Identifying and Overcoming Barriers to COVID-19 and Flu Vaccine Uptake in Tees Valley Communities: Insights from a Mixed-Methods Study

Background and aims: In the wake of the global COVID-19 pandemic, alongside the perennial challenge posed by seasonal influenza, understanding and addressing vaccine hesitancy has become central to public health initiatives. The present study aimed to identify barriers to uptake for COVID-19 and flu vaccines within Tees Valley’s diverse communities, with a specific focus on housebound individuals, ethnic minorities, those in socioeconomically disadvantaged areas, and care home residents and staff. This was driven by the urgent need to bolster vaccine uptake among these communities, ensuring widespread immunity and safeguarding public health. Considering the variety of social, cultural, and economic backgrounds in Tees Valley, the study aimed to provide actionable insights tailored to the unique challenges and opportunities present within this locality.
Method: The study employed a mixed-methods approach, incorporating both quantitative surveys and qualitative interviews to gain an in-depth understanding of vaccine hesitancy. A survey and an interview schedule were developed to explore participants’ perceptions, attitudes, and experiences with flu and COVID-19 vaccines. The survey targeted a broad demographic within Tees Valley, with 157 individuals across various local authorities, age groups, and socioeconomic backgrounds participating. It assessed vaccine readiness, barriers to vaccination, and facilitators that could enhance vaccine uptake, focusing on the 7Cs of Vaccination Readiness: Confidence, Complacency, Constraints, Calculation, Collective Responsibility, Compliance, and Conspiracy Beliefs. Practical barriers to vaccination were also assessed. Additionally, interviews were conducted with 58 individuals to elicit further in-depth information. Participant recruitment was conducted via social media promotion, professional networks, and community outreach. The survey was administered online through the Joint Information Systems Committee (JISC) platform, supplemented by paper surveys administered face-to-face, thereby ensuring accessibility for a range of participants. Interviews were conducted online via Microsoft Teams as well as face-to-face to enhance the depth and authenticity of the data collected. Quantitative data were analysed using version 29 of The Statistical Package for the Social Sciences (SPSS). Inductive thematic analysis was conducted on the qualitative data.
Results: The study revealed a complex landscape of vaccine perceptions among Tees Valley’s residents. While many acknowledged the importance of vaccines in disease control and expressed trust in their safety and efficacy, notable hesitancy persisted. Concerns included fears about vaccine side effects, the rapid development of COVID-19 vaccines, and a general mistrust of the pharmaceutical industry and government health advisories. Personal narratives and lived experiences, particularly regarding side effects and vaccine- induced health issues, played a significant role in shaping vaccine perceptions, highlighting the impact of personal and vicarious experiences on vaccine decision-making. Access and logistical issues emerged as significant barriers in all groups. The study also highlighted the pervasive influence of misinformation through social networks and media, affecting vaccine perceptions and emphasising the need for comprehensive information campaigns.
Recommendations: Based on these findings, targeted interventions are proposed to address the identified barriers. For housebound individuals, enhancing in-home vaccination services and implementing user-friendly scheduling systems are recommended. Ethnic minority communities would benefit from culturally sensitive vaccination campaigns and community outreach programmes. For those in socioeconomically deprived areas, facilitating pop-up vaccination clinics and launching targeted information campaigns could mitigate access barriers. Care home residents and staff should have access to regular on-site vaccination sessions and ongoing education to address vaccine misconceptions.
Conclusions: The present study illuminates the complex factors contributing to vaccine hesitancy within the Tees Valley. Adopting a multi-pronged approach that includes targeted interventions, trust-building communication strategies, and improved vaccine accessibility, could significantly enhance vaccine uptake among Tees Valley’s diverse communities, contributing to improved public health outcomes.