Understanding Community Experiences in Greater Manchester during the COVID-19 pandemic and Exploring Inequalities in the COVID-19 Vaccination Programme
What did we do?
Emerging evidence over recent years has highlighted inequalities in the uptake of the COVID-19 vaccine at the national level. We conducted a series of research projects to explore:
- Inequalities in the COVID-19 vaccination programme in Greater Manchester.
- The drivers behind these inequalities and responses to the COVID-19 vaccine in Greater Manchester.
- The role of the voluntary sector in supporting the response to the pandemic and vaccination programme.
- Inequalities in the routine influenza vaccination programme post-COVID.
Inequalities in the COVID-19 vaccination programme in Greater Manchester
Using the Greater Manchester Care Record, this study compared COVID-19 vaccine uptake to previous inequalities in flu vaccine uptake to try to understand similarities and differences compared to routine vaccine uptake.
The quantitative analysis sought to address the following research questions:
- What are the inequalities in COVID-19 vaccine uptake in Greater Manchester by ethnic group, income deprivation and local area?
- How do inequalities in COVID-19 vaccine uptake compare to pre-existing inequalities in flu vaccine uptake?
The findings have been published in the PLOS Medicine.
Responses to the COVID-19 vaccine in Greater Manchester and the role of the voluntary sector in supporting the pandemic response and vaccination programme
Alongside the quantitative analysis, in partnership with an Advisory Group set up with public contributors from the NIHR ARC-GM and Health Innovation Manchester Public and Community Involvement and Engagement (PCIE) Panel and Forum, we developed a qualitative research community to better understand the experiences of groups that have been adversely effected by the pandemic in Greater Manchester. Interview and focus groups were held with members of diverse communities, community leaders and community organisations, as well as key stakeholders from local government and the NHS. The findings of the study have been published in BMC Health Services Research and BMC Public Health
The qualitative work sought to answer the following research questions:
- What are the views and experiences of disadvantaged communities during COVID-19 and the associated vaccination programme?
- What are the key drivers and barriers to vaccine uptake and associated inequalities in GM?
- How do community experiences and drivers and barriers to the vaccine vary across different disadvantaged groups and communities (i.e. ethnic minority and seldom heard groups, young adults etc.)?
- What can be learnt from the work of community members, voluntary organisations, policy-makers and service providers on how best to address inequalities and build community trust for future health and care research and service delivery?
- How did community engagement initiatives play a role during the pandemic and vaccine rollout?
A lay summary of the findings can be downloaded here.
The National Insights Prioritisation Programme (NIPP) - Optimising vaccination in Greater Manchester
The NHS Insights Prioritisation Programme (NIPP), commissioned by the NHS Accelerated Access Collaborative (AAC) and the National Institute for Health and Care Research (NIHR), was designed to accelerate the evaluation and implementation of innovation that supports post COVID-19 pandemic ways of working, focussing on building service resilience and delivering benefits to patients. Its main objectives were:
- To facilitate Applied Research Collaborations (ARCs) and the Health Innovation Network's (HIN's) contribution to NHS Reset and Recovery by generating rapid insights in relation to promising innovations;
- To identify interventions that will contribute to Integrated Care Systems (ICSs) and regional needs, aligned to the four Beneficial Changes Network themes; namely: a) remote consultation; b) remote monitoring; c) new approaches to service delivery; and d) Health and Social Care workforce;
- To build local capacity and expertise for evaluation and implementation.
As part of this programme we received funding to provide rapid insights into the way vaccinations for COVID-19 were provided to people living within Greater Manchester, with the aim of improving local vaccine uptake and delivery in future.
We took a rapid evaluation approach to explore:
- Vaccination activity that was implemented to date in Greater Manchester;
- The evidence for community-targeted vaccine delivery;
- The variation in vaccine coverage rates at a local area level across Greater Manchester;
- High priority areas and vaccine delivery approaches that then became the focus of further implementation.
More information about this work and all the findings are avaulable from the National Insights Prioritisation Programme (NIPP) - Optimising vaccination in Greater Manchester- here
The Creative Community Output Collective: exploring local communities experience during the COVID-19 pandemic in Greater Manchester
The Advisory Group for this study raised the importance of developing a lay-friendly, engaging and accessible output that could bring the findings of the research to life in a different, non-academic format.
Taking inspiration from the globally acclaimed Chicken Soup for the Soul, we developed a spin-off booklet (‘zine’) (entitled Manchester Memories: A Triumph over Adversity). Between 2022 and 2024, a collective of public contributors and researchers worked together to co-design, plan and co-create a ‘zine’. Using anonymised data from the qualitative research as the basis of the material, we worked with local community groups: the Caribbean and African Health Network and Young Identity to host a series of writing, poetry and art workshops to collectively co-create and write short stories, poems and testimonies that reflect and highlight the experiences of local groups during the pandemic.
A copy of the zine can be downloaded here.
On the 6th June 2024, we held a launch event as part of the University of Manchester Bicentenary festival. Featuring live performances and poetry readings from our contributors, the event captured the essence, hard work, creativity and spirit of the group over the previous two year of making the zine. A summary of the event can be watched below.
Why was it important?
We know that, nationally, vaccine uptake has been faster and higher for some groups, and often these patterns reflect socio-economic inequalities. Engagement with the PCIE Panel and Forum suggested that there may be new and additional barriers to the COVID-19 vaccine that may exacerbate inequalities, and as such it is important to explore how vaccine uptake varies between groups. Sitting alongside the statistical work, the qualitative research helps to provide key context and deeper insights into the statistical findings of inequalities in uptake.
Prior public engagement work undertaken by the team has highlighted the importance of exploring experiences and views around various factors during the pandemic including misinformation and communication, trust towards institutions, and health and safety concerns towards the vaccine. The engagement work highlighted the need for an in-depth exploration into some of these factors that may impact COVID-19 vaccine uptake, as well as the need to capture the experiences of these groups during the pandemic as a whole.
The impact of the creative ouptut has demonstrated the utility and benefit of using creative methods to engage a variety of audiences, including academics and members of diverse, under-served communities in sharing research findings. It demonstrates how academic research findings can be disseminated and delivered to a wider breadth of audience than would normally engage, reiterating the importance of lay-friendly and accessible, co-developed outputs. This demonstrates greater likelihood of impact or uptake of the findings due to its wider relevance and greater engagement with the content.
This project has been recently recognised by the NIHR Clinical Research Network Greater Manchester Evening of Excellence, in which it won a joint award for “Recognising Outstanding Engagement”.
Who did we work with?
- NHS Greater Manchester
- Greater Manchester Combined Authority (GMCA)
- NIHR Greater Manchester Patient Safety Translational Research Centre (GM PSTRC)
- Public Health England North West (now the UK Health Security Agency)
- Health Innovation Manchester
Downloadable Resources
- Publications
- Gillibrand S, Kapadia D, Watkinson R, Issa B, Kwaku-Odoi C & Sanders C., (2024). Marginalisation and distrust in the context of the COVID-19 vaccination programme: experiences of communities in a northern UK city region. BMC Public Health
- Watkinson RE, Williams R, Gillibrand S, Munford L, Sutton M (2023) Evaluating socioeconomic inequalities in influenza vaccine uptake during the COVID-19 pandemic: A cohort study in Greater Manchester, England. PLOS Medicine 20(9)
- Watkinson RE, Williams R, Gillibrand S, Sanders C, Sutton M (2022). Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: A cohort study. PLOS Medicine 19(4)
- Watkinson RE, Sutton M, & Turner AJ (2021). Ethnic inequalities in health-related quality of life among older adults in England: secondary analysis of a national cross-sectional survey. The Lancet Public Health, 6(3)
- Mason TFD, Whitston M., Hodgson J, Watkinson RE. Lau YS, Abdulrazeg O, & Sutton M. (2021). Effects of BNT162b2 mRNA vaccine on COVID-19 infection and hospitalisation amongst older people: matched case control study for England. BMC Medicine 19(1)
- Evaluation Reports
- News Stories
- 'Perfect storm' of distrust deepened inequialities during COVID-19 pandemic (published October 2024)
- Unique research collaboration highlights innovative approaches for post-pandemic healthcare (published March 2024)
- New study shows widening socieconomic inequalities in flu vaccine uptake during COVID-19 pandemic (published October 2023)
- How NIHR ARCs rose to the challenge of COVID-19 (published March 2023)
- COVID-19 vaccine rollout worsened existing health inequalities (published March 2022)
- Blogs
- Manchester Memories - Book Launch: A blog by Russ Cowper (July 2024)
- Exploring experiences during the COVID-19 pandemic and inequities in the vaccination rollout: insights from the public community involvement and engagement (PCIE) work – Stephanie Gillibrand (November 2021)
- Area-based vaccination would better protect against COVID-19 - Prof. Matt Sutton and Dr Ruth Watkinson (February 2021)
More information:
Senior Programme Lead