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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?

 

Findings

Details of the study have been published in the PLOS Medicine. The main findings were:

  • In total, 83.64% of eligible people received the COVID-19 vaccine.
  • Less people from 15 of 16 ethnic minority groups had the COVID-19 vaccine, with numbers particularly low for people in the following groups: Black African, Black Caribbean and 'other Black background'.
  • Less people from the groups 'White and Black Caribbean' and 'White and Black African' had the influenza vaccination than White British, Bangladeshi, and 'other ethnic group' people.
  • Generally, less people from ethnic minority groups had the COVID-19 vaccine than the influenza vaccine. 
  • Ethnic inequalities in people having the COVID-19 vaccine were most common among older, extremely clinically vulnerable adults with the least income. 

 

 

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?

 

Findings

 A lay summary of the findings can be downloaded here. The main findings were:

  • Communities in Greater Manchester were not supported enough by mainstream services during COVID-19. This meant that local community groups had to provide support instead. 
  • Local community groups were important to the success of the COVID-19 vaccine rollout. 
  • Community groups helped to reach diverse communities, helping more people to have the COVID-19 vaccine. 
  • The work of community groups during the pandemic is not fully recognised or valued by the health system and its decision-makers. 

 

 

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:

 

 

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.

 

Findings

More information about this work and all the findings are available from the National Insights Prioritisation Programme (NIPP) - Optimising vaccination in Greater Manchester- here.

 

There were 6 key insights that came out of this work:

  • Key insight 1: In Greater Manchester, we should focus on the use of targeted vaccination activities that are based on the evidence available.
  • Key insight 2: Community engagement is important and should be used when designing targeted vaccination activities.
  • Key insight 3: We must make sure that community engagement activities and targeted vaccination delivery are working together to provide the best results. 
  • Key insight 4: We need to allocate enough time and money to targeting underserved groups of people for vaccination. 
  • Key insight 5: We need to use evidence to design targeted vaccination activities. 
  • Key insight 6: We need to support continued partnership working in Greater Manchester. 

 

 

 

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?


 

Downloadable Resources

 

 

 

More information:
 

 

Senior Programme Lead

 

Mike Spence

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