Devecchi, Cristina

Ward, Alison

English

The project, commissioned by the NHS Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) in collaboration with Cambridgeshire County Council and Peterborough City Council, aimed to gain greater insights into Covid-19 vaccine hesitancy in lower uptake areas and specific populations in Cambridge City, Peterborough City and Fenland, to inform ways of enhancing confidence and vaccine take-up. The evidence confirms findings from international literature showing that vaccine hesitancy is a complex phenomenon in which a number of factors contribute to vaccine hesitancy or confidence. Evidence from community members in particular show that vaccine hesitancy should be viewed on a flexible continuum in which their views are not fixed. The current study identifies that while diverse groups of people have specific needs, their attitudes towards vaccination are not necessarily determined by the group they belong to. The study shows that there is evidence of community liaisons, local authorities and NHS staff having used a multi-dimensional and flexible approach while being forced to adapt to fast changing situations on the ground. A further insight of the study shows that even vaccinated individuals are no less sceptical, wary and confused about the information they received about the pandemic and the vaccine itself.<br/

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 © University of Northampton commercial and confidential June 2022 0                     Exploring Covid-19 Vaccine Confidence in low uptake areas and populations in Peterborough and Cambridgeshire – Executive Summary  Dr Cristina Devecchi Dr Alison Ward  © University of Northampton commercial and confidential June 2022 1  Contents Table of Contents Acknowledgements .......................................................................................................... 2 Infographics ..................................................................................................................... 3 Executive Summary .......................................................................................................... 5       © University of Northampton commercial and confidential June 2022 2   Acknowledgements   The research team would like to thank all those who took part in this research. First of all we would like to thank the participants in the interviews, focus groups and survey for their time and for sharing their views, experience and recommendations about the Covid-19 vaccination programme. This project would have not been possible without the support of many other frontline health and local authority staff, community liaisons and professionals who generously shared their expertise and facilitated the team’s access to community members. A thank you to the members of the Vaccine Confidence Steering Group, the Community Engagement – Vaccine Confidence group and the Cambridge Vaccine Access Group who welcomed us to their meetings which were invaluable in providing the context in which policies and practices were developed and implemented. We would like to thank Suzanne Goff for inviting the Team to present interim findings at the conference she organised. Last, but not least, we would also like to thank our advisory group Barbara Paterson, Jonathan Bartram, Alexander Phillips, Denise Revens, Vivienne Shaw, and Joanna Hudson for their ongoing support, feedback and suggestions.              © University of Northampton commercial and confidential June 2022 3  Infographics     © University of Northampton commercial and confidential June 2022 4   5  Executive Summary  The project, commissioned by the NHS Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) in collaboration with Cambridgeshire County Council and Peterborough City Council, aimed to gain greater insights into Covid19 vaccine hesitancy in lower uptake areas and specific populations in Cambridge City, Peterborough City and Fenland, to inform ways of enhancing confidence and vaccine take-up.   Aims and objectives The following project objectives were identified:  To gather a deeper and more nuanced understanding of the personal, cultural and social barriers in low uptakes areas and population groups including ‘white other’, ‘other ethnic groups’, migrant workers and 50+ users face in taking advantage of vaccination programmes;   To identify motivational factors and practices which funders and sponsors can use to modify individual’s attitudes and behaviours;   To provide fact-finding and evidence-based recommendations for practice.  Methods  The project included three phases. Phase 1 was an initial ‘fact finding’ with local authority and NHS staff to rapidly assimilate current local ‘soft intelligence’ on vaccine hesitancy, identify strategies to date to boost vaccine uptake and to inform the next stages including identification of participants. This was followed by Phases 2 and 3 during which a deeper and more nuanced understanding of participants’ personal, cultural and social barriers were gathered, and for which the data was a formal part of the project.  In total, the project gained evidence through a survey, interviews and focus groups from a total of 162 participants, including 12 representatives from across Cambridgeshire and Peterborough representing the Local Authority, Public Health, GPs, and the Voluntary Sector; 13 community liaison leads; 115 questionnaires responses, and 20 members of the community as the main target population.  Key findings The evidence confirms findings from international literature showing that vaccine hesitancy is a complex phenomenon in which a number of factors contribute to vaccine hesitancy or confidence.  Evidence from community members in particular show that vaccine hesitancy should be viewed on a flexible continuum in which their views are not fixed.   The current study identifies that while diverse groups of people have specific needs, their attitudes towards vaccination are not necessarily determined by the group they belong to.   The study shows that there is evidence of community liaisons, local authorities and NHS staff having used a multi-dimensional and flexible approach while being forced to adapt to fast changing situations on the ground.   A further insight of the study shows that even vaccinated individuals are no less sceptical, wary and confused about the information they received about the pandemic and the vaccine itself.   Key factors A number of key factors can impact negatively or positively the way in which   © University of Northampton commercial and confidential June 2022 6  community members make decisions regarding vaccination. Such factors are fluid and changeable:  Trust - Trust in health professionals, in official communication channels, in science, but also in one's own Immunity;  “I trusted our scientists and medical professionals to produce a vaccine that was as safe as possible given the speed with which it needed to be available.” (Community member)   Risk – Perception of risk and willingness to take risk, or risk aversion in regard to both vaccination and Covid infection;  “I wasn’t sure whether I wanted to take the vaccine because I didn’t mind going through symptoms of Covid in case I would get it. However, when I heard that people who have problematic health conditions and elderly would have worse symptoms, it changed my mind because I wouldn’t want to pass on an Illness ...” (Community member)   Safety – Perceived safety of the vaccine and how the vaccine was developed and its long-term effects;  “I believe the vaccines are dangerous and the propaganda campaign to have experimental vaccines wrong.” (Community member)   Communication - Consistent, coherent, and effective communication from trusted official sources, at the national and local/community level;   “We were given good information and advice why we should take vaccination. Our community had good Covid coordinators who gave the most updated advice on Covid 19 & vaccination. The information came from NHS Doctor who is part of our Covid team.” (Community member)   Collaboration – Effective, multidisciplinary collaboration between health professionals, GPs, social care and community workers, and local authorities;  “…work in partnership, aligning priorities, collaborating where it makes sense to do so and where there is agreement to do so.  It’s looking at this partner-wide style of working, working with our communities rather than doing things to them is very much the essence of the role.” (Community liaison)   Access – Ease in booking vaccination; ease in accessing vaccine centres; literacy level to access information provided.  “So, they can’t get appointments, they don’t know how to use the booking system or can’t access the booking system; appointments aren’t available at the right time, mixed messaging around bookings.” (Community liaison)  Challenges of delivering the vaccine programme  Conflicting messages – Inconsistent messages between local and national government; changes in vaccine and Covid-19 guidance;  Getting the right message – putting pressure on people; the need to deliver the message in multiple languages; engaging in conversation rather than just sharing information; adapting the message to the target group;  Building relationships – Time and local knowledge needed to build relationships; consistency with planned activities (e.g. vaccine bus visit) to avoid damaging local relationships and trust;  Business relationships – providing support to larger organisation to enable staff time off for vaccination and isolation; coping with different   © University of Northampton commercial and confidential June 2022 7  local and national policies for larger organisations; transitory nature of many workers in the region, including highly mobile academic and student population.  Key recommendations Recommendations focus on access and participation with the vaccine programme, to continue to develop inclusive approaches to communication and support which foster access and participation, which meet generic, group specific and individual needs of community members.  In regard to access, both physical access to vaccination facilities and access to knowledge and information about the vaccine, it is recommended that the extensive work already carried out and the knowledge and expertise developed in regard to effective means and channels of communication continues and is developed further as a way to cope with a possible Autumn vaccination initiative, but also in regard to other future and ongoing health initiatives.   In regard to fostering participation, it is recommended to foster two closely related aspects of participation, that is, the involvement of community members as key stakeholders in the development, implementation and evaluation of policies and practices the involvement of community members as respected and valued decision makers independently from their views about the vaccine, and providing educational opportunities.  In regard to communication, it is recommended that communication teams continue with their best practice work of using different formats/approaches, working through local organisations and trusted individuals and providing materials in different languages. The report also acknowledges the challenges in responding locally with nationally agreed communication strategies. Consideration could be given to priorities that enable face to face engagement, messaging form health professionals, or coproduced communications through collaborations with local communities. The emphasis could be placed on encouraging a two-way communication to enable different sides of the vaccine debate to be considered. Further recommendations relate to the timely address of misinformation and fears of the vaccine (e.g. how the vaccine was developed in the time frame, impact on immune system, value of having a booster with so many still getting Covid) and showcasing the positive impacts of the vaccine (e.g. how time off for staff is lower, customer confidence increased) can highlight benefits that will resonate with businesses and individuals.     For further information about the project or to provide feedback on the findings and how these have informed your practice, please contact:  cristina.devecchi@northampton.ac.uk 

Exploring Covid-19 Vaccine Confidence in Low Uptake Areas and Populations in Peterborough and Cambridgeshire

https://pure.northampton.ac.uk/files/37753653/Executive_Summary_Exploring_Covid_19_Vaccine_Confidence_in_Low_Uptake_Areas_and_Populations_in_Peterborough_and_Cambridgeshire_2022.pdf

Exploring Covid-19 Vaccine Confidence in Low Uptake Areas and Populations in Peterborough and Cambridgeshire

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