Factors & Strategies

The factors and strategies identified by the collaboration can be used by anyone looking to develop and deliver policies, strategies, and plans to improve vaccine uptake across different communities.

More detail on each of the factors that influence vaccine uptake and the strategies that can improve uptake can be found below.

If you are interested in reading the full data summaries from the rapid review, please email hello@couchhealth.co

Factors

Factors identified by the collaboration that influence vaccine uptake.

Strategies

Strategies identified by the collaboration that can improve vaccine uptake.

Factor

Is there trust in organisations and individuals who advise on vaccine uptake?

Shabir:

trust involves various layers — individual past experiences in seeking services, governmental policies — which all have implications for people. BME is not ‘one group’, it is not homogeneous. Cultural factors will all come in to play.

Charles:

because of mistrust in the government, local / community channels have more trust among minoritised groups than say, the BBC.

Jody:

Trust in individuals is important, but knowing that those speaking are not being forced or paid to say things about the vaccines is just as important.

Phanuel:

In Suffolk, community groups worked with GPs from different communities to front messaging about the vaccine. This allowed a conversation, ‘I look like you, but I’m also a doctor. I know a bit more about the vaccine than many, and I’ve taken it. I wouldn’t take it and suggest you do if I wasn’t confident about it.’ Being from the same background added weight to the message and people did trust those individuals from the same background.

Sundus:

Why trust the system now? We need to remember that inequalities existed prior to COVID-19, and that issues affecting minoritised groups have not been addressed – so why now?

Susan:

Mistrust links to historical perspectives and the rise of misinformation that is spreading across social media. This is exacerbated by the hostile environment, where BAME groups are blamed for ‘not cooperating’

Kirit:

Public Health asked to rally communities after a historical lack and neglect of engagement, public health should ensure communities are adequately funded not just expect their good will

Azzizum:

Trust can differ at a national and local level. In Rotherham where local communities have seen increasing enforcement action across public services, trust has deteriorated considerably.

Phanuel:

Why trust the system now? We need to remember that inequalities existed prior to COVID-19, and that issues affecting minoritised groups have not been addressed – so why now?

Factor

Is there culturally and linguistically appropriate information that covers issues of concern, including an honest discussion of benefits and harms?

Ceri:

In our experience, pre-existing health conditions are a big factor in vaccine hesitancy. These disproportionately affect people from ethnic minoritised communities. People want to discuss how the vaccine is likely to affect them and interfere with any medication, but instead of any referral process to a qualified professional, they are referred to a general switchboard number staffed by people who tell them they “have to” get the vaccine. They are being labelled as an ‘anti-vaxxer’, when they just want to understand any likely impact on their health.

Davine:

The approach that PHE used was not transparent at times and could lead to further mistrust as the information was not clear. For example, people are still dying after both vaccinations and people are still getting COVID, communications should have been honest - “we don’t know, we’re all learning

Jody:

We need to talk honestly about anomalies and adverse events as these have a significant impact on people's perceptions of the vaccine

Factor

How does the accessibility of vaccinations and appointments impact the uptake of COVID-19 vaccines in ethnic minority communities?

Davine:

Much of the negative publicity was made of multigenerational households for ethnic minorities but the vaccine invitations came by age, meaning some older people could not access family help to get to vaccination sites and for poorer families it would have been costly to have multiple trips rather than a single trip for household. It would have been better with a more flexible system, with invitations from GP or primary care and for whole household, uptake would probably be more.

Factor

How does the use of appropriate language affect COVID-19 vaccine uptake in ethnic minority communities?

Factor

How do perceived vaccine benefits and harms impact COVID-19 vaccine uptake in ethnic minority communities?

Strategies

Using trusted messengers to provide information.

Hanif:

Ethnic Health Forum were successful on the Community Champions Funding, which enabled us to employ a Covid Chat Volunteer coordinator and recruit volunteers. They were trained by the Manchester Public Health Team and the Manchester City Council to ensure awareness messages were correct and to build confidence among local residents to promote safe vaccination. One positive result was that many people who were hesitant in the beginning were now accepting the vaccine.

Strategies

Tailoring the message culturally, linguistically and through the range of issues covered so that people get information that directly addresses their concerns.

Susan:

We organised an intergenerational event with performers together with vaccine, went well, the artists also mentioned COVID and being ill, and giving experience of what it was like and why vaccine important.

Phanuel:

People naturally delivering messages on social media was resonating more than the corporate speak of public health messaging. Need to ask, how would you deliver this message if you were talking to friends on WhatsApp. For example, ISCRE discussed the different dialects used in the Roma community

Strategies

Providing flexible venues and times for vaccination.

Phanuel:

People naturally delivering messages on social media was resonating more than the corporate speak of public health messaging. Need to ask, how would you deliver this message if you were talking to friends on WhatsApp. For example, ISCRE discussed the different dialects used in the Roma community

Susan:

For migrants, or undocumented, it took a while to convince them that vaccination is not linked to immigration status. It also took a while for the government to accept this, they had to be lobbied to give vaccination to all.