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.
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.
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%.
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:
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
(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.
1. To provide information on rates of COVID-19 vaccination uptake by ethnic group for Scotland compared to the other UK nations.
2. Scotland, England and Wales publish data on COVID-19 vaccination uptake by ethnic group. Northern Ireland publish data on the number of vaccinations by ethnic group but do not publish rates (% uptake).
3. As each nation uses different data sources and ethnicity groupings, the data is not directly comparable. Due to the lower population of ethnic minorities in Scotland and Wales, the ethnicity groupings are based on aggregated groups and less detailed than those for England. Public Health Scotland (PHS) have released disaggregated data for Scotland (more detailed groups) as part of supplementary tables but these estimates are subject to more uncertainty due to the small population sizes. This note summarise the data available for each nation and helps to highlight differences in uptake between ethnic groups, but does not examine causative factors.
More detailed information for each nation, including a summary of the data sources used, is provided below.
4,Public Health Scotland publishes statistics on COVID-19 vaccination uptake by ethnicity for those aged 18 and over for both first and second dose. Vaccination data are extracted from the National Clinical Data Store (NCDS) which sources data from both the Vaccine Management Tool and General Practice Patient Management Systems. The latest data presented is for those who have had 1 or 2 doses of a COVID-19 vaccine up to, and including, the 28 September 2021.
5. Ethnicity data are sourced from various datasets – it incorporates an individual’s ethnicity as recorded in outpatient (SMR00) and inpatient or day case (SMR01) hospital records from March 2010, Rapid Preliminary hospital Inpatient Data (RAPID) records from February 2020, COVID Case Management System (CMS) from June 2020, Electronic Communication of Surveillance in Scotland (ECOSS) from February 2020 or from the Urgent Care Datamart (A&E, SMR04) from January 2011.
6. Population data are extracted from the Community Health Index (CHI) dataset representing all those currently registered with a GP practice in Scotland.
7. Table 1 shows vaccination uptake for first and second dose by ethnic group for adults aged 18 and over in Scotland. Ethnic group categories are based on the Scottish 2011 census ethnicity categories which are used as standard across the NHS in Scotland.
|
First Dose |
Second Dose |
White |
88.9 |
84.1 |
Mixed/Multiple |
73.6 |
65.7 |
Asian |
77.9 |
71.2 |
African |
68.8 |
59.1 |
Caribbean or Black |
68.4 |
60.2 |
Other |
67.3 |
60.5 |
Unknown |
70.1 |
66.4 |
Source: Public Health Scotland COVID-19 statistical report
8. NHS England publish monthly statistics on vaccination uptake by ethnicity. Vaccination data is extracted from the National Immunisation Management System (NIMS).
9. Ethnicity data is sourced from the NIMS datasets and is derived from data extracted by NHS Digital as part of their GP extraction service (GPES), Data for Pandemic Planning and Research (GDPPR) and Hospital Episodes Statistics (HES) datasets.
10. Vaccination uptake percentages should be considered as estimates only. Vaccination uptake percentages are calculated using the NIMS population denominators and are likely to be underestimates. However, coverage can be viewed as being ‘at least’ the figures calculated using the NIMS denominators. The NIMS denominators do not include those without an NHS number and so do not cover the whole population.
11. Table 2 shows vaccination uptake for first and second dose by ethnic group for adults aged 18 and over in England. As NIMS population denominators are not published, the data cannot be presented in comparable ethnic groups to Table 1.
First Dose |
Second Dose |
|
A: White - British |
89.4 |
85.3 |
B: White - Irish |
79.8 |
76.1 |
C: White - Any other White background |
61.9 |
57.6 |
D: Mixed - White and Black Caribbean |
56.6 |
49.4 |
E: Mixed - White and Black African |
64.9 |
56.6 |
F: Mixed - White and Asian |
73.2 |
67.0 |
G: Mixed - Any other Mixed background |
66.8 |
60.5 |
H: Asian or Asian British - Indian |
79.4 |
74.3 |
J: Asian or Asian British - Pakistani |
70.0 |
59.8 |
K: Asian or Asian British - Bangladeshi |
77.3 |
68.9 |
L: Asian or Asian British - Any other Asian background |
75.1 |
68.9 |
M: Black or Black British - Caribbean |
54.0 |
48.4 |
N: Black or Black British - African |
62.5 |
53.6 |
P: Black or Black British - Any other Black background |
55.8 |
47.5 |
R: Other ethnic groups - Chinese |
50.1 |
47.2 |
S: Other ethnic groups - Any other ethnic group |
62.3 |
56.1 |
Not stated/Unknown |
62.6 |
56.0 |
Source: NHS England COVID-19 monthly announced vaccinations 14 October 2021
12. Public Health Wales publish an equality report, summarising surveillance of equality in COVID-19 vaccinations in Wales. Vaccination data are sourced from the COVID-19 Welsh Immunisation System (WIS), from Digital Health Care Wales (DHCW).
13. Ethnicity analysis were carried out in SAIL Databank using WDSD (Welsh Demographic Service Dataset) and CVVD (WIS) data. The denominator includes all those alive and resident in Wales as at 31/08/2021. The vaccination (numerator) data are as at 10/09/2021. Ethnicity has been derived into the standardised ethnic grouping as a composite variable from data available in the SAIL Databank including the ONS 2011 census and over 20 routine electronic health record (EHR) data sources.
14. Table 3 shows vaccination uptake for first and second dose by ethnic group for those aged 16 and over Wales.
First Dose |
Second Dose |
|
White |
89.1 |
84.4 |
Black, Asian, Mixed and Other Combined |
72.5 |
* |
* Data censored to comply with SAIL statistical disclosure control requirements, due the small number (<10) of people in these groups who had received their first vaccine dose but not their second. This means that the coverage level of two doses in these groups is very close to the coverage level of the first dose.
Source: Wales COVID-19 Vaccination Enhanced Surveillance Equality Report, 23rd of September 2021
15. Northern Ireland publish data on the number of vaccinations by ethnic group on their COVID-19 vaccinations dashboard but do not publish rates (% uptake).