Making sense of the Covid-19 vaccines - Part I - NHS Kent and Medway

hello now there's one subject area that always when it's raised brings a lot of argument controversy anger you name it whatever it's and it's vaccination vaccination is a is a topic that whenever is brought up we have different sides with different opinions different stories and different idea ideas and what whatsoever but I think tonight we're here to discuss vaccination but hopefully we would have Insight out of this conversation that would help us make um informed decisions on our stand when it comes to do a vaccination and I'm so excited to have me here Healthcare professionals so we're not getting people who have no understanding of what this conversation about but we were Healthcare professionals who would sort of guide us through this whole thing about vaccination hopefully by the end of this conversation we would have broken set myth um Chang mindset and also giving us a better understanding in order to help us protect ourselves and protect our community and I to start off I say welcome guys for joining us on this special conversation and I think to introduce from my extreme left I have Abby and Then followed by Priscilla Logan and that's right so thank you guys for joining us but I think before we dive into today's this this afternoon or this evening's conversation we would want to hear just a word or two about who you are and what Authority you have to be on this around this table to share in this sensitive conversation on vaccination I I I'll explain why I say sensitive as we go along uh as in terms of why we talk about vaccination sensitive very sensitive when it comes to this conversation but I'll be you know just give us a word about than you yes um it's a pleasure to be to be here to to speak with you know my colleagues um my role is uh a clinical lead for vaccinations um for Kenton Medway and I also support the Southeast region um uh for NHS England with the vaccination program so hopefully I can bring some of that experience to the table here and be a part of what is hopefully going to be a very good conversation fantastic AB be and Prisa yes I'm Prisa Canam and I'm the senior responsible officer for the vaccination program for ker Medway um area which covers about just under two million residents and I'm also a clinical pharmacist by background so I think as a healthc care professional I'm able to engage and have those conversations bring some insights into the the discussion yeah Logan so um I'm Dr Logan manikam I'm a public health consultant in Medway Council but also a ACU medical doctor in Medway hospital so I'm not technically leading the vaccination program in Kenton Medway so I support um really in sort of some of the implementation drives for improving vacine uptic in Medway Council and the and its residents but I've also really been closely involved in seeing a lot of patients um released really during waves one two and three uh prevaccination program and post vaccination program particularly in an in the front line so lot of LIF experiences about that excellent and praa hi I'm praa jikar head of vaccination Workforce inequalities for NHS England and I look after the Southeast region and Kinton Midway is one off our system and I'm an occupational therapist with background and one of my main role as head of um vaccination Workforce inequality is to ensure that inequality in terms of vaccination um provided to everybody um to reduce that and make sure no one is Left Behind and everybody is vaccinated so it looks as if I intentionally picked PR to give us a last word here because I'm sure you're all wondering we've got a very diverse panel here from the ethnic Community represented in the United Kingdom it's intentional because this conversation about vaccination is one thing that affect us as a community so much and I think that's why we decided to have a conversation with healthc Care Professionals from within our community to come and share their experience and also to help us understand what this whole conversation about vaccination what is about so yes yes ladies and gentlemen thank you so much for joining us on this panel now I think many conversations like this start of from Midway where we start talking about how fast the vaccine is connected all that sort of stuff but I think let's go to the basics can any of you on this panel tell me what vaccination is all about maybe the the the the pharmacist and the clinical People Help Kickstart that but yeah anybody we can all share yeah I mean I'm happy to to start but I'm sure you know um my colleagues will have plenty to add um ultimately you know vaccinations are there to help prevent serious illness and disease and I know that this conversation is perhaps centered around the covid vaccination drive but you know vaccinations are not a new thing at all you know you go as far back as as you know things like the small poox vaccine to chicken pox um to polio and to the to to the Early Childhood vaccinations you know mizzles Mom rebella and that type of thing so ultimately vaccinations are there to help reduce the um incidents of serious illness they're not foolproof so vaccinations are not um absolute um but they're there to hopefully reduce the incidence of disease and and increase the health of of the population I think adding on to what AB says I think um I know this this conversation is focused on Co um but you know even in the current climate where there's current issues on migrants coming through the channel the issue of dfia um in this unvaccinated population vaccination or high rates of dfia vaccination in our UK population has been able to prevent serious illness or dfia actually coming across so it's definitely um a very key part in sort of protecting the health of the white public I I just want to ask the question probably for yourself pra because you're from the EDI you know sort of background but the question is that as Abby mentioned vaccination has been there for years and years and years uh but suddenly we're seeing that there's been disparity when it comes to uptake of vaccination and people will be asking why now what's the big deal why are we now focusing on this conversation because of covid now from your outfit obviously from an EDI point of view what's been your observation and what do you think is so important for us to take action now absolutely and I think Co has thrown a light I don't I I don't think the disparity have just started now or just begin now and I think we just probably didn't know um there was some disparity or how much the disparity was uh it's co is almost a blessing in dis sky that it has shown light on what is the disparity in terms of healthcare outcomes uh and and certainly there are certain ethnic Community groups have got far more um inequality or the Gap in terms of vaccination uptake and therefore um the impact of the health outcomes are quite large um I'm not exactly sure right now the exact percentage but over the course of two years of the covid vaccination program um we have seen about 10 to 20% of difference in terms of the uptake when compared to the white British to our ethnic Community background uh so that that's the major kind of disparity um and and as kind of colleague said it is important because um it has got quite a lot of bearing on long-term impacts and uh um and not just for oneself but for their family and friends as well so therefore it is quite important for us to have a look at um reducing the disparity right and I think um Dr Logan you're Public Health consultant so which means from my uh blame and understanding which means you're in the community you're seeing the impact of communities that are not taking vaccinations would you like to share your experience from that I think fundamentally what we saw overr across Co but even before Co is that um where lower rates were more evident in vaccination rates um outbreaks were much more common and that led to obviously increasing risk of illness hospitalizations um and that's widely preventable you know with a good of preventative action so it's a shame that it happened yeah I just want to add that um I think the it's quite obvious now because during the covid program we collected real-time data so we were able to tell straight away where our gaps were whereas in the past what we have done has gone done retrospective reviews and understood where the gaps were but the real- time data gave us the opportunity to really drill down into the different communities to really understand what was going on and I think that's why this conversation is so important because we know compared to our um white British colleagues the uptake in the black ethnic minority group the black African black Caribbeans is quite low right now I think let's sort of take a step back again and then look at the vaccine because I think that's probably where the concern is as to how do we make vaccines how do vaccines come about you know people are talking about U using animals or you know pics and things like which obviously goes against some other people's beliefs and religions and um cultures and things like that can you throw any light I mean any of you as to how these vaccines are developed or created yeah I mean I can I can start and I'm sure colleagues will add to to the conversation you know the development of vaccines is varied um some of the things you refer to there around using egg cultures using um animal um sort of pig to to to create vaccines in in the in the initial stages that was the case there are some vaccines that are made using air cultures for example like the flu vaccines um and so it is important to differentiate between different types of vaccines and how they are produced and if we bring the conversation back to covid I think one of the the the main uh flash point has been around the MRNA vaccines it's not something that people have heard of before um and then that leads us down a path of myth you know and and and what the vaccine can do but you know vaccines are made by scientists and and this process is rigorous there are several phase um trials that have to take place these vaccines have to be approved by you know the the the regulatory authorities in in in the nations in which they're produced so so I think it's what I'm trying to say is to add some confidence to the conversation around vaccine manufacturer it's a very stringent process um and I'm sure we'll come to sort of the myth in a bit as well that's right and I think the the points that you were talking about it's a rigorous process it goes through a lot of um trials and tests and all that has become one of the major points that members of our commune are holding on to to say how genuine is this current covid vaccine and things like because people are saying oh how could you develop vaccine within a year when we still have sickle cell that we haven't found a vaccine for we have other conditions that we're still struggling to find cure and stuff like that for what what sort of how would you share light I think the important thing to remember is that the Corona virus is not a new we have other Corona viruses um which have been uh have allowed scientists to develop the vaccines quicker than than than you would normally have the other thing if you think about uh Co and when the pandemic began is it became a a global priority um and so recruiting patients one of the challenges one of the delays in drug manufacturer or vaccine manufacturer is in getting people to join the trials so that takes a while but with covid people presented themselves much more readily than than in previous iterations of vaccine manufacturer so putting all of those things together and the fact that the MRNA technology that was used in developing some of the covid vaccines was already available um so if you add all of those things together you get the speed and there was a lot of Finance um poured into it as well because we had to do something you know we were going into a state of lockdown you know economies were were struggling and and there are all these other factors that that created this the speed and and and the rapidity with which vaccines were manufactured but none of that took away the quality right if you see what I mean yeah I like to always thr because you're the EDI person that would be looking at how to make sure that there is inclusivity in everything that we do now Abby just mentioned about how people presented themselves to be tested and I think one of the conversations within our community which we know and we laugh about is we know we never presented ourselves to be tested you understand so how do we then justify to this community that that is hesitant that we know you didn't present yourself but you're also covered you know and obviously with your work as an edap you need to make sure that there is inclusion how is that impacted on your abely and I think it it's sometimes you just need to listen and engage people not necessarily to promote the vaccination but first of all to listen what their quaries are or issues are um why they are not coming and sometimes it could be genuinely um the access problem you know people are really working long hours you know they don't um get to go to the vaccination Center or to the GPS during the days in which case you need to promote you know access or you might need to take the ACT you know take the vaccination to them having a pop-up clinic or something like that and sometimes really you know different languages would been um you know different communities speak different languages they they don't understand understand the message so it could be just purely a language barrier and sometime it's just the belief system depending on the community depending on the religion depending on the culture so it's really trying to understand and having that conversation and providing the information so that people can have a informed decision to take the vaccination or not it's not about blaming it's not about uh forcing your opinion on others it's more more important to talk through engage and listen to people what their issues are to start with right that that's what I would say to start with which then moves me to Prisa obviously because that's your patch making sure that uh the dissemination and availability vaccine and all that sort of stuff now with the concerns that PR was just raised and we all being aware of how the community perceive this whole vaccine how was your outfit how are you positioning yourself to be at the doorstep of these communities yeah so right at the beginning of the program the um approach was to vaccinate on mass so to get the vaccine out to as many people therefore we created large vaccination centers we got our generala GPS involved in vaccinating and to get as many people vaccinated as possible the next step of our approach is taking the vaccine out to individuals who haven't come forward so PR tached on the fact that we're doing popping we popup clinics we're doing walking um offering walking services so people can come in and have that done I think it's absolutely important that we've done the hard work in vaccinating The Mask we need individuals to come forward to have the the the rest of the population to come forward and so we are creating more access points and the access point is flexible enough to cover you know early morning clinics late evenings weekend appointment so people who have busy lives can try and find a clinic to fa also we're using the data to drive this um well we know we've got low uptake we are taking the vaccine to do low uptake and with that we are providing services to address hesitancy so there will be people around to talk to people about what are your concerns why don't you want to cover what can we do to support you to have your vaccine so on an operational level we are doing a lot of work and I think PR on it's not about forcing people to have the vaccine it's about addressing people's concerns and making sure that they understand the importance and I think that's why we're doing this we really want to engage our communities to come forward so Dr Logan maybe I would move to yours because you're in the community well as a public so you you were seeing this firsthand in your engagement with the community and what sort of messaging are you getting from them and how are you also helping to sort of of um change mindset or encourage them to sort of uh think otherwise and and take action yeah so I think the first thing to say is that it's not just a vaccination issue so even during the course of covid when you know when we started to implement Mass testing in sort of and we Medway was the first in southeast um in November we obviously set up Mass testing sites in a variety of um of areas in met with Military Support but we also then realize quite quickly that you know ending minority populations weren't coming forward to get tested from the initial data so we set up a commit Champions program but actually a lot of that was sort of um commited facilitators who were already involved in the community on a variety of other health issues so um and fundamentally there's this disconnect between for the most vulnerable populations we have between the UK health services and these populations so things simple things like infant feeding you know um or engagement on Primary Care you know it's a whole range of issues and so by using the sort of really you know trusted peer facilitators we then engage them to say well actually come forward to get tested you know we're not tracking you if that makes sense through testing um and then using that same meth message you know or method you know going to them about vaccination and say well what's your concerns and then sort of you know putting a lot of effort really in the last quarter mile in addressing that um through those sort of peer Champions right comedy Champions so I I I'm still sinking my head here that people and I can hear people still saying why should we trust this why should we trust this you know you know that's that's being the you know because yes we're focusing on covid we know that our community are not responsive to vaccination in general and suddenly seeing this big push for one issue which is co what we doing about the others the other sort of vaccination that people need to have generally as part of their General life cycle you know from childhood to you know old age what are we doing around all these vaccinations well I think there is you see when there is a a global priority it takes center stage and so some of the other conversations that are in fact happening uh sort of in the background so so we many of us work in in you know healthc care as you know and the drives or drivers for vaccination continue to happen so elderly people are encouraged to get their shingles vaccine these messages go directly from their clinicians to them it may not go via the media so it's not in the public Consciousness you know children or babies when they're born they looked after by midwives so their mom's well aware of when or or their dads of of when to present and and take their children for their vaccinations so those conversations continue to happen but in the background um because of the pandemic and the effects of that disease we had I don't know if you remember the daily briefings we used to have from down in street we we don't we never had that for any other the vaccine because we didn't quite get to that pandemic stage so I think that's the only difference it isn't more important than the other vaccinations um but those conversations are more um directed to the patients from their clinicians rather than on public forums like this one uh and if I can add so I think coming from my own experience as a clinical doctor so obviously I sort of was very involved in Wave 2 and you know we had the Kent variant uh and obviously we were in Kent um and we had difficulty in controlling the rates very initially you know compared to everybody else and we couldn't understand why and then we realized that and being an acute medical doctor sort of between a and intensive care and Medway I've never seen More Death you know in that one year than I ever did in sort of 10 years and to see every single patient coming through it doesn't matter whether you're white or black or Asian and you had covid there's nothing that would prevent that you you know all we could give was oxygen at that point and a bit of steroids and hope for the best and people who really in their 40s or 50s who really would never end up seeing in hospital were in hospital so I think way before that sort of vaccination came in the sort of second half of 2021 um you know there was this massive push for that reason we didn't want another wave like that where so many people were dying un necessarily okay so I think now let's turn our attention to the myths around this vaccination we've had people out there sharing information and for some strange reason they are voices seem to be louder than the voices of the professionals and I think because some Sometimes some of the things that they say does seem like it makes sense and I think that's why this evening we wanted to have professionals like yourself around the table for us to have conversations to see how we can clarify some of these issues I think uh one one of it which you've already answered was it's been developed so fast and you know that I think the other one that I've got noted here is well covid is over why should we bother now having the vaccination we want to touch on that and then I've got a toall list but we want to touch on this and that you know that people are saying Co is over because obviously the agency with which covid was treated or being dealt with when we were in the height of the P pandemic is no more we're not having the daily briefings like you're saying and all that sort so in the minds of people we're not wearing the face mask all the signs that reminded us of the pandemic is being taken away so people are saying it's over why should we bother so yeah it's it's interesting I think I ionically if you think about the reason why people are saying Co is over it's because a lot of people have been vaccinated right if those people didn't present for vaccination we wouldn't be in this current position where we're able to get some of our liberties back you know people would cast their minds back to when we couldn't you couldn't leave the house and you could only walk a few a few times a day um Co is certainly not over um you know we continue to see that there are cases um uh in in healthcare settings um there are many people who have long covid who continue to struggle with with the challenges of that disease many of who are young people um so because the daily briefings aren't happening and people you know we we we're we can move about without wearing masks and so on uh it's absolutely not an indication that it's over we're certainly in a better place but we we would regret if we don't keep up with our vaccinations um so I think it's it's important to to say that and also um it's just to reflect on the fact that because people are vaccinated when they do get covid the illness is mild and so the co is still circulating but we're not picking up the high mortality we had at the beginning of the um pandemic and so that there's the assumption that oh oh and people are not being tested as much as we tested at the beginning so we know that they're still circulating in the system but because AB just said because of the high vaccination rate we are benefiting from the low mortality we're seeing now and the low kind of illness rates you want to touch on no just adding I'm just confirming what you wanted well I want to then add the next one with another big one is fertility so a lot of younger um women are saying that I'm going to Second let's hold off on that we're not sure about fertility some are claiming they know people within their Network who have been affected so how how true or false is this statement about fertility I think one of the things we're trying to do here is to speak to people about vaccination so it's important to acknowledge their views the experiences that they may have had or or friends and family so I think it'll be glip to dismiss those but I think we can only speak from our experience and from the clinical understanding that we have and a lot of the negative outcomes um that we've seen in in the healthcare settings have been from women uh who haven't been vaccinated um there was a review in fact of uh um uh you know of new new NATO sort of wards and and settings like that looking at midwives and collecting the number of uh illnesses um and difficult births and it was skewed in the direction of those who hadn't been vaccinated um so I think that's an an indicator um of some of the reasons why the fertility uh conversation is almost a futile one there is no real clinical basis for that statement um and it's impossible to provide a 20-year um review because the the vaccination program is very recent but what we can certainly hanger hats on is the fact that vaccinations in general not A New Concept you know and we've seen successful vaccination drives in the past um so this shouldn't be shouldn't be any different [Music]