Agenda item

To receive an update on the rollout of the vaccination programme in Enfield.

RECEIVED the report of the Director of Public Health.

•  Introduction by Dudu Sher-Arami (Director of Public Health) and Dr Fahim Chowdhury (GP and CCG Board Member).

•  The vaccination programme was not finished: there would be a roll out of the booster dose for vulnerable adults in the Spring, and roll out of vaccination to 5 – 11 year-olds via primary care. Planning had already begun for Winter 2022/3.

•  Tackling health inequality was a major focus. The Borough Partnership Immunisation and Screening Workstream Group would continue to work on vaccine inequality. Closer work would continue with local communities.

•  The high level of collaboration between organisations across Enfield, including the NHS, voluntary sector and the Council, was highlighted. A lot had been learned from the vaccination work so far.

In response the following comments and questions were received and responded to.

1.    In response to the Chair’s queries about potential concerns further to recent relaxation of restrictions, it was confirmed that nationally there had been a slight rise in the number of Covid cases and the pandemic was not over. No-one could accurately predict the future, but the vaccination was very effective at preventing death and hospitalisation, and vaccinated people who did become infected experienced much lower severity of disease. Concerns focused on groups with lower vaccine uptake as the unvaccinated would experience higher rates of hospitalisation and death. This was still work in progress. Vaccine manufacture would respond to future Covid variants in a speedy manner and the vaccination programme would continue, along with work to raise vaccine confidence and respond to community needs. Assurance was given that relaxation of restrictions was now appropriate. There were multiple lines of treatment even for the very vulnerable. North Middlesex University Hospital ITU had returned to normal patient numbers.

2.    In response to the Chair’s query about the scaling down of vaccine infrastructure locally, assurance was given that the borough had greater vaccine provision and slots than there was currently demand for. There was extra provision in the borough via additional pharmacies and an additional primary care location, and provision was 7 days a week.

3.    In response to Councillor Georgiou’s queries about difference in vaccine uptake rate by gender, it was advised that women were generally more likely than men to present for health care and to follow health seeking behaviours.

4.    In response to Councillor Georgiou’s further queries, it was confirmed that low vaccine uptake was seen in various geographical, socio-economic, ethnic, and cultural groups. Risks had been highlighted early to Black communities which were known to be more badly affected by Covid. It was confirmed that all patients had continued to be contacted to receive vaccinations. Vaccine uptake inequality did not seem to be related to availability or accessibility but rather to misinformation. An appointment system had been necessary early on to prevent overwhelming the system and to prioritise the most vulnerable. After that point, a walk-in system was better. Pop-up vaccination facilities were provided in support and had been very successful at the beginning of the rollout, but less so recently despite provision in good community venues. Approval had just been received to begin a pilot door-to-door vaccination scheme. More innovative and creative solutions were being sought.

5.    Councillor Hamilton asked how misinformation could be stopped. It was advised that the amount of misinformation shared was huge, but there had been a programme of communication work, including by the Council’s communications team, to attempt to tackle the issue within their finite resources. This included posts and short films on social media, messages in a variety of languages, and engagement with faith leaders so that people could hear from trusted sources. There had also been use of people trained to have vaccination conversations on the streets in the east of the borough.

6.    In response to Councillor Hamilton’s query regarding the current situation in the borough’s care homes, Doug Wilson confirmed that vaccination had made a huge difference and care homes were now seeing hardly any deaths due to Covid. The Council had been clear from the outset that people would not be admitted into its care homes without negative Covid test results: locations had been established for people to go who tested positive and co-operation had been good.

7.    In response to Councillor Neville’s queries, it was confirmed that Figure 7 in the report showed the latest data used by the Public Health Intelligence team to inform action. There was a trend of lower vaccine update in Eastern European groups and engagement work continued with those groups; in particular to assist with registration with local GPs.

8.    Councillor Demirel asked about the low booster rate for care home staff shown in Figure 10. It was clarified that as many care home staff received first and second doses at the end of the period, when the vaccination mandate was brought in: they were only just becoming eligible for the booster. Doug Wilson added that the booster was not part of the mandate, and that concerns of staff reflected concerns among the general population, but there had been engagement and face to face conversations.

9.    In response to Councillor Demirel’s further queries regarding vaccination of children, it was confirmed there had been relatively low uptake for 12 – 15 year olds despite opportunities to be vaccinated at school. For 5 – 11 year olds, parents would be required to take them to primary care centres for vaccination, which may also lead to lower uptake. Grant funding had been applied for through NHS England to expand communications.

10. Councillor Anolue asked about numbers presenting with Long Covid. Dr Chowdhury advised that there were around 30 people presenting to his practice, but it was likely there were a lot more people with symptoms. There was research taking place, and a special clinic at UCLH, but it was early days and little was known at this point. There was evidence that vaccinated people were less likely to be affected by Long Covid.

11. The Chair asked about the role of the Council, and it was advised that though the vaccine programme was delivered by the NHS, the Council had worked in partnership, as had the voluntary sector, to support in any way it could. Coordination, leadership and communication routes had been provided and many staff across Council services had become involved.

12. The Chair recorded thanks for a very good paper, and that he was encouraged by the work taking place and the creative approaches.