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Vaccination programme

Letter from the Cabinet Secretary for Health and Social Care on the vaccination programme dated 26 October 2021

Dear Siobhian,

I am writing to respond to queries raised following the evidence session with the COVID-19 Recovery Committee on 7 October 2021. The below will cover evidence that Scottish Government marketing and communications has made a positive impact on uptake, further information on vaccine hesitancy among certain groups including ethnic minorities and how the figures in Scotland compare with the rest of the UK, and an update on mitigation measures in schools and school safety measures.

Roll Up Your Sleeves - Covid-19 Vaccination Marketing Campaign

The main ‘Roll Up Your Sleeves’ vaccine campaign to encourage uptake has been quantitatively evaluated by independent research agency Progressive Partnership Ltd.

Campaign activity ran across two bursts of activity. Phase one targeted priority audiences from 21 January to 31 March, and phase two targeted 18-49 year olds during the period 20 April to 30 June, with digital activity up-weighted to specific age groups within this period as they became eligible for first and second doses.

Both campaigns performed strongly, achieving high awareness and engagement with all audiences. Evidence clearly shows that they encouraged action, including vaccine uptake. Key results from the evaluation for each of these are provided below.

Roll Up Your Sleeves Phase One

• The first priority audience for the vaccine was healthcare workers, social care workers, those aged 80+ and older adult residents in a care home. The evaluation(1) took the form of a post-campaign online survey using an online panel provider and distributing the link via SG clinical networks to the priority audiences and other groups who became eligible during the campaign (age 65+ and clinically vulnerable people) .
• When prompted, 95% of the sample were aware of at least one of the campaign elements (a national door drop, radio, digital display, social, out of home and TV advertising) – a level of awareness rarely seen. The door drop leaflet supported the media campaign well - 75% recognised the leaflet and seven out of ten recognised both the leaflet and the advertising campaign.
• Reactions to the campaign were positive, with for example: 76% agreeing that ‘the advertising makes me more aware of the importance of being vaccinated’ and 73% that ‘the advertising encourages me to get vaccinated against COVID-19’.
• Two thirds of those who saw or heard the campaign, said that they had taken action in response to it and among this group some of the actions taken are particularly noteworthy:
  
  • 36% said they got the COVID-19 vaccine
  • 35% talked to family or friends about the COVID-19 vaccine
  • 33% encouraged a friend/ family member to get vaccinated
  • 20% looked for more information on the COVID-19 vaccine
  • 10% visited the NHS Inform website.

Roll Up Your Sleeves Phase Two

• The second phase of activity was developed using results and learnings from Roll Up Your Sleeves Phase One, along with additional insight gathering with the target audience, in order to maximise effectiveness.
• Evaluation(2) took the form of a post campaign online survey with a sample of the target audience - 18-49 year olds not previously eligible for the COVID-19 vaccine (main sample) and a boost sample of minority ethnic respondents aged 18+ (English speaking). Unless otherwise stated the figures below relate to the main sample.
• When prompted, 76% of the target audience (both samples) were aware of at least one of the campaign elements (TV, radio, out of home and social media advertising), with awareness broadly consistent across sub-groups.
• Around half saw or heard more than one campaign channel which is valuable in helping to drive action, and this was higher among the minority ethnic sample (62%).
• Reactions to the campaign were positive, suggesting clear understanding of and engagement with the messaging. For example:
  
  • 70% of the main sample and 78% of the minority ethnic sample agreed ‘I believe that the advertising is aimed at people like me ’
  • 66% and 76% respectively agreed that ‘the advertising encourages me to get vaccinated against COVID-19’
  • 63% and 82% respectively agreed that ‘the advertising makes me more aware of the importance of being vaccinated’.
    
    
• Just under half of those who had seen or heard the campaign (45%) reported taking action as a result of the campaign. Among this group, reported action was most likely to be talking to others about the vaccine (including encouraging others to have it) (at 24%), getting/deciding to get/taking steps towards having the vaccine (23%) and looking for more information (22%). These results are lower than phase one, which was to be expected given we were talking to younger cohorts and the programme was more established, with more people likely to have already been vaccinated.
• Overall, of those who had seen or heard the campaign but said they had done nothing in response (n=133) 61% were vaccinated, suggesting that they were potentially already vaccinated when they saw the campaign.
• At 65% the minority ethnic sample was more likely to have taken action than the main sample.

Vaccine uptake equalities reporting

The latest PHS data on equality of COVID-19 vaccination uptake highlights that, as at 28 September 2021, in those aged 18 and over, dose 1 vaccine uptake is highest in White ethnic groups (89%) and lowest in the Caribbean or Black ethnic groups (68%). For dose 2 this is 84% and 60% respectively. For dose 2 the lowest uptake is in African ethnic groups (59%).

As each nation uses different data sources and ethnicity groupings, the data available on vaccine hesitancy across the four nations by ethnic groups  is not directly comparable. However, it does indicate that there are differences in COVID-19 vaccination uptake rates by ethnic group across all nations. So while uptake in Scotland  is lowest in Caribbean or Black and Other ethnic groups, in England uptake is lowest for Chinese, Caribbean and Mixed (White and Black Caribbean). Asian ethnic groups have higher uptake rates compared to other ethnic groups, with the exception of Pakistani where uptake rates (available for England) are lower. Further information on COVID-19 vaccination rates by ethnic groups is attached to this letter at Annex A.

As at 28 September 2021, 84% of those aged 18 and over in the less deprived areas had received their first dose of vaccine for COVID-19 compared to 76% in more deprived areas. For dose 2 this figure is 80% and 69%.

Actions taken to support inclusion and equalities

We have embedded inclusion as a key aspect of our national COVID-19 vaccination programme, working alongside Health Boards and other partners to respond to evidence of low uptake in certain groups:

• All NHS Boards have dedicated inclusion plans within the vaccination programme, outlining how they will actively offer vaccination to people who may face barriers in taking up the vaccine.
• We have ensured our COVID-19 vaccination communications are suitable for everyone in Scotland, building on PHS’s Health Inequality Impact Assessment, with the production of translated information and assets in a range of languages on NHS Inform and the development of our vaccine explainer video, informed by insights from organisations representing various under-served communities.
• ·vaccinations are offered in a variety of places including places of worship and in other community settings.
• Concessionary bus travel to appointments is available
• Our Vaccine Inclusive Steering Group meets regularly to advise on inclusive policy and delivery and is a forum for a range of partners to share practice and learning and we are working with community leaders to promote uptake.
• We also use data to inform our approach including Public Health Scotland’s regular publication on uptake of the COVID-19 vaccination by ethnicity and deprivation.

Mitigation measures in schools and school safety measures

Previous updates to the Reducing risks in schools guidance committed to keeping further changes to mitigations on hold “until at least the October holidays”.

Last week, following advice from the Chief Medical Officer and other clinicians regarding the levels and trends in case rates, we confirmed that we would extend that period. I understand the Cabinet Secretary for Education and Skills wrote to you last week to confirm that position and provide details regarding the guidance itself. 

We do not wish for mitigations to be maintained in schools any longer than is necessary and, as always, the challenge is to balance risks. Crucially, however, pausing implementation of any further changes will allow more time for 12 to 15-year-olds to take up the vaccination. I am pleased with the early progress made with that rollout, and current uptake figures are already over 50%.

We know that ventilation is one of the most important ways in which we can reduce the risk of airborne Covid transmission. That is why we have committed to providing local authorities with £10 million of funding, to ensure that schools and childcare settings have access to carbon dioxide monitoring. This funding was in addition to previous support that was provided to local authorities for Covid logistics, including improved ventilation.

The Cabinet Secretary for Education and Skills will write to the education committee later this week, and will provide an update on the progress local authorities have made in completing initial CO2 assessments of their schools and other education settings.

Humza Yousaf
Cabinet Secretary for Health and Social Care

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(1) Quantitative post campaign survey – conducted online, using a trusted panel provider and distributing the link via SG clinical networks. Target audience: priority groups eligible/becoming eligible for the COVID-19 vaccine. Fieldwork was conducted 22 February – 8 March 2021, with a resulting sample of 1,480 interviews. The sample consisted of 109 people who were shielding, 163 aged 65+, 570 healthcare worker and 638 social care workers.

(2) The evaluation took the form of a quantitative post campaign survey – conducted online, with sample provided by an online panel provider. Interviews were conducted with 18-49 year olds not previously eligible for the COVID-19 vaccine (e.g. through employment or having a health condition), with a boost sample of minority ethnic respondents aged 18+ (English speaking). Fieldwork was conducted from 14 to 29 June 2021, with a sample of 500 18-49 year olds (quotas set for gender and SEG to provide a representative sample) and 156 minority ethnic respondents.