Flu and COVID-19 vaccination programme 2023-2024: equality impact assessment

COVID-19 and Flu Vaccine Policy Aims

7. The Joint Committee on Vaccination and Immunisation (JCVI) is an independent scientific advisory body charged with providing recommendations to all Governments within the UK, including on the safety and efficacy of vaccines. The advice provided by the JCVI and the UK Chief Medical Officers (CMOs) support the government in the development of a vaccine strategy for the procurement and delivery of a vaccine programme to the population.

8. The safety of all vaccines and medicines is monitored by the Medicines and Healthcare Products Regulatory Agency (MHRA) on a UK wide basis .

9. COVID-19 and Flu vaccines are a critical part of suppressing the viruses to the lowest possible level, in order to save lives, protect health and wellbeing, alleviate pressures on the health and care system, reduce health inequalities and maintain quality of life. The vaccines produce an immune response that we know reduces severity of illness, hospitalisation and death from the viruses. It therefore makes a significant contribution to reducing the impact of the wider economic, educational attainment and work impacts on people, families and communities.

10. The COVID-19 pandemic has produced disproportionate impacts across a range of outcomes for a number of groups, including households on low incomes or in poverty, low paid workers, children and young people, older people, disabled people, minority ethnic groups and women^[1]. These groups and intersections between them have been considered in development of the policy approach and delivery.

11. Immunisation programmes are designed to help protect the population from serious vaccine-preventable diseases. 2023 has seen the JCVI, and therefore the Scottish Government, continue to transition away from a pandemic emergency response towards pandemic recovery. The primary aim of the programme is now the prevention of severe illness, hospitalisations and deaths. During the current phase of pandemic recovery, whilst the virus continues to circulate and cause illness, the objective is to focus the offer of vaccination on those at greatest risk of serious disease and who are therefore most likely to benefit from vaccination.

12. The COVID-19 and flu vaccination programme contributes to the delivery of the Scottish Government’s National Performance Framework Outcomes 3 and 10:

• (3) Ensure healthy lives and promote well-being for all, at all ages;
• (10) Reduce inequality within, and among countries.

13. The approach being taken focusses on ensuring that everyone who is eligible has the relevant information to make an informed choice about taking up the offer of vaccination against flu and COVID-19 this year. Through delivery we aim to:

• Protect people in Scotland most at risk of harm from COVID-19 and flu through timely vaccination;
• Ensure the programme is person centred and informed by those most at risk of inequalities in access to or uptake of vaccination.
• Support protection and recovery from COVID-19, minimising the need for non-pharmaceutical interventions;
• Reduce the pressure on the NHS;
• Increase uptake rates for those at greatest clinical risk of flu and COVID-19;
• Focus on a co-administration model, offering flu and COVID-19 vaccinations at the same appointment where possible.

14. The complexity and pace of the COVID-19 vaccination programme has been unprecedented and progress has been remarkable. With the reduction in testing and removal of societal restrictions, vaccination remains our best route out of the pandemic. Whilst we continue to promote non-pharmaceutical interventions such as good hygiene practice and look at ways to protect society in future through COVID-19 Ready Society, vaccination remains our best tool against severe illness.

15. For detail on earlier parts of the programme, please refer to the Flu and COVID-19 vaccination programme - autumn/winter 2021-2022: equality impact assessment, and the Flu and COVID-19 vaccination programme - autumn/winter 2022-2023: equality impact assessment.

16. The COVID-19 and flu vaccination programme has a wide ranging impact across Scotland. The scope of this equality impact assessment, therefore, is extended beyond the list of protected characteristics to include wider socio-economic considerations: including people living in remote, rural areas and island communities; in areas of multiple deprivation; prisoners; migrant workers; those with substance misuse issues and sex workers who are eligible to be vaccinated.

17. As the COVID-19 Vaccination Programme progressed through the younger cohorts, the Scottish Government completed a Children’s Rights and Wellbeing Impact Assessment (CRWIA) covering the period up to spring 2022. This is currently in the process of publication. An updated CRWIA for 2023/24 is also due for publication.

18. The Scottish Vaccination and Immunisation Programme (SVIP) communications strategy supports the delivery of all vaccination programmes across Scotland. This framework outlines the overarching approach to all vaccinations in Scotland, this is a joint framework working in collaboration with Public Health Scotland (PHS). The framework’s key purpose and ambitions include:

• To outline an overall cross-discipline, cross-agency communications strategy and plan to support the delivery of all vaccination programmes across Scotland.
• Provide a joined-up strategic approach to all vaccine communications.
• Continue to adopt an audience-first approach to ensure flexibility so emerging issues are addressed.
• Ensure we address vaccine hesitancy.
• Hone and improve our communication approaches and tactics on an iterative basis.
• Work closely with partners/stakeholders to maximise reach and impact.

19. The strategy aims to help maximise vaccine uptake and reduce health inequalities across Scotland. Its policy objectives are to:

• Encourage a healthy level of vaccine uptake to support herd immunity against disease
• Reduce inequalities in vaccine uptake rates by deprivation and ethnicity.