Exploring factors that influence the uptake of immunisation in ethnic minority groups

1. Exploring factors that influence the uptake of immunisation in ethnic minority groups Dr Anna McGee Head of Research anna.mcgee@sense.org.uk Manveet Patel Research Officer manveet.patel@sense.org.uk Sense

2. Background to the project

3. Groups known to be vulnerable Western Pacific e.g. China, Cambodia, Vietnam SE Asia e.g. Bangladesh, Sri Lanka, Pakistan Eastern Europe e.g. Bulgaria, Latvia, Lithuania, Romania, Poland, Russian Federation Eastern Mediterranean e.g. Afghanistan Sub-Saharan Africa e.g. CAR, Kenya, Uganda, Zimbabwe, South Africa, Somalia, Sudan

4. Reasons for vulnerability Minority ethnicity migrants may be susceptible to rubella and at risk of catching rubella, because they may have come from countries: with no vaccine where vaccine has recently been introduced with low vaccine coverage are less likely to have been vaccinated with MMR since coming to the UK live in communities where there may be dense populations of people in similar circumstances

5. Study methodology Focus groups- to evaluate existing knowledge base and perspectives on immunisation Workshops- to extend awareness and address concerns Interventions: own language leaflets, adverts in ethnic publications, liaising with key link workers, health professionals and leaders of specific communities Follow up with communities about increased awareness and possible increase in uptake

6. Details of focus groups London- Bengali and Sri Lankan Peterborough- Czech, Slovak, Polish, Lithuanian and Latvian Nottingham- Pakistani, Polish, Kenyan, Ghanaian, Zimbabwean Tower Hamlets- Somalian community already contacted by Local PCT

7. Reasons for low uptake in UK Lack of knowledge of UK immunisation programme Lack of awareness of risk factors of non immunisation Complexity of schedule especially if more than one child under 5 Confusion over partial uptake (number of immunisations needed for full protection) Specific objections (religious beliefs or local observations of incidence of vaccine damage) Low priority amongst other family crises Chaotic family life leads to frequent relocation

8. Implications for intervention strategies Need to tailor strategy to specific reason for low uptake e.g. general leaflet indicating schedule will not address doubts about safety of vaccine Need to assess the source of the message about immunisation e.g. in some communities it may be more effective to target community leaders �gatekeepers� Need to acknowledge that some decisions about refusing immunisation opportunities are �informed� but are based on obsolete information e.g. Wakefield case Health professionals need to be prepared to address complex arguments against immunisation through comprehensive training and up to date information

9. Next stages of the project Focus groups in London to be undertaken early 2011 Outcomes of focus groups undertaken by New Link (Peterborough) and Central London Healthcare (London) and in Nottingham to be further analysed Interventions: Leaflets in a range of community languages to be distributed in GP surgeries, Sure Start Centres, Antenatal clinics, nurseries, baby cafes, places of worship, walk in centres Deliver training to various advisors in the community; health trainers, link workers, new arrivals advisors Establishing mobile immunisation clinics to respond to increased demand Follow up of focus group participants to identify what actions if any have been taken

10. Any questions?