Sandwell Council: Creating an army of vaccine advocates

Sandwell has a network of community leaders to promote vaccination; follow-up calls are also being made to those who refuse a jab; early data suggests there is little difference in uptake between ethnic groups.


This is part of a series of case-studies published on 12 February 2021 

  • Sandwell has a network of community leaders to promote vaccination
  • Follow-up calls are also being made to those who refuse a jab
  • Early data suggests there is little difference in uptake between ethnic groups.

Local context

Sandwell is a metropolitan borough in the West Midlands, bordering Birmingham. It is a densely populated borough and is home to nearly 330,000 people – a third of whom are from ethnic minority groups.

There are eight primary care networks, which are running vaccination clinics in a variety of locations from GP surgeries to community settings. Sandwell and West Birmingham NHS Trust also acts as a vaccination hub, while the near mass vaccination centre is in the centre of Birmingham at Millennium Point.

Working with trusted leaders in the community

The Government has provided funding to councils to create network of COVID champions to promote vaccination. But Sandwell Council began planning this before Christmas and had already established a Community Vaccination Leadership Programme by the time the government initiative was launched.

Director of Public Health Dr Lisa McNally said: “We knew from our work with local contact tracing and from flu uptake figures that there are difficulties engaging some communities, particularly some ethnic minority communities.

There are a number of other reasons – digital exclusion, car ownership, language barriers and there are some cultural factors that means myths circulating more strongly.

We knew straight-away we would have to harness trusted voices – it is something we have done throughout the pandemic.

It is not me or council leader or even local doctors that are listened, it is faith sector leaders, community group leaders, the local go-to guy who knows everyone in the neighbourhood.”

In December, Sandwell launched its COVID Vaccination Leaders Programme. By early February more than 50 leaders had been recruited and trained, including faith leaders, representatives of Age UK, members of Sikh football team, someone form the local deaf community organisation and neighbourhood group members. The hope is by the end of February there will be more than 100.

Creating positive social norms is key

Online training is provided by one of the public health nurses with input from a behaviour change specialist. The sessions are live and interactive sessions so leaders can ask questions.

Dr McNally said: “It is more informative and actually helps us tailor our training and learn what the issues are on the ground. It is much better than just providing people with pre-recorded online modules.

We talk about advocating. These people are well versed in it. But the thing we stress is that it is important to engage those who have concerns and not the outright anti-vaxxers – it is not about locking horns with them.

Nor is it about lecturing. One of the most effective tools is creating positive behaviour and norms and leading by example.

“For example, I tweeted recently about my mum getting called in for vaccination and being out of the door in a flash, not even having time to put her lippy on. I used a gif of a penguin racing along. It was viewed 250,000 times. It makes people think, if its good enough for Lisa’s mum, its good enough for me.

So we have seen our leaders producing films of people getting vaccinated, talking about how simple it is and how it makes them feel safe and positive. It is about creating positive feelings about something.”

Alongside providing training, the council has also been providing support with promotional material, such as posters, while a vaccination uptake grant has been set up to help community groups run their own projects, such as hosting dedicated vaccination sessions in faith settings.

One of those who has led from the front is Harmohinder Singha Bhatia, a lay preacher who has worked on community projects in Sandwell for nearly 50 years and was awarded an MBE last year. He has been active in talking about how he has received the vaccine and encouraging others to do the same. “One thing this pandemic has shown me is how communities in Sandwell have come together to support one another.”

Follow-up calls to those who turn down jab

Another initiative to improve uptake is also just getting under way. The Healthy Sandwell team, which normally does smoking cessation and weight management programmes and so are skilled negotiators, are running a phone line and following up those who have not come forward for the jab.

There may be practical reasons, such as not being able to read the letter or needing transport, which can then be arranged for them, while others may have concerns about the vaccine itself. Health Protection Service Manager Valerie Unsworth said: “One of the common concerns we hear a lot is that people are worried that the vaccines have been rushed. That steps may have been missed out.

We are able to reassure that, although it’s all happened quickly, it hasn’t been rushed. We summarise the vaccine approval process and explain the rigorous testing that all vaccines undergo.

“And say that this is a great example of international co-operation and what can be achieved when we are all working to a common goal.

“Once people have an insight into the whole process they are less concerned and several people have changed their minds and have been vaccinated.”

At the moment the service is being provided for one PCN, but will be expanded out to all eight in the coming weeks.

Dr McNally is delighted with the efforts that are being made. “It is about getting everyone in the system playing to their strengths. We can make that happen – and I think have a significant impact on uptake. It is still early days, but we are not seeing a big difference between uptake at the moment so it suggests we are having an impact.”