Already, well over two million Londoners have had their first dose of Covid-19 vaccine, but completing the job remains one of the greatest challenges facing the capital. We need to ensure that no Londoner is left behind. If significant clusters of unvaccinated people remain, they and their communities remain at risk.
This “final mile” stage of the programme is still some way off, but completing it will be essential to ensuring that in the future London does not have to deal with continued localised outbreaks, with all the heartbreak and potential disruption that might bring.
The “3Cs” model of vaccine hesitancy (see pages 11 and 12) sets out three determining factors: convenience (how easy it is to access vaccination), complacency (lack of awareness of the vaccine or appreciation of its benefits), and confidence (trust in the vaccine, healthcare services and policy makers).
Ensuring that people have access to the vaccine in a place and in a way that makes sense to their lives is going to be vital. In part, this is already being addressed through GPs and community pharmacies and imaginative use of spaces such as churches, mosques and other community venues. But the challenge will remain as we move into broader cohorts, particularly of younger Londoners.
The national conversation is presently dominated by the third “C” – confidence issues, particularly among black and ethnic minority communities. To tackle this and to make the best use of the city’s public sector capacity, London has built a partnership between NHS London, responsible for the delivery of the vaccine, and the boroughs and the Greater London Authority (GLA) under the leadership of Professor Kevin Fenton at PHE London.
It should be stressed that hesitancy is not a euphemism for people being “anti-vax”. Indeed, all the research suggests that only about one per cent of Londoners are dyed-in-the-wool anti-vaxxers. Instead, it covers very broad, diverse and often reasonable concerns.
Insight work with different communities carried out under the umbrella of the Keep London Safe campaign suggests it requires informed and respectful conversations to build confidence in the vaccine and vaccination process, and to ensure that people respond positively to the call to be vaccinated when it arrives.
As far back as the last week of January, boroughs were able to respond to this emerging issue by rapidly setting up online conversations with communities, led by the borough Director of Public Health and using trusted local NHS clinicians to answer people’s questions.
These initial events regularly attracted audiences of over 300. Within weeks, they’d been developed into a programme led by Professor Fenton and Martin Machray, Chief Nurse for London featuring a diverse range of speakers such as the Bangladeshi High Commissioner, BBC Radio London’s Eddie Nestor and Lord Simon Woolley.
Events might be organised by the NHS, the GLA or a borough, but all are promoted across the partnership to ensure maximum participation. Where a borough has a long-established relationship with a particular community, for example the Portuguese in Lambeth, that borough takes the lead but the events are promoted across London so they are available to people in those communities, wherever they might live. The most recent of these events organised by Hackney, Haringey and Enfield working together, attracted over 1,500 attendees on Facebook alone.
While the statutory agencies are collaborating to play their part, it has been the response of community leaders that has been most heartening. There has been a rapid mobilisation of community action with communications to address hesitancy designed and delivered by community leaders – and informed by public health information supported by PHE London and borough Directors of Public Health. Give the community the tools and they will finish the job.
Early research shows that young Londoners are significantly more uncertain about the vaccine than older age groups. To address this, Stoke Newington School and Hackney Education have developed a resource pack for Key Stages 2-4 on vaccination, Covid-19 and misinformation, which have been distributed to all London schools. While children in these age groups are not yet able to have the vaccine, the aims is to build the resilience of young Londoners against misinformation in the years to come.
Meanwhile, the London Councils Keep London Safe communications toolkit devised by young people for engaging young people in promoting vaccine take up has just been launched, providing a further means for ensuring that London is successful in the final mile.
We are already beginning to see some good indications that vaccine hesitancy is receding at both a national and London level, but determined, ongoing and patient work is required to ensure that trend continues.
Polly Cziok is Director of Communications and Community Engagement at Hackney Council. Image from BBC London.
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