To receive an update on the Covid vaccination programme in Wokingham Borough and plans for next steps in this.
The Committee received an update on Covid vaccinations within the Borough.
During the discussion of this item the following points were made:
· Katie Summers, Berkshire West lead for vaccinations and Director for Place Partnerships for the NHS Berkshire West CCG, provided an update on the vaccination programme.
· Kate Summers took the Committee through a timeline of the Covid vaccination programme.
· In December 2020 the first Hospital Hub programme had begun. The vaccination of cohorts up to the age of 18 was still continuing, however a new phase was also beginning; the booster programme and vaccinating 12-15 year olds.
· The first phase of vaccinations had focused on the most vulnerable including those in care homes and over 80’s. These were carried out in the primary care centres.
· In January 2021, the first mass vacation site had opened at the Kassam, followed by the Madejski Stadium in February. By February Cohorts 5-6 were being vaccinated.
· Different delivery mechanisms such as the Health on the Move van had also been used, which had made a big difference in vaccination levels.
· Katie Summers highlighted the number of people vaccinated in the different months across the BOB ICS. As an Integrated Care System, the BOB ICS, performed the best for vaccination rates in the country.
· Katie Summers went on to outline Phases 1 to 3 of the programme.
· In Phase 1, from December 2020, residents in care homes and older adults and their carers, frontline carers, the extremely clinically vulnerable, 16-64 with underlying health conditions and those aged 50 plus, had begun to be vaccinated. Until April the focus had tended to be on undertaking first vaccinations. This had then shifted to second vaccinations, due to the good uptake in vaccines. Also, evidence had suggested a better outcome following two doses of the vaccine.
· Phase 2 had been staged from April 2021 and focused on vaccinating those 18 and over. Since August 2021 the vaccination of 16–17-year-olds and clinically vulnerable 12-15 years old, had begun. From September 2021 the vaccination of 12-15 year olds would begin.
· Anyone over aged 18 and over who had still not been vaccinated were still encouraged to be, and would be offered a vaccination.
· Members were informed that Phase 3, boosters, had begun that week. Anyone living in a care home or who was over 70, or a front-line care home worker would be offered a booster initially. Boosters would be offered 6 months from the second vaccination. Immunosuppressed residents would receive an invitation to have a booster 3 months after their second dose. Following this the remaining cohorts would be offered boosters. Katie Summers indicated that Pfizer was approved for boosters by the Joint Committee on Vaccination and Immunisation (JCVI). A half dose of Moderna could also possibly be offered. This was currently undergoing the approval process by the JCVI. A Member questioned whether Pfizer and Moderna would be compatible for those who had originally received the Astra Zeneca vaccine, and if so, how this would be communicated. Katie Summers stated that the JCVI had confirmed to the PCN’s that the mixing of doses was considered safe, and in some cases preferable. There was likely to be national communication on this. Most of those who had been vaccinated first, had been vaccinated with Pfizer.
· Members were informed of the different delivery methods.
Ø Primary Care Networks – in Phase 1 all Wokingham PCN’s had opted into the national contract. In Phase 2 some of the PCNs had changed their delivery method. Wokingham PCN and Wargrave and Woodley Surgeries had opted in. All practices except Wilderness Road had opted in for Phase 3. Wilderness Road patients would be covered by Brookside Surgery.
Ø Mass Vaccination Centres – commissioned by NHS England. The Madejski Stadium centre had been replaced by Broad Street Mall in July following the change in social distancing requirements.
Ø Pharmacies – commissioned by NHS England – initially only two had signed up locally but this had since increased for the booster phase.
Ø Health on the Move van – commissioned by the BOB ICS and deployed around the ICS. The clinical provider was Oxford Health, and it was used to target areas of low take up. Areas it had travelled to included Asda in Lower Earley, Bulmershe School and Sheeplands. Katie Summers thanked Officers for their help in the planning of the deployment of the van.
Ø Specialist – Dr Jim Kennedy had worked with and led the vaccination of the homeless community. Berkshire Healthcare had helped to vaccinate house bound residents. Members asked that their thanks be passed on to Dr Kennedy for his hard work. Surge vaccinations had also been organised. Members were reminded of the pop-up vaccination site at Bulmershe following a surge in cases. Take up had been good.
· From 6 September, clinically vulnerable 12-15 years had begun to be vaccinated. Berkshire Healthcare had gone into some of the specialist schools to undertake this. From 23 September the 12-15 year old population would begin to be vaccinated by the Schools Immunisation Teams. Close work had been undertaken with the schools to ensure effective communication and consent.
· Members considered the vaccine take up rate to date. Katie Summers informed the Committee that Wokingham was one of the best local authorities for vaccine take up.
· The Committee was also updated regarding seasonal influenza vaccinations for 2021/22. Confirmation had been received that the JCVI supported the co-administration of the influenza and covid vaccines and that there would be no delay in the delivery of either. Individual practices were working up plans on how to support co-administration.
· It was noted that the eligibility for the influenza vaccination had changed this year. All children aged 2-15 years old were now encouraged to be vaccinated, where previously it had been up to the age of 11. Those aged 50 and over were also encouraged to be vaccinated.
· Members were informed that all Wokingham Borough GP practices had opted into the national contract for influenza vaccinations. Community pharmacies could vaccinate those aged 18 and over and Berkshire Healthcare would vaccinate school children.
· The expectation was that all care home residents had to be vaccinated by 1 November. The GP practices had been contracted to deliver on this.
· Katie Summers outlined some issues with the influenza vaccination including transport distribution.
· Members considered a forward plan of vaccination work. A timetable of when the PCN’s would be going live with the booster vaccinations, would be circulated to the Committee.
· It was noted that it was hoped that school children would be vaccinated by the Autumn half term. However, there had been some delays, such as a lack of guidance from government and staff shortages in the Schools Immunisation Teams. The Schools Immunisation Teams would be undertaking both Covid and influenza vaccinations, creating additional workload. The CCG was working with Berkshire Healthcare Trust to ensure that they had additional staff who had received the appropriate paediatric accreditations.
· Members sought clarification on the vaccination of health workers. Last year Berkshire Healthcare Trust had been able to offer vaccinations for front line health and social care staff from the Hospital Hub within Wokingham Community Hospital. However, this was not possible due to the teams being used to vaccinate school children for Covid and influenza. Health and social care workers would be invited to make a booking for a booster via the national booking system at a community pharmacy, a mass vaccination site, or a participating GP practice.
· The vaccination programme had been delivered in a very challenging time. With the delivery of Covid and influenza vaccinations, GP practices had concerns around the delivery of core services. Whether there was any impact on the delivery of core GP services would be monitored.
· The Committee was advised that some incidents of anti vaxxers were being seen locally, including in schools and GP practices. Some were using headed paper from Public Health England and the NHS for their communications. When identified this was being reported to the Police. Members were pleased to note that action was being taken to address this. A Member questioned whether the Committee could issue a press release indicating its concerns about what the anti vaxxers were doing.
· A Member commented that Wokingham wanted the highest rate of vaccinations possible for its residents. They expressed concern that the rate of vaccinations in the 18-24 year old cohort had dropped off, and that rates of Covid infection remained high in school age children. She questioned when the vaccination of school children was likely to be complete given the highlighted delays. Katie Summers responded that the reduction in vaccination rates was being actively monitored. Capacity was still high but take up had reduced. There was still a degree of hesitancy in some people. A large amount of communication work had been provided and was being undertaken with the school providers and the universities. Officers had gone to the Reading University Fresher Week to encourage new students to be vaccinated. With regards to staffing levels, Katie Summers indicated that she had been reassured by BOB ICS that sufficient staff would be available and that targets would be delivered. She went on to express concern regarding supporting children who were home schooled and their families, to ensure that they received the opportunity to take up a vaccination.
· A Member questioned whether the slowing rate of vaccinations in 18-24 years olds was due to people not knowing what to do or where to go, and if there was an issue with communication. Convenience was often very important. Katie Summers commented that there were two ways communication could be received – those who were eligible for vaccinations were being sent a text message encouraging them to take up the vaccination. The national booking system was widely promoted. Members were also informed of the ‘Grab a jab’ walk in facility at the mass vaccination centres and some community pharmacies. GP practices in Berkshire West had chosen not to be on the national booking system for Phases 1 and 2 but would be encouraged to do so for the booster programme. With regards to convenience, the ‘Grab a Jab’ system helped to address this as did the Health on the Move van.
· A Member commented that they were hearing that many residents were not clear where to go for their second vaccination, particularly for Moderna. She asked how the CCG made sure that people knew how and where they could access this, and also the Covid booster and influenza vaccinations. The Committee was informed that Moderna was only available at the mass vacation site at Broad Street Mall and the community pharmacy sites. The CCG website was promoting what types of vaccinations were available and where. Katie Summers assured Members that the Communications Lead would link with the Communications Team at the Council to actively promote this. With regards to the boosters, residents would receive text messages inviting them to make a booking when appropriate. GPs would be inviting their patients for an appointment and highlighting other delivery methods.
· In response to a Member question, Katie Summers highlighted the location of the participating community pharmacies in the Borough.
· A Member questioned whether the reduction in vaccination take up was due to a shortage of vaccinations and was informed that it was not. A mutual aid system had been set up between the PCN’s. Whilst there had initially been some difficulties with transporting Pfizer, this was now less of an issue. Members were also informed that some of the lower vaccination levels were in the Council’s neighbouring authorities and some of the staffing had had to be diverted to areas with more significant need.
· In response to a question regarding the booster vaccines for the different cohorts, Katie Summers commented that there would be some flexibility for delivery.
· A Member asked about the delivery of booster vaccines for the over 50’s. Presently the contract for the GP Practices and the community pharmacies was up to the over 50’s. The uptake in the first stage would be reviewed to establish the success or otherwise of the booster programme.
· A Member questioned whether there was a lower uptake in ethnic minority communities and if so, what additional communication was being undertaken to address this. Katie Summers stated that there had initially been some hesitancy in communities of different ethnic origins including in the Black African, Black Caribbean, Eastern European and Chinese communities. The Health on the Move van was starting to make a difference and uptake in these communities was increasing, although there was still quite a low uptake in the Chinese community. Messages would target the Chinese community who were attending the Reading University Fresher Week. Work had also been undertaken with the Gurkha communities and leaders to send out encouraging messages. A positive impact was being seen as a result. It was noted that the Council’s Communication Team had undertaken a lot of work to encourage local communities to take up the vaccine.
· It was hoped that another vaccine clinic would be held at the Aisha Masjid Mosque in Earley.
· The Health on the Move van would be halted for October and November. It was owned by Oxford Health which also managed the Schools Immunisation Teams. Some of the School Immunisation Team had been part of the Health on the Move van delivery unit and had been recalled to undertake vaccines in schools in Oxfordshire. The Executive Member requested a discussion on what could be done to increase the number of vaccinations in the Borough during that period.
· The Committee queried how data was collected and how this data shaped the design. Members were informed that the actual delivery rate was closely monitored. The system used could provide information down to an individual ward. This helped to highlight areas with a slower uptake, where messages needed to be targeted, and also helped to shape the schedule of the Health on the Move van.
· The Executive Member referred to some notable successes that the Council had had in working with the CCG. He referred to the 4,000 people vaccinated within 2 weeks at the pop clinic at Bulmershe Leisure Centre, following a surge in cases.
· Wokingham had wanted to see an additional pop-up clinic whilst the CCG had focused more on the Health on the Move van. The Executive Member stated that the Council would welcome working more collaboratively with the CCG on planning, operation, and communication.
· The focus for the Council currently was the second vaccination for the under 40’s, supporting the booster programme for the health and social care work force and the roll out in schools.
· In response to a Member question regarding the pressure on GP practices and the ability to deliver the vaccinations in addition to core services, the Executive Member commented that demand for GP services was much higher than pre Covid. He was of the opinion that the majority of practices in the Borough would be able to cope with the additional demand but that he had some concerns regarding the ability of some practices to deliver, which the CCG were aware of. Members were again assured that the practices’ ability to maintain core services would be monitored.
· The Committee discussed face to face GP appointments.
· Members were informed that the local authorities would lead the communications on vaccinations, going forwards.
· Ingrid Slade, Consultant in Public Health, outlined the role of Council Officers within the vaccine programme. She worked closely with Matt Pope, Director Adult Services. Officers provided a support role, acting as a bridge between residents and the CCG.
· There had been some confusion amongst residents particularly around where to access a second dose. A helpline had been established so that residents could ask questions about vaccinations. This helped to identify issues which could then be fed back into the system and addressed.
· Support would be provided to schools on the roll out of the vaccination of 12-15 year olds. A Children’s Services Task Force had been established as part of the Covid response. One of its roles was to monitor the number of cases within schools. Members were informed that over the next 4-6 weeks the Covid marshals would be patrolling the key walking routes to the schools and removing any anti vaccine information found.
· Care home staff would be supported. Ingrid Slade reminded Members that not all health and social care staff worked within care homes.
· There was still work to be undertaken to maximise the uptake of vaccines, particularly with the harder to reach communities and the under 40’s. Some concerns and vaccine hesitancy amongst young women hoping to shortly start a family, had also been identified.
· Data driven evaluation was helping to identify demand and capacity across the Borough.
· A Member asked if continuous high levels of stress on officers within the Council, health and social care and the voluntary sector were anticipated, should Covid be considered ‘the new normal’, and if so, how it would be addressed. Ingrid Slade commented that officers had risen to the challenge, but that Members were right to question how long this could be sustained. Additional funding had helped alleviate some pressure, but this would be ceasing in March. The situation would need to be monitored. Katie Summers referred to training offered to NHS staff which focused on supporting mental wellbeing.
· The Executive Member praised the lead officers and external partners who he felt had gone above and beyond in the response to the pandemic.
1) the Covid Vaccination update be noted.
2) Katie Summers, Ingrid Slade and Councillor Charles Margetts be thanked for their presentations.