Thread by @DrWallBolton

1/ SRO vaccine Bolton - experience of #VaccineHesitancy thread. #WHO defines vaccine hesitancy as a “delay in acceptance or refusal of safe vaccines despite availability of vaccine services’’ As lead for vaccines in UK #covid hotspot #bolton this is of interest to people I meet

2/#WHO specifies complacency, convenience, confidence, and sociodemographic contexts as factors. #bolton is a diverse town with over 10 years life expectancy variance between rich and poor areas and hugely different healthy life expectancy #inequalities

3/ Feb 21 -data started to emerge that poorer parts town had lower uptake. People worried that misinformation, digital poverty, cultural beliefs etc meant people didn’t want the #vaccine in these areas. Other parts of town consistently hitting >95% uptake in eligible cohorts.

4/ community engagement; door knocking @boltongpfed and @BoltonCVS intel heard patients cite barriers such as no transport, poor mobility (main site 0.5 miles away), no funds to access phone to book or pay for public transport and fear of having to travel on buses etc in #Covid

5/ some demonstrated apathy ‘il go at some point’, very few said they didn’t want it- less than 2%. It became clear that drivers to #vaccination such as eventually going on holiday and ‘normality’ where different to many of this population who had to prioritise day to day life.

6/ March 6th saw our first #popup clinic in the heart of the community. Patients queued round the block. Confirmed our new revelation many did infact want it. Hope was born again for our teams . Pop ups continued @boltongpfed at large.

7/ Pockets communities started to be uncovered. 22 diff languages in one part of town- several spoken not written. Key messages challenging to get out. Understandably trust of healthcare bosses and teams needed to be built not given. Community leaders came forward/ approached.

8/ Trusted engagement with faith leaders, community role models, icons were key to building trust. Messaging about this not being a means to ‘find’ people etc helped by key group like Brass (refugee support) assisted. Those without nhs numbers still vaccinated

9/postcode data enabled mapping to street level where uptake low- may be struggling to access and #vaccinebus was launched April 12th. Removing more barriers transport, travel, appointments. Every single vaccine felt like a special moment for #teambolton reaching new people

10/ some are scared / unsure/ waiting to see. Continual engagement of these people is paramount. Giving accurate information but also time and no endpoint to the offer of #covidvaccine has seen many come forwards later than we planned but at the right time for them- important.

11/ #VaccineHesitancy is complex and no one thing will reduce it. Approach with empathy, understanding and non judgement eliciting concerns and barriers and attempting to build bridges to help overcome these. It’s requires patience and listening to your population.

12/Thanks to all teams working hard to overcome this in our town @boltongpfed @BoltonCVS @PH_Bolton @boltoncouncil @sulongnhs @WesthoughtonPCN @BoltonCCG @RmiHorwich @TalbotAnne @gingerplodder and anyone I’ve missed!