Sandwell: Ensuring good uptake in black and ethnic minority groups

To ensure good uptake in black and ethnic minority communities, the council has worked closely with its communities, training local people to become vaccine advocates and running mobile pop-up clinics.

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Sandwell is very ethnically diverse. A third of its population are from black and ethnic minority groups with a particularly big Indian community.

To ensure good uptake in these communities, the council has worked closely with its communities, training local people to become vaccine advocates and running mobile pop-up clinics in a wide variety of locations from mosques and gurdwaras to community centres and even West Brom’s football stadium.

‘We were purposely pessimistic’

Sandwell Council decided very early that take-up could be a problem with Director of Public Health Lisa McNally describing the approach as “purposely pessimistic from the start”.

“We knew from uptake of the flu vaccine that we could expect the numbers coming forward from our BME groups to be lower. That would have been disastrous as these groups had been really badly affected, particularly during the second wave in winter. They are more likely to be in frontline, public-facing jobs so are less protected by lockdowns.”

It meant as soon as the vaccination programme got under way the council started planning ways to reach out to groups that were likely to be hesitant. One of the first steps that was taken was the launch of the COVID-19 Vaccination Leaders Programme. The scheme provides training to people from local communities, including faith leaders and neighbourhood representatives.

Training has been provided by public health nurses and an expert on behavioural change. Dr McNally said: “They were very open forums – we dealt with how vaccines work and how to address hesitancy in communities. We also left time for debate and discussions – it became a two-way process with the leaders providing feedback on how the vaccination programme was going.”

By the spring more than 50 leaders had been trained and that has gradually increased throughout the course of the year so that by autumn there were close to 200. To support them in their work the council has provided small grants to the to enable them to host events or run initiatives in the community. Funding has been provided to set up websites and run open days where members of communities are able to drop-in and discuss vaccination is a relaxed, informal setting.

One of those who has been trained to be a vaccine leader is Parpinder Dhatt, Chief Executive Officer of SAFS, a family support service.

She said the approach that has been taken has helped built a “relationship of trust and confidence” and the training provided gave the vaccine leaders the skills they need to talk about vaccination across diverse communities.

“It has led to an increase in take up of the vaccine in our local community, particularly from people who were reluctant to have the vaccine for their own personal reasons,” she added.

The mobile vaccination clinic

The council has also sought to make it easier for people to get vaccinated by running pop-up clinics via a mobile vaccination service. A library service bus was refurbished and staff including NHS vaccinators and the council’s public health development officers go out into communities to offer drop-in vaccination clinics. These have been run at mosques and gurdwaras as well as community venues.

Dr McNally said: “They have proved incredibly popular. We’ve had people say they would not have been vaccinated if they had not been able to get it at their mosque. The idea of going to a mass vaccination centre can put people off. We should also remember not everyone who has not come forward is necessarily hesitant, they maybe more apathetic. People are busy, they may not have transport to get to a vaccination clinic.

“We had the mobile vaccination bus going out five days a week at one point and even in recent months it has been out two or three times a week. The public health development officers are crucial. We have them in each of our local areas so they really know the communities they are going out to.

“We are now using the bus for boosters, but we have made sure they can also do first and second doses. We still getting people coming forward for those – the publicity around the boosters may for some just tip the balance so we want to make sure we are ready for them if they do come forward.”

Work with key, trusted partners

Dr McNally also said it is important to partner with trusted organisations to engage hard-to-reach groups. An example of this is the work done with Raaj FM, a radio station aimed at the Indian community.

“We have done Q&As and interviews. But it was much more than just going on. The station really worked with us to shape how it was done to make sure it was addressing the things their listeners wanted to know.

“We have also done a lot of work with West Brom football club. We’ve run vaccination clinics at the stadium and players have spoken about the importance of getting vaccinated. The football club is really important to the local community especially the working class white and black population – this is not just about BME groups. You can have low uptake in other communities.”

The approach seems to have worked. Uptake among the over 50s and younger adults with health conditions in the Indian community for example is at a very similar level to their white peers at over 90 per cent.

The impact can also be seen in the infections rates. At the turn of the year, Sandwell was consistently in the top 10 areas, but since March it has been below the regional and national averages. “Our good vaccination uptake is a major reason for this,” Dr McNally added.

The work has also been praised by the local NHS. Sally Roberts, Chief Nursing Officer for Black Country and West Birmingham CCG and local vaccination programme lead, said the councils hard-work and commitment “has played a key role in boosting uptake”.

"The vaccination programme continues at pace, with boosters now available at locations across Sandwell for everyone who is eligible, so we look forward to continuing to work with the council to protect the most vulnerable in our community."

Contact details

Dr Lisa McNally

Director of Public Health

Sandwell Council

[email protected]k