Evaluation of childhood immunisations and a potential COVID-19 immunisation in the Somali population in the London Borough of Hammersmith and Fulham

Problem

Previous studies have suggested a lower than average childhood immunisation uptake in the Somali population in London. Surveys on COVID-19 immunisations have suggested significant numbers in the UK may not accept a vaccine, particularly in Black, Asian, and Minority Ethnic groups, who are disproportionately affected by the virus. There is no published data on immunisation uptake of the Somali population in the London Borough of Hammersmith and Fulham. However, there have been concerns from healthcare professionals in primary care about immunisation uptake levels in this population in the borough through anecdotal evidence. This service evaluation set out to explore and address these issues with the following aims:1. Review data on childhood immunisation uptake amongst different ethnic groups in the London Borough of Hammersmith and Fulham.2. Explore views of Somali-origin parents on childhood and COVID-19 immunisations in Hammersmith and Fulham in focus groups.3. Propose interventions to improve immunisation uptake in the Somali community in Hammersmith and Fulham.

Approach

We undertook a service evaluation of immunisations in the Somali population in Hammersmith and Fulham. Data on immunisation uptake and ethnicity was requested from the Child Health Information Services. Data on immunisation status was collected on children born in Hammersmith and Fulham between 1st January and 31st December in 2014, 2017, and 2018. Outcome measures were immunisation status for vaccines up to age five and ethnicity.Focus groups were used to ascertain views on immunisations. Participants were Somali parents living in Hammersmith and Fulham recruited from three parents’ groups. Three focus groups with 7, 12, and 20 participants were run. Outcome measures for the focus groups were views on childhood and COVID-19 immunisations, and how to improve uptake for the Somali population.

Findings

Overall immunisation uptake was lower for the African and Black British groups compared with the White British group in all cohorts. For the African group, 22% lower in 2014, 17% in 2017, and 8% in 2018. For the Black British group, 7% lower in 2014, 3% in 2017, and 23% in 2018. In the focus groups, all parents were aware of the importance of childhood immunisations and had immunised their children. Most concerns were about MMR and some had delayed vaccinations. Participants reported unclear information and lack of time with clinicians led to seeking information from peers instead. There was general distrust from the majority of participants about COVID-19 vaccinations, with only one participant saying they would accept it.

Consequences

Primary care has a crucial role in improving immunisation uptake in the Somali population of Hammersmith and Fulham. More time is needed to discuss immunisations with healthcare professionals. Question and answer sessions with a trusted professional would be welcomed, as well as written information in Somali.