We hear from Cleo Butterworth, Associate Clinical Director for Patient Safety and Experience at the HIN (pictured with Sir David Sloman, NHS Regional Director for London at a recent visit to the North Lewisham and Alliance PCN Covid Vaccination Hub at the Waldron Health Centre) as she talks about her experiences with the south London community.
Alongside my work as an Associate Clinical Director at the Health Innovation Network, I have recently been volunteering as part of the Covid-19 vaccination efforts in my local area, North Lewisham. Figures from early February put south east London as a region where rates of vaccine uptake have so far been worryingly low, and I hoped I might be able to use my and experience as a pharmacist to reassure those with concerns about the vaccine.
For any pharmacist, providing reliable and accessible information about medicines to the public is a fundamental skill. When I volunteered to contact individuals, who had declined their Covid-19 vaccination and see if I could change their mind, I anticipated I might be able to make a difference quite quickly. Surely, I thought, most of the issues I encountered could be tackled by reassurance about safety or side effects, correcting misinterpretations of the (admittedly very complex) science around these new vaccines, or debunking far-fetched myths propagated by “anti-vaccination” news sources.
The reality I encountered, however, was much more complex. It soon became apparent that decisions about getting the Covid-19 vaccine were based far more on emotion than just medical fact.
I did have many very productive conversations about fear of side-effects, worries about catching the virus from the vaccine and other more challenging or complex questions to do with the medical science behind the vaccine. For example, many people appreciated me taking the time to explain how these vaccines have been delivered so quickly without compromising safety or efficacy. However, I felt I had little power to significantly change the position of the majority of the individuals that I talked to.
The majority of the people I spoke to were from BAME communities – communities with higher rates of serious illness and death from the coronavirus. The communities that have felt the impact of health inequalities for decades; the communities where adults are more likely to work in public-facing occupations such as social care or public transport, increasing exposure to the virus; the communities which tend to have larger multi-generational households where the virus can spread easily if it is brought in by family members unable to work from home.
On reflection, this defensive mindset should not have been unexpected. The key missing ingredient was trust, a factor I had perhaps underestimated in my interactions with the fearful, worried, yet proudly self-determined people I spoke to about the Covid-19 vaccine.
Trust is not something given lightly or conferred on the basis of a short telephone call. Trust is the years of seeing the same friendly face at a community pharmacy; trust is the practice nurse who helped you overcome a fear of needles and take a blood test; trust is the GP who went above and beyond to give an elderly relative dignity in death. But trust is also your kind neighbour; your friend; your colleague – and that is why every contact count when it comes to addressing vaccine hesitancy.
All this is not to say that we should give up on engaging with vaccine hesitant individuals, or that these groups are a “lost cause”. Quite the opposite, in fact. Whatever your background, healthcare professional or otherwise, understand that you might well be the trusted “medical expert” that someone turns to for guidance on the vaccine. Whether it turns out to be a mumbled half-question from a colleague or a bemusing WhatsApp from your Auntie, my advice would be to prepare yourself to make sure you can seize the opportunities when they are presented.
You can help equip yourself for those conversations by reading about the vaccine on the NHS website as well as more detailed “FAQ” information on vaccine safety and effectiveness from SEL CCG, and learn about the best tactics to explain vaccination science to the general public or this FAQ site made by experts.
Above all though, my advice is to be prepared to listen, empathise and reassure. In the face of a frightening pandemic and a seemingly uncaring system, you might be the only voice with the sufficient level of trust to make a difference.