attitudes to vaccination. That is a valuable insight which could contribute to post-Covid recovery, particularly in regions where COVID-19 is just one of many challenges over recent decades, and even help us prepare for future pandemics.” 

Professor Daniel Thomas, Consultant Epidemiologist for Public Health Wales, and a member of the research team said: 

“The opportunity to work with public health practitioners in Eastern Kentucky to look at how the coalfield regions of Wales and the US have developed over the past few years has been both fascinating and incredibly rewarding.  I hope we will be able to build on this partnership and mutual learning between colleagues in the US and Wales to help improve public health in coal mining communities on both sides of the Atlantic.”