Promoting the measles, mumps and rubella vaccine in Bristol: development of a media resource

In 2019/20, a report by Bristol City Council and Public Health England (now OHID/ UKHSA) was undertaken to investigate low uptake of the MMR vaccine among the local Somali community in Bristol, informed by interviews and focus groups with residents and a review of local data and existing resources. An options appraisal was developed to examine potential approaches to creating resources for the Somali community focussed on raising awareness of the importance of routine childhood immunisations, particularly MMR. Due to the pandemic, there was limited opportunity to take this work forward. 

Post pandemic, we reviewed MMR vaccination at a population level which identified 17 to 30-year-olds had lower vaccination coverage (in addition to the Somali community).  Bristol City Council received a small, dedicated pot of funding to create resources for the Somali community, focussed on raising awareness of the importance of routine childhood immunisations, particularly Measles, Mumps and Rubella. Bristol City Council decided to commission a trusted local community health partner to co-produce a film with community members, aimed at improving uptake in 17 to 30-year-olds (driven by the low vaccination uptake rates in this age category and the lack of resources targeted at young adults).

This approach recognised the additional potential to improve younger age uptake, as the 17 to 30 age group may also be parents or future parents.

The overall objective was to produce a short media clip on MMR vaccination and for this to be circulated widely, to reach the target audience, to increase awareness and knowledge of the MMR vaccination. Longer term, the aim of the project was to increase the number of 17 to 30-year-olds going to get their MMR vaccination, increase coverage of the MMR vaccination amongst this age group and through this, reduce the risk of MMR outbreaks in Bristol.

Through Bristol City Council Communities Team, a local, community health partner was named as a trusted local source of health information and were invited to submit a proposal. Bristol City Council decided to commission this local, trusted community health partner to co-produce the media resource. 

In Phase 1, the local, trusted community health partner held four focus groups with volunteer’s representative of the target population to explore views, concerns, and barriers. Findings highlighted limited knowledge and uncertainty about vaccination status, alongside significant barriers (e.g. misinformation particularly around autism, language barriers, cultural influence and distrust of the government and healthcare systems), with more detailed information about the MMR vaccine desired and community specific approaches suggested. Clear/ accessible information, pop-up sessions and creative videos in Somali language were also mentioned as well as addressing language/ communication barriers, building trust and involving trusted community members and healthcare professionals. 

Following the focus groups, a Task and Finish Group guided the project, with a local filmmaker employed to film and edit the video. The film was informed by the points raised in the focus groups, and local residents (aged 17 to 30) and a local community doctor featured in the video; it was filmed in English (agreed by the focus group members as their preferred language) and included local sites and had subtitles. Before launch, the video was taken to various stakeholder meetings and positive feedback was received. 

The video was launched at a community conversation at Easton Leisure Centre on 25 January 2024 (one of many community conversations held in Bristol inner city) and published on the Healthier Together YouTube Channel the same morning; around 25 people attended the community conversation and there was media presence from BCC Points West. The video was shared locally and nationally including being referenced in a BCC Documentary “Incident Room – Measles Outbreak – Why Now?”

Present at the event was a panel of healthcare professionals answering questions and providing evidence-based information on the MMR vaccine.

The film was targeted at 17 to 30-year-olds from the Somali community, however during the time period set aside for the evaluation, uptake/ coverage data for the 17 to 30-year-old age category was unable to be obtained.

The video was uploaded on various social media platforms and received positive engagement. Positive feedback was received from stakeholders and members of the community including feedback from focus group members that their perspective was changing as a result of the video and the message in the video would inspire them to get the MMR vaccine.

Some isolated, negative comments around the motives for producing the videos were received, emphasising the importance of not stopping work on promoting the MMR vaccination, but rather continuing to promote it. It was noted that the video production process took longer than intended and more could have been accomplished with increased funding.

Overall, the video received a vast amount of positive feedback and strong relationships were built and developed, with a model for collaborative working established. Despite the positive feedback, it is important that work is continued to promote MMR and other vaccinations, particularly noting the changed schedule for MMR/ MMRV. Working collaboratively with a community health partner trusted within the local community was fundamental to the success of the project due to the existing relationships with community members.

• Let's talk about the MMR vaccine (video)
• New community film spotlights the need for measles vaccination
• Bristol film tackles MMR vaccine myths which spread 'fear' (BBC News, 2024)
• Measles outbreak: why now? (BBC News, 2024)
• UK Measles and rubella elimination UK strategy (Public Health England, 2019)