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

8. Summary and moving forward

The national programme and local delivery approach to inclusion within the first phase of the vaccinations programme evolved as circumstances and advice changed, with experience, and as new data and evidence emerged.

As set out in this document, the national programme, health boards and a range of other partners trialled many different approaches and activities to ensure they were reaching everyone in their communities. It will be for all partners to evaluate the success of each of these interventions.

The programme has been clear that the impact it has on someone's experience of vaccination is critical to success, not just numbers. Many of the activities and approaches mentioned in this report were aimed at a small portion of Scotland's population, however, without them, it is likely that:

• many more people would have been hesitant or concerned about taking up the offer of the vaccine;
• health inequalities would have increased further;
• the country would not have reached the high levels of vaccination uptake that it did meaning a more challenging recovery from the pandemic; and
• the ways in which people access vaccinations, including the information on informed consent, would not be suitable for all.

Moving forward

Although the pace and urgency of the first programme was unprecedented, it gave us agency to trial new and creative activities and approaches - and build or strengthen relationships with partners and communities. Where these approaches were successful, it is vital that this valuable learning is shared with other parts of the health service, as well as wider initiatives, such as Test and Protect.

The work undertaken in the first phase of the programme has also helped advise and shape national inclusion and equalities expectations for the autumn/winter flu and COVID-19 vaccinations programme. It will also continue to inform the future delivery of all of Scotland's vaccinations. This report, and the approaches and activities detailed in it, will form valuable learning for this future development and embedding an inclusive approach into a future service.

A snapshot of some of the key pieces of learning include:

• Co-create a user-journey that works for those who experience the most barriers and it will be suitable for all. This encompasses all aspects of the journey, from the initial communications and marketing telling people about the programme to the process of receiving or booking an appointment to access to the information required to make informed consent to getting to the vaccination centre, to any aftercare;
• Tailored communications developed with and delivered by trusted community representatives should be promoted at the same time, or as close as possible to the national communications. This ensures people do not feel as though their messaging was an afterthought;
• An evidence driven approach is key but we must continue to build on this evidence-base and enhance and improve our data to ensure we can better understand the needs of our different communities;
• Choice is important. Feedback from the public indicated that they were keen to ensure that appointment time and locations suited them, especially when clinics were far away. The online and helpline rescheduling option supported with this in the first programme;
• The approach of digital choice is also something to be taken forward. Whereas digital solutions can be of preference for many, lots of people still find the internet difficult to use, or do not have access to it at all. Often, people prefer to speak with another person, or hold a confirmation letter in their hand;
• Whereas we found common concerns and experiences across different communities, the approach to support each community, and individuals within those communities, needs to be properly considered and tailored; and
• Reaching everyone takes time, but it is worth the effort.

Public Health Scotland's COVID-19 Daily Dashboard provides up to date information on the uptake of the COVID-19 vaccinations for both first and second dose.