VHS is carrying out important research across the third sector to help ensure that the distribution of the COVID-19 vaccine doesn’t widen the health inequalities gap by missing vulnerable groups. We are keen to ensure that the opportunity to get vaccinated is made as easy as possible for everyone in Scotland, including those who are furthest away from public services and who already face a wide range of inequalities. We will be feeding back our short survey results to the Public Health Scotland Evaluation of the Flu Vaccination COVID Vaccination (FVCV) programme and to the Scottish Government teams co-ordinating the COVID-19 Vaccination programme. If you are a third sector organisation working actively to support people’s health and wellbeing, you can help by completing our survey by Friday 19th February 2021.
What we are researching
We want to get a third sector overview of which groups are most likely to miss out on the vaccine, even if they are offered it. You can help us identify what the barriers to accessing the vaccine are as well as what can act as an enabler to increase vaccine uptake. We would also like to hear what organisations think about the public-facing communication so far regarding the vaccination programme and how this could be improved. And we want to hear about the role voluntary and community organisations are already playing in supporting the vaccination programme, what more you think could be done and what additional resources and levers might be necessary.
Why is this important?
It is important that there is maximum uptake of the vaccine, because the vaccine is the best protection against coronavirus.
Christina McKelvie MSP, Minister for Older People and Equalities, has recently distributed two letters to equalities and human rights stakeholders, seeking their support in developing and delivering targeted messages to communities, to address specific barriers people may have to taking up the vaccination. VHS has been asked to help disseminate these letters across our own networks. The Minister highlights particular BAME groups, people whose first language is not English, women, people with lower income and lower educational qualifications, homeless people and gypsy travellers, as being of particular concern. She says, “We really want to learn from you so that we can make practical changes that improve people’s experiences of getting the vaccine. So please send us any feedback, about what could be improved as well as what has worked well. Please also let us know about specific questions or concerns so that we can respond quickly. Please also tell us about the kinds of things you have done to encourage and support uptake in your communities and we can share this with others.” VHS’s survey is set to play a part in helping gather this kind of information and feeding it back to the Scottish Government.
Read Christina McKelvie’s letters here:
Vaccine hesitancy, vaccine transparency
The term ‘vaccine hesitancy’ is used by the Minister for Older People and Equalities and is increasingly used in the discussion around uptake of vaccines. VHS believes we need to be cautious in the use of this phrase, lest it result in people themselves being ‘blamed’ for not taking up the vaccine when it is offered. We think it is really important to unpack the term and understand how it can be applied in different circumstances. Vaccine hesitancy may be a health literacy issue in some cases. Some people may be naturally reticent about new technologies or medical advances, or have concerns about vaccine efficacy or side-effects. Vaccine hesitancy may also be rooted in social, economic and health inequalities and the barriers some people face in accessing healthcare and other public services. Only this week a homeless charity and a family charity have talked to VHS about their concerns as to how vulnerable homeless people and families living with multiple deprivation and exclusion will be invited and supported to take up the vaccine.
Concerns about the particular barriers to vaccination facing black and ethnic minority populations have been making the headlines in recent weeks. The Guardian highlighted the issues in an article on 18th January, “People in high-risk minority ethnic groups must be prioritised for Covid immunisations, alongside a targeted publicity campaign, experts and politicians have said amid growing concerns over vaccine scepticism”. The New Scientist published an article on ‘vaccine transparency’ on 23rd January, pointing out that, “surveys in the US and UK last year suggested that hesitancy about Covid-19 vaccines may be more prevalent among racial and ethnic minority groups, raising concerns that this might result in lower vaccine uptake among those most at risk of the disease”.
Missingness in health care
Last year Dr Andrea Williamson, a founder Deep End GP and Clinical Senior Lecturer at the University of Glasgow, published a paper called Missingness in health care- a ‘new normal’ is not a level playing field . In it she shines a light on patients who time and again miss healthcare appointments, and she reflects on a year of dealing with Covid-19: “In the places where marginalisation is common: a person grappling with poverty, the struggle with problem drug use, the experience of homelessness; missingness in health care has been more visible at the patient level”. She asks how permeable are health care services for patients; who within the practice population would benefit from sticky care; what does a practice need to do to stay linked in with patients who have need but whose engagement in care is low? She argues that missingness is a patient safety issue. Whilst Dr Williamson’s focus is on improving the overall primary care response for those who currently fall through the cracks, adapting her recommendations to the operation of the vaccine programme would help ensure a preventative approach towards those people who may otherwise be missed and miss out.
We hope you share our belief that the vaccine is the best protection people can have against Covid-19 and that it is crucial to identify those groups who stand to lose the most if they are not readily able to take up the vaccine, and to support them in any way we can. Please help by completing our survey by Friday 19th February 2021.
For authoritative and comprehensive information about the Covid-19 vaccine programme in Scotland, go to NHS Inform