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Poorer areas falling behind on vaccination against coronavirus

The Independent finds deprivation an independent factor for lower take-up

Shaun Lintern
Health Correspondent
Wednesday 17 February 2021 19:21 GMT
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Some of the most deprived parts of England have the lowest vaccine uptake levels
Some of the most deprived parts of England have the lowest vaccine uptake levels (PA)

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The NHS is increasing efforts to reach out to ethnic minority communities in more deprived areas of England as analysis by The Independent shows poorer areas are vaccinating fewer at-risk people.

Among the most deprived parts of the country, fewer people aged over 80 and in their mid-70s had received their first dose of vaccine against coronavirus by 7 February when compared with more affluent areas, sparking concerns communities most at risk are being left vulnerable.

Comparing local NHS vaccination data with Public Health England’s deprivation scores for each NHS region reveals six of the most deprived parts of England were in the bottom 10 local areas for vaccine uptake among the over-80s and those aged over 75.

The worst performing NHS region was East London, with just 73 per cent of over-80s vaccinated by 7 February. East London was also one of the worst-affected areas during the second wave of the virus as hospitals became overwhelmed early on in the crisis.

Both the North London and North West London NHS regions were also among the lowest-performing areas for vaccine uptake.

Birmingham and Solihull, the most deprived NHS region, achieved a vaccination rate among the over-80s of just under 85 per cent by 7 February, compared with Gloucestershire NHS area, the least-deprived region, which achieved a vaccination rate of more than 98 per cent among the over-80s.

Also among the six most-deprived areas with the worst vaccination rates for the over-80s were the Black Country and West Birmingham NHS region, the Greater Manchester Health and Social Care region and the Nottingham and Nottinghamshire areas.

Dave Finch, a senior fellow at the Health Foundation, said: “Lower vaccine uptake in the most deprived areas is worrying as these areas have seen some of the very highest Covid-19 death rates. A higher likelihood of having poorer pre-existing health increases their risk of more severe symptoms if they do get the virus. And people living in poorer areas are increasingly showing signs of intense financial hardship as a result of lockdown measures.

“Many will have higher risk of exposure to Covid-19 because they are more likely to have jobs that require them to be outside of their homes such as working in care or retail. They are also less likely to have generous occupational sick benefits, increasing the chance that they will keep working rather than self-isolating.

“The government must prioritise understanding why vaccine uptake has been lower in these areas and take urgent, targeted action to address this. However, in the longer term, there must be a focus on investing across the UK to address major health inequalities in order protect everyone’s health and wellbeing.”

Dame Margaret Hodge, MP for Barking and Dagenham in East London, has written to vaccine minister Nadhim Zahawi about the poor rates of vaccination in her constituency.

She said that by Friday, only 68 per cent of the over-80s and only 67 per cent of those aged 75 to 79 had been vaccinated. She said that among the clinically extremely vulnerable groups only 54 per cent had had the jab.

She told the minister: “In one of the most deprived parts of the country, vaccine rollout has fallen dangerously behind schedule. In health terms this is levelling down on an industrial scale. My constituency has already seen its local hospitals pushed to breaking point and one of the highest infection rates in the country. We need to do better.”

Almost 16 million people have been vaccinated across the UK with vaccination now extended to all those aged over 65.

Across Manchester efforts are underway to recall people in the first four priority groups who have not yet been inoculated. In Trafford, two extra satellite vaccination sites have been set up in the north of the borough which has a high ethnic minority population and where there was a lower uptake. Local GPs have also hosted webinars to tackle vaccine misinformation and to reassure residents.

In Rochdale, pop-up vaccine units have been set up in community venues for a few hours each day and officials report they have been fully booked. Recipients say that they are not prepared to travel to the town centre to get vaccinated.

Dr Veena Raleigh, a senior fellow at The King’s Fund, told The Independent there were probably many reasons why some areas had a worse uptake of the vaccine but added: “Deprivation does seem to be an independent factor for vaccine hesitancy.

“The uptake of public health messages does tend to be considerably higher in more affluent groups and the vaccine uptake is, in a way, mirroring that.

“To reach some of these communities with messages that will persuade them to alter behaviour is very difficult, but it can be done. You need to go beyond the mass national appeals and use local, culturally sensitive messages. Very often local services know their communities better.”

In a wider analysis for The King’s Fund she warned that public health and NHS efforts needed to be tailored to ethnic minority communities to help reduce the wider burdens from preventable conditions including diabetes and cardiovascular disease and to increase cancer screening.

Dr Nikki Kanani, NHS England primary care medical director, said the NHS was now fighting two epidemics of Covid and disinformation among minority groups.

She said: “There is evidence that people from ethnically diverse backgrounds are most likely to be hesitant about getting the vaccine, despite being disproportionately affected by Covid. It’s vital that we give these communities the support they need to get the vaccine when invited to do so, building both trust and confidence.

“This is why opening sites in places of worship, engaging with various faith leaders and encouraging open discussion with local communities, has been a crucial part of our approach to tackling this issue so far.

“Disinformation about the vaccine must not be permitted to transmit and spread through communities faster than the virus itself. Scare stories and myths online cost lives and that’s why the NHS is doing our bit to fight back.

“Health care workers and volunteers are going out into their communities to talk directly to people with concerns.”

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