Health minister Maria Caulfield told the Health and Social Care Committee today (23 May) that boosting immunisation rates required a shift away from a general-practice-led system towards a multidisciplinary approach that includes community pharmacies.

And Dr Nikki Kanani, a GP and deputy chief of the NHS Covid-19 Vaccination Programme at NHS England, said that the trusted relationship that people had with their community pharmacy was 'key', and that vaccine uptake could be improved by working across sectors.

The comments came as part of a Health and Social Care Committee inquiry into falling rates of childhood and adult immunisations.

Speakers highlighted lessons learned during the pandemic to improve vaccine delivery.

‘I think Covid was a game changer,’ said Ms Caulfield, ‘traditionally it was either the GP or practice nurse [delivering immunisations]; now we’ve got pharmacists; we’ve got community vaccinators which were never around before.’

She highlighted the success of bringing vaccinations into  communities with a lower rate of uptake.

'Black Afro Caribbean groups were 20% less likely to come forward for a vaccination than than white counterparts, and it was really crucial that they got vaccinated.

'So things like taking the vaccine into the communities to places of worship, working with faith leaders, community leaders, vaccination buses, you know, making it as easy as possible - they're the lessons that we've learned from COVID that we are now rolling out across vaccine programmes', she said.

Ms Caulfield said that while vaccination programmes should be managed nationally for a joined-up approach, they should be rolled out locally, with integrated care boards (ICBs) 'taking a lead in terms of local provision' to increase uptake and tailor the approach for local needs.

'There are local factors. So for example, Cornwall is a much harder geography to vaccinate than, say, an urban city centre, just simply because of the distance people often have to travel to get a vaccination. So the solutions in Cornwall will be very different to say solutions in London and ICBs are best place to make those decisions,' she said.

Chair of the Health and Social Care Select Committee asked Dr Kanani whether she thought that ICBs were 'up to the task' of challenging 'often traditionally very powerful GP partners who enjoy doing vaccinations' and spreading the vaccination workload across providers.

She replied that 'they absolutely are' and said that ICBs provided an opportunity to work together.

And she said that a multidisciplinary approach toward vaccine provision was 'exactly the direction of travel', adding: 'if it means that the care that we offer is much closer to an individual in the community and reflects what they actually need, that's what I'm driving for'.

And she welcomed creating more vaccination providers to help ease pressure on general practice.

Speaking of her own experience as a GP in South East London, Dr Kanani said: ‘I do like giving vaccinations because it’s nice to see families but actually the reality is we’ve got a lot of other things to do.’

Vaccination rates continue to fall post-Covid, particularly among children and young people.

Data from the UK Health Security Agency showed 7% fewer 13-to-14-year-olds in Year 9 were vaccinated against meningococcal disease, diphtheria, tetanus and polio, than the year before, and around 20% less were vaccinated than when compared with pre-pandemic levels.

Vaccine hesitancy and vaccine confidence was identified as a key contributing factor to the continued fall in uptake with Ms Caulfield saying that a lack of trust in the MMR vaccination had ‘taken time to restore’.

‘We had issues around MMR where there was misinformation and disinformation for parents.

‘But it is about getting those routine vaccines back onto people’s minds. And I think there was a lot of damage done around MMR, and that has, you know, had a knock-on effect on vaccination rates for childhood vaccines as well.’

However, Ms Caulfield said that that the issue was not just about confidence in ‘the vaccine itself.

‘People have to feel a number of things to take part in a vaccination programme: they have to feel that that there’s a risk from the actual illness itself. And if they don’t feel that they’re at risk, they’re less likely to come forward for a vaccination.

‘They have to feel as confident in the vaccine as possible, as well. And also, they have to have the ease of access to so in some communities,’ she added.

A version of this article first appeared on our sister site Nursing in Practice.

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