Brighton and Hove: Encouraging vaccination among vulnerable groups

Vulnerable groups such as travellers and asylum seekers are known to have lower rates of vaccination than the general population. In Brighton and Hove the local immunisation team has been working closely with health visitors, commissioned by the city council, to increase uptake.


What was done?

The services – provided by Sussex Community NHS Trust – work side-by-side as part of the Health Child Programme. Within the health visiting service, dedicated nurses work with families with extra vulnerabilities and complexities.

These families include teenage parents, asylum seekers and refugees, care leavers, those under the care of social workers and the homeless alongside traveller families. These specialist health visitors are able to call in a link nurse from the immunisation team when they have concerns or evidence that children are unvaccinated. This often involves home visits to establish vaccination history and to provide immunisations if the family agrees.

Link nurses and health visitors hold health clinics every school holiday at the dedicated traveller sites in Brighton and Hove. One-off visits are also made to other temporary sites when the need arises, to offer immunisations alongside other health advice and support.

The impact

Immunisation Clinical Service Manager, Rosanna Raven, said: “The partnership works really well. The health visitors have developed a trusted relationship with these groups and that makes it easier to broach this subject and convince them of the need for vaccination. But, you do have to be quite tenacious – sometimes it is just about convincing and reaching out to one family at a time.

“You also have to be prepared to do your research, especially for children who have come from abroad where it can be difficult to determine their vaccination history.

“We have the schedules for lots of different countries so we know what the children would have been offered. We speak to the parents about what immunisations they believe they have had. But, if we are in doubt we vaccinate – that is the Public Health England advice to be cautious.”

The team is able to offer the full range of childhood vaccinations to these groups from the pre-school jabs such as MMR through to HPV vaccinations, which are offered to teenagers.

What else is happening?

Specialist outreach work has also been done out in the community.

An example of this is the work completed recently with a school, which has a significant Muslim population. There was a lower uptake of the flu vaccines because of concern about the pork ingredients. The immunisation service went in and spent time talking to the families and were able to encourage some families to agree to the vaccination. Linda Evans, manager of the Healthy Futures Team, which includes the specialist health visitors, said the partnership work was proving invaluable.

“This close working relationship is essential to developing creative ways of improving the uptake of immunisations – a public health priority. Specialist health visitors working with vulnerable families are ideally placed to talk with them about the importance of immunising their children. They highly value the joint working with our colleagues in the immunisation team.”

Contact details

Linda Evans
Healthy Futures Team
Brighton and Hove
linda.evans7@nhs.net