How Shropshire, Telford and Wrekin vaccination programme is tackling health inequalities

SHROPSHIRE COMMUNITY HEALTHCARE NHS TRUST IS THE LEAD PROVIDER FOR THE SHROPSHIRE, TELFORD AND WREKIN VACCINATION SERVICE AND WORKS IN PARTNERSHIP ACROSS ALL HEALTH PARTNERS AND WITH LOCAL AUTHORITIES TO DELIVER A HIGHLY SUCCESSFUL COVID VACCINATION PROGRAMME ACROSS ITS CONURBATION, WHICH IS BOTH RURAL AND URBAN.

Shropshire, Telford and Wrekin Vaccination Team has come up with a novel and highly effective solution to help address low vaccination uptake in some of its most vulnerable communities, tackling health inequalities with three Vaccination Buses – Bob, Betty and Basil and targeted community engagement. Working in close collaboration with a range of partners including both Local Authorities and the military, the Vaccination Team utilised three vaccination buses to help them to respond to the fast- spreading omicron variant during the Booster Sprint in December 2021.

The vehicles were sourced and repurposed into mobile vaccination units with changes such as privacy screens, power connections and heating added to allow NHS teams to set up the clinics wherever they parked. The buses, affectionately named Bob,

Betty and Basil, have been run by a variety of staff including the Council, the military, NHS staff and volunteers. All staff members have gone above and beyond, working weekends and holiday periods to ensure its efficient running and as part of the effort to get the vaccine to as many people as possible by the New Year. Using a combination of data and insight – backed up by a comprehensive and imaginative communications campaign that included tailored text messages to unvaccinated patients, and calls to residents encouraging them to get their jab – the Vaccination Buses have improved access to vaccination. This was particularly effective in the county’s most disadvantaged, diverse and rural communities, significantly increasing the number of vaccinations delivered to these groups of people.

How it worked

This intelligence-led approach allowed locations to be selected where Covid vaccine uptake was lowest, through community engagement either via direct contact, communityfocused communications or both. Areas targeted were amongst the most deprived and ethnically diverse communities in the county.

Residents were targeted in Telford and Wrekingby:

• Sending texts to residents in target areas to make them aware of when the vaccine bus was coming.

• Outbound calling to residents in the lowest uptake areas.

• Targeted social media messages to residents in low uptake areas.

• Requests to Town and Parish Councils, ward members etc. in low uptake areas to promote via their channels.

Residents were targeted in Shropshire by:

• Outbound calling to vulnerable residents flagging vaccinations and other available support.

• Targeted social media messages to residents in low uptake areas.

• Community Outreach Team in areas of lower uptake and most vulnerable communities including minority populations.

• Farming communities, and targeting working places, alongside specialist Gypsy and Traveller Team and Business support teams.

• Targeting large employers of our Eastern European populations by taking the bus to them and translating materials.

Impact

This initiative has clearly narrowed the vaccine-related inequalities in Shropshire, Telford and Wrekin, particularly with respect to an increase in first doses, as well as reduced the number of unvaccinated people in the most disadvantaged areas and among ethnic groups where uptake was lowest. An impressive 85% (+49.5%) of over 18-year-olds had come forward for their booster vaccination. There was also an increased uptake of first (+1.8%) and second doses (+5.2%) of COVID-19 vaccination since the booster sprint, with 81.6% of the eligible population receiving both doses. The ethnicity gap narrowed by 0.4% for 1st dose, 1.5% for 2nd dose and 2.9% for boosters (white v all BAME groups). 1st dose deprivation gap narrowed by +0.14% (most deprived v most affluent).

1st dose uptake of people with COPD (97.1%) Also of note is uptake of vaccine amongst people who are immunosuppressed (3rd in the country), pregnant women (best in region) and people with learning disabilities and autism, with bespoke clinics being provided for these groups.