Closing the gap: Targeted vaccination outreach for Manchester students

In response to a measles outbreak declared by UKHSA in January 2024, Manchester delivered pop-up university vaccination clinics to rapidly protect its large student population. The project aimed to increase MMR uptake, interrupt transmission, reduce inequalities, and improve awareness. Delivered through strong university partnerships, mobile clinics and targeted engagement achieved high uptake and helped stop campus transmission. The programme demonstrated clear public health benefits and cost efficiencies. Learning informed improvements, including multi-vaccine delivery and use of on-site facilities to reduce costs. The model proved effective, well-received, and scalable, with ongoing plans to expand delivery and integrate wider student health services. Across 14 clinics, 391 vaccines were delivered.

January 2024, UKHSA announced a national incident due to the rapidly growing outbreak of measles in the West Midlands. In May 2024 Manchester reported cases of measles linked to university settings. To minimise potential outbreaks in the student population, Manchester Local Authority and NHS ICB teams arranged pop-up vaccine clinics to provide MMR vaccines on the university campus.

• Rapid protection of our local student population in a flexible delivery model
• Interrupt transmission in areas where rapid spread is likely through shared student accommodation and classrooms.
• Adjust locations and hours based on demand and epidemiological data.
• Improve and reduce inequalities- bringing services out into the community and removing access barriers.
• Raise awareness of vaccination in a population who may only just be taking control of their own health decisions.

Universities in Manchester were key stakeholders in planning the clinics. Clinics were advertised via accommodation settings, social media, posters, and emails to students and staff. Engagement sessions were held with student clubs and societies to prepare campaign materials, and to develop the clinic offer during welcome weeks. Local further educational settings, including colleges, were invited to attend.

The initial project included two pop up vaccination clinics, held in June, the success of these prompted us to schedule a further twelve arranged for the university welcome week, covering a four week period. Clinics were held on various days and times to accommodate student timetables and welcome week activities. A mobile health van was commissioned, based on the model successfully used in Manchester for the delivery of COVID19 and Flu vaccinations. Neighbourhood Health Champions were positioned in key student areas during the four weeks to engage with students about the clinics and signposting to where students could be vaccinated.

Subsequently, the Universities have requested we hold clinics the following academic year, again with a high success rate and a very well evaluated model.

The Public Health and wellbeing impact of this project is demonstrated by a successful end in the transmission of measles within the student community.  University settings are high-density, high contact environments that have the potential to see rapid transmission of vaccine preventable disease- as demonstrated by recent Men B outbreaks. In this context, the implementation of effective and timely outbreak control measures, including targeted vaccination, is critical to limiting onward transmission and preventing linked cases.

Manchester has one of the largest student populations in Europe, comprising a significant proportion of international students who may have varied vaccination histories. Early intervention is essential to ensure optimal protection within this potentially vulnerable population group. The programme successfully addressed key barriers to vaccination, including access, convenience, and awareness of available services.

By reducing these barriers, it was possible to engage with individuals who may otherwise have remained unvaccinated. This included international students, those not yet registered with a GP, and cohorts potentially influenced by historical vaccine hesitancy, including concerns arising from the MMR ‘Wakefield scandal’.

Financial impact of any successful vaccination campaign is significant but difficult to quantify. Direct healthcare cost savings include a reduction in primary and secondary care associated costs as well as reducing outbreak management costs. This targeted mobile campaign is an efficient use of resources, maximising value for money in local public health delivery.

A midpoint review of the initial roving model suggested that communications could be improved. Based on student feedback, a decision was made to amend the fliers, purchase NHS signage for the van, and change the van locations.

Most students that have been vaccinated to date have been international students. Translated materials in commonly spoken languages, or via QR code would be beneficial.

To enhance both efficiency and effectiveness, it was agreed that all future clinics would deliver a broader offer of vaccinations, including HPV and MenACWY (subject to eligibility).

At the request of the university, two additional vaccination clinics were delivered in February and March 2026. These clinics were able to provide MMR, HPV, and MenACWY vaccines, achieving high uptake and demonstrating strong demand when multiple vaccinations are offered in a single setting.

Further adaptations were implemented to the original delivery model through the utilisation of the on-site University Occupational Health facility at no additional cost. The initial approach had been informed by the success of the Manchester Peripatetic COVID-19 vaccination van; however, the van was procured on a ‘block booking’ basis, despite clinics operating only on selected days. This resulted in disproportionately high costs, estimated at approximately £2,500 per week, in addition to staffing costs of £500 per six-hour session. The removal of this expenditure reduced the cost per vaccine administered, thereby improving overall value for money.

However, this change did reduce the visibility associated with the mobile vaccination van model, including the loss of opportunistic ‘walk-in’ footfall.

Despite this, the university implemented an effective engagement campaign through its established communication channels, which maintained strong attendance levels. In addition, previously developed communication materials were reused, further minimising costs to the Local Authority while ensuring consistent messaging.

Future considerations could include onsite GP registration for new students, and a sexual health service would allow for a more holistic service for this cohort.

• Collaboration with the University was integral to the success of the clinics, Manchester LA was able to build upon a strong pre-existing partnership developed during the COVID-19 pandemic. This highlights the importance of leveraging established and trusted communication channels when engaging with specific population groups.
• Feedback from attendees consistently indicated that awareness of the clinics had been raised through university communications, which were widely regarded as a trusted and credible source of information. This underscores the value of institutional partnerships in effectively promoting public health interventions and maximising uptake.
• The physical location and visibility of the clinics influenced attendance, future clinics need to balance cost efficiency with visibility and accessibility. 
• Expanding the offer to include MMR, HPV, and MenACWY improved the overall reach and effectiveness of the programme.

This innovative approach to vaccination delivery has demonstrated significant benefits across multiple domains. The clinics were well received by both students and staff, with a high volume of vaccinations delivered and meaningful engagement conversations taking place, helping to increase awareness and confidence in vaccination.

The model achieved low running costs while effectively reducing barriers to access, particularly for internationals students and those individuals who are new to Manchester.

The accessible, on-campus delivery model ensured that vaccination was convenient, familiar, and easy to access, contributing to strong uptake.

The collaboration between Manchester Department of Public Health and Manchester Locality ICB has demonstrated a successful intervention that is easily replicable at low running costs. Given the recent high profile infectious disease outbreaks and vaccination events in university settings, there is potential for student engagement to increase further in future events.

Annie Barton- Manchester Department of Public Health
Email: [email protected]