Coronavirus (COVID-19) vaccine inclusion: vaccination programme - phase one

7. Data and evidence

Programme objectives:

Key groups and communities that require more focus are identified and health boards are able to maximise vaccine uptake.

Provides intelligence for service improvement and future vaccination programmes.

Examples of national programme support:

New data and evidence regarding the COVID-19 vaccination programme was emerging all the time. The national programme supported the development of some of this, as well as sharing new research, data and evidence with health boards and partners to support their approach. A fuller list of evidence developed as part of this programme can be found in the appendix.

Public Health Scotland extended their COVID-19 Statistical Report to include uptake data by SIMD and ethnicity on a regular basis. This data has been used widely by service delivery partners to plan their vaccination services. Health boards have, for example, used these data for targeting support to increase vaccine confidence in particular groups showing lower uptake levels. Uptake rates were also analysed by intermediate data zone and outreach support was targeted in the form of 'pop-up clinics' in areas of high deprivation.

Public Health Scotland also prepared a management information tool which supports health boards to identify, by intermediate zone, where the low levels of vaccine uptake were. The data is updated and available weekly. This enabled health boards to plan where to locate their drop-in or pop-up clinics to target those who may not otherwise have attended an appointment.

As part of the evaluation of the COVID-19 vaccination programme, Public Health Scotland conducted a survey in March 2021 to explore the attitudes and experience of the frontline health and social care workforce. A PHS report was published which detailed workers' views of how the programme could be improved and more inclusive.

In response to data showing low uptake in certain ethnic minority communities, the national programme met with a range of community and third sector partners to better understand the reasons for this. This included:

• Black and Ethnic Minority Infrastructure Scotland (BEMIS)
• The African Council
• Counselling, Personal Development and Support Services LTD (FENIKS)
• British Islamic Medical Association (BIMA)
• Minority Ethnic Carers of People Project (MECOPP)

New data and evidence from partners, including Public Health Scotland, third sector, and academia, was regularly shared at meeting of the National Vaccine Inclusive Steering Group and cascaded out to health boards to support them with their inclusive approach.

The national programme engaged with the Expert Reference Group on COVID-19 and Ethnicity on their recommendations. A commitment was made to undertake work on the collection of ethnicity data through the vaccinations programme. Although not complete for this phase of the programme, the commitment shows the intent to embed the process of ethnicity data collection in the culture of the NHS in Scotland.

Examples of health board approaches and activities:

As well as drawing on local knowledge, data and insights, health boards analysed the Public Health Scotland's vaccine uptake data and other evidence to inform their decisions on delivery.

Using quantitative and qualitative information, health boards targeted and tailored their approach for under-vaccinated groups. The evidence also supported them to identify the concerns different groups had and barriers they may experience.

Health boards took a dynamic approach to their inclusion activities which evolved as new information was available.

Examples of use of data and evidence include:

• NHS Ayrshire and Arran: Carried out analysis of update data on pregnant women. Identified uptake had been low in this group and information and communications were increased.
• NHS Borders: Looking at deprived areas with low uptake rates and took mobile units to those communities to encourage vaccination.
• NHS Dumfries and Galloway: Vaccine uptake data was pulled by ethnicity and SIMD and considered when planning outreach activity locations. Following this, links were made with relevant community health improvement teams.
• NHS Fife: When reviewing their vaccination centre model used SIMD mapping to identify how to successfully target different areas.
• NHS Forth Valley: Worked closely with local authority teams to map
  'hot spots' for COVID-19 infection and targeted surrounding communities with
  a specific focus on learning environments.
• NHS Grampian: Undertook insights gathering into student opinions and experiences to help inform their delivery.
• NHS Greater Glasgow and Clyde: Engaged with research undertaken by University of Strathclyde on vaccine hesitancy to inform their approach.
• NHS Lothian: Interrogated uptake data to better understand vaccine uptake by geographical location with aim of targeting their outreach clinics to reach under-vaccinated communities.
• NHS Lanarkshire: Assessed the differences between the data zones with highest and lowest vaccine uptake to see if they can do more targeted work.
• NHS Tayside: Undertaken analysis of reasons people did not attend to inform their approach to messaging and delivery.