The HPRU held a public engagement workshop at Friends House on 18 March 2024 with members of the public and healthcare professionals. The days' activities included interactive sessions where we discussed our research projects and gathered suggestions on how we can better involve and engage with the public throughout our research in a meaningful way. Six healthcare professionals 11 members of the public , and some members of the HPRU participated in the workshop.

The workshop began with a presentation from Louise Letley (UKHSA) which outlined the current UK immunisation schedule. This was followed by two interactive, round table sessions where attendees shared their input on the topics of “What are your priorities for vaccine research?” and “How can we best involve you in our research”? We are keen to consider learnings from these sessions as we develop our research plans and develop new outputs.

Many thanks to our thoughtful contributors! 

What was this study about?

People under 65 in clinical risk groups are at risk of severe illness, hospitalisation and death from influenza, yet seasonal influenza vaccine coverage rates in this cohort are profoundly low. We explored the reasons for non-vaccination among 3 different clinical risk groups. We also interviewed healthcare providers and commissioners to understand the acceptability and feasibility of integrating vaccine programme delivery in non-primary care settings.

What did we find out?

The study found that people in clinical risk groups were often unsure about the relevance of influenza vaccines for their long-term conditions, or did not feel themselves to be at risk of severe illness from influenza. Healthcare providers rarely discussed or recommended influenza vaccines, despite being well placed to offer condition-specific information. Healthcare providers were positive about integrating vaccine programme delivery in non-primary care settings, but questions remain about feasibility due to resources and training.

View the research summary (pdf).

On Tuesday 5th December, we hosted a showcase at LSHTM and online for our NIHR-funded PhD students to share some of their research findings and methodologies with members of the public and the LSHTM community. It was an exciting event, hosted by HPRU Director Anthony Scott, with engaging presentations and thoughtful questions.

Presentations included:

• Understanding the association between maternal mental health and vaccine uptake and timeliness in early childhood – Anne Suffel, LSHTM
• Exploring childhood immunisation among Nigerian migrant families in South London: A critical look at 'vaccine hesitancy' – Oyinkansola Ojo-Aromokudu, LSHTM
• ​Advancing methods to account for biases in observational vaccine effectiveness research – Sophie Graham, LSHTM
• ​Socioeconomically disadvantaged parents' experiences of accessing childhood vaccination services in England from birth to age 1: emerging findings from a qualitative longitudinal cohort study – Georgia Chisnall, LSHTM

Watch one of our student's presentations below: 

• Should England introduce a universal chicken pox vaccine? Modelling and health economic results - Lauren Adams, University of Cambridge

We are very proud of our PhD students – for all of their achievements to date and to come!

Many thanks to those who attended.

Three years have passed since the first doses of COVID-19 vaccines were administered in the UK. Multiple booster campaigns have been conducted each year, with varying eligibility based on age and clinical vulnerability.

To help summarise overall progress of the vaccine roll-out, HPRU researchers have collaborated with the University of Oxford to develop a new vaccine coverage ‘snapshot’. This looks at how many doses of COVID-19 vaccine people in England have typically received, how long ago they were last vaccinated, and how these measures differ by age, ethnicity, socioeconomic status, and in different clinical risk groups.

The report highlights the considerable progress of the vaccine roll-out. For example, prior to the autumn 2023 booster campaign, people over the age of 75 had typically received six doses, and 88% had been vaccinated in the last year. However, the report also highlights significant differences in vaccine uptake according to ethnicity and socioeconomic status, as well as gaps in vaccine coverage in several vulnerable clinical subgroups. Continued efforts to address these immunisation gaps are needed as a new round of autumn boosting commences.

HPV is a common infection that is spread by skin-to-skin contact, including sexual contact, which can lead to the development of cancers affecting both women and men, including the cervix, vulva, vagina, penis, anus, and oral cavity.

In England, young people aged 12 to 13 years are offered immunisation against HPV as part of the NHS vaccination programme. Research has shown that in England cervical cancer has almost been eliminated among young women who were offered the HPV vaccine. The programme has also been shown to be good value for money for the NHS.

Our research has identified sustained inequalities in uptake by area and minority ethnic groups. Further, we identified unmet information needs among young people in schools where vaccination uptake is low, with implications for obtaining consent and vaccination uptake.

Addressing young people’s information needs

To address information needs among young people, we used co-production research methodologies and the 'person-based approach' to develop a lesson about the HPV vaccine with young people from disadvantaged backgrounds and diverse ethnic groups.

The resources for the EDUCATE lesson include films and exercises to assist learning, along with supporting the delivery of the HPV vaccination programme by providing young people with information and answering questions they may have. It prepares them to be vaccinated at school and helps them make the decision to be vaccinated or not. It is designed to be delivered before the school-based HPV vaccination session begins and can be delivered by different professionals, including teachers and immunisation nurses.

The research team partnered with the Personal, Social, Health and Economic (PSHE) Association and then resource has now been awarded their quality mark. It is available free to download from the PSHE website.

The videos that we co-produced with young people can be found on the HPRU in Behavioural Science and Evaluation website.

The work conducted in collaboration with the Health Protection Research Unit in Behavioural Science & Evaluation, was funded by the Medical Research Council’s (MRC) Public Health Intervention Development (PHIND)  Programme and the Economic and Social Research Council (ESRC) Impact Acceleration Account (IAA).

Improving communication with parents

We are also carrying out a project which aims to co-design an intervention to improve parental confidence, and increase adolescent’s access to, the HPV vaccination programme. As part of this, we have developed a series of films about the HPV vaccine. The content, style and format of the COMMUNICATE films are intended to address vaccine misinformation and were informed by the preferences of vaccine hesitant, ethnically diverse parents.

The videos that we co-designed with vaccine hesitant parents can be found on the HPRU in Behavioural Science and Evaluation website.

The study was conducted in collaboration with the Health Protection Research Unit in Behavioural Science & Evaluation, and funded by the National Institute for Health and Care Research (NIHR) Research for Patient Benefit (RfPB).

Next, we plan to co-design, refine, and implement a communication strategy to support use of the films locally. We will also engage with key players nationally to share learning and explore opportunities for the films to support delivery of the HPV vaccination programme on a wider scale.

Publications

1. Fisher H, Chantler T, Finn A, Hickman M, Letley L, Mounier-Jack S, Thomas C, & Worthington K, Yates, J, & Audrey S. Development of an educational package for the English universal human papillomavirus (HPV) vaccination programme: a co-production study with young people and key stakeholders. (2022) BMC Research Involve & Engagement.  8, 16  https://doi.org/10.1186/s40900-022-00349-7

2. Fisher H, Chantler T, Mounier-Jack S, & Audrey S. Human papillomavirus (HPV) vaccine communication tools for young people: A content analysis. Health Education Journal, April 2022. 10.1177/00178969221092135 2022.

3. Fisher H, Chantler T, Denford S, Finn A, Hickman M, Mounier-Jack S, Roderick M, Tucker L, Yates, J, Audrey S. Development of a multicomponent intervention to increase parental vaccine confidence and young people’s access to the universal HPV vaccination programme in England: protocol for a co-design study. BMJ Open. 2022

A plain English summary of our research article about communication interventions for countering vaccine misinformation was recently published on the NIHR's website.

Communicating the scientific consensus that vaccines are safe and effective, and using humour to dispel vaccine myths, may tackle misinformation effectively. Scare tactics, and failing to acknowledge uncertainty, could be unhelpful. These and other findings come from a review of 34 studies into communication strategies to tackle untruths about vaccines.

To read more, please visit the NIHR page on the subject.

Members of the HPRU team attended the UKHSA conference at the Royal Armouries Museum in Leeds on 18-19 October.

Presentations from the HPRU team included:

• Lauren Adams (Cambridge) – Estimating the potential number of cases prevented by infant/ toddler immunisation with a MenACWY vaccine
• Nick Andrews (UKHSA)– Rapid COVID-19 vaccine effectiveness assessment to inform policy
• Harri Fisher (Bristol, HPRU in Behavioural Science and Evaluation), presented by Tracey Chantler (LSHTM) – Involving young people and key stakeholders in the development of a lesson to be delivered in schools about the universal human papillomavirus (HPV) vaccination programme
• Freja Kirsebom – Vaccine effectiveness against mild and severe disease caused by COVID-19 variants in England
• Helen McDonald (LSHTM) – Supporting the national COVID-19 vaccination programme to prioritise people at highest risk of dying from COVID-19, through analysis of anonymised electronic health records
• Vanessa Saliba (UKHSA) – Detection of vaccine-derived polio virus type 2 in London sewage samples
• Julia Stowe (UKHSA) – Supporting the COVID-19 vaccine programme through robust epidemiological vaccine safety investigations
• Anne Suffel (LSHTM) – Disentangling patterns of vaccination timeliness in early childhood in the UK

HPRU research posters included:

• Sophie Graham – Assessing the robustness of COVID-19 vaccine effectiveness studies to bias
• Anne Suffel – Exploring the impact of mental health conditions on vaccine uptake in high-income countries
• Jemma Walker (presented by Nick Andrews) – Near real time safety surveillance of COVID-19 vaccines in the UK

Watch the keynote speakers and plenary sessions from the conference.

In August, HPRU in immunisation colleagues will be travelling to Denmark to take part in the ICPE 2022 conference. This year it will be a hybrid conference with people attending in person and remotely. Colleagues will be presenting posters and running sessions on a range of topics from safety surveillance of the Covid-19 vaccine to research into mental health and vaccine uptake. Full details of their events are in this agenda. If you are attending too, please do say hello!

Our MedRxiv preprint explores how #PublicHealth services can collaborate with community health groups to 'localise' #COVID19 #vaccination & co-deliver services. This approach offers benefits for minority groups with suboptimal #vaccination coverage.

Minority groups in the UK & elsewhere have been disproportionately affected by #COVID19 & are considered less likely to accept available #vaccines. We analyse an attempt to promote & increase #COVID19 vaccination coverage using local community health partners.

A ‘localised’ approach to delivering immunisations can include communication or implementation strategies, but both approaches involve consideration of investment, engagement and coordination, which are not cost-neutral.

Localising vaccination services in collaboration with welfare groups raises opportunities for the on-going Coronavirus Vaccine Programme and other immunisation programmes, and constitutes an opportunity for ethnic and religious minorities to collaborate in safeguarding community health.

Preprint available here: https://www.medrxiv.org/content/10.1101/2021.09.10.21263372v1

People with learning disabilities with COVID-19 are five times more likely to be admitted to hospital and eight times more likely to die compared with the general population of England, according to a new study in The BMJ.

Led by the London School of Hygiene & Tropical Medicine (LSHTM) and the University of Oxford, the research found risks were particularly high for those with severe to profound learning disability, Down’s syndrome and cerebral palsy.

The researchers say prompt access to COVID-19 testing and healthcare is warranted for this group, and prioritisation for COVID-19 vaccination and other targeted preventive measures should be considered.

Read more about this study, co-produced with HPRU researchers, on the LSHTM website here.

Read the article published in The Guardian on 15th July 2021 here.

Publication

Elizabeth J Williamson et al. Risks of COVID-19 hospital admission and death for people with learning disability: population based cohort study using the OpenSAFELY platform. The BMJ. DOI: 10.1136/bmj.n1592 

An easy read summary of this research is also available.

Produced by colleagues at the Vaccine Confidence Project, these media monitoring reports provide insights on key topics of conversation around coronavirus in the UK with a focus on five preventive behaviours (hand washing, social distancing, self-isolation, wearing masks, and using NHS 111).

Social media conversations and attitudes in the UK towards COVID-19

On Thursday 20th May 2021 from 12:00pm – 1:30pm BST, the NIHR Health Protection Research Unit in Vaccines and Immunisation is hosting a virtual open science event to share some of our timely research findings related to COVID-19 vaccination. The live event will feature presentations including:  

• Perspective on assessing the benefit and risk of COVID-19 vaccination - Katherine Donegan, Pharmacoepidemiology Research and Intelligence Unit Manager, MHRA

And HPRU researchers:

• Evaluating societal risk/benefit – how would the value of vaccination be impacted among groups with various levels of adverse events? - Frank Sandmann, Health Economist, Public Health England
• Role of risk and trust in COVID-19 vaccine decision making amongst UK health and social care workers - Sandra Mounier-Jack, Associate Professor of Health Policy, LSHTM
• Who could benefit most from COVID-19 vaccination? Using National Health Service (NHS) medical records to find out who is at highest risk of severe COVID-19 - Helen McDonald, Clinical Assistant Professor, LSHTM

The event will conclude with a panel discussion - chaired by Anthony Scott, Director of the HPRU in Immunisation - including experts:

• Philip Bryan, Pharmacovigilance Expert, P-95
• Alberto Giubilini, Senior Research Fellow, The Oxford Uehiro Centre for Practical Ethics
• David Salisbury, Associate Fellow, Global Health Programme, Royal Institute of International Affairs, Chatham House

Post event update 

This event was not recorded however below are links to two of the presentations: 

• Role of risk and trust in COVID-19 vaccine decision making amongst UK health and social care workers (HSCWs).pdf 
• Who could benefit most from COVID-19 vaccination? The study will be published soon. We are developing an Easy Read summary to share the findings in an accessible format. It will be shared on this website. Williamson EJ, McDonald HI, Bhaskaran K, et al. BMJ In press. 

The COVID-19 pandemic has fundamentally changed our lives over the last year. Certain groups are affected more than others, both in terms of risk of death and serious illness and as a consequence of living under lockdown and other restrictions. In this seminar, Professors Tom Shakespeare and Hannah Kuper will consider whether the 14 million disabled people in the UK are a particularly impacted group.  

Webinar: Tuesday 27 April 2021 13:00-14:00

Hannah Kuper’s presentation will include a study of the risk of COVID-19 related hospital admission and death among people with learning disability in collaboration with Elizabeth Williamson, HPRU-researcher Helen McDonald, and the OpenSAFELY collaboration. More details of the study are available here. (This is a pre-print which has not been peer-reviewed).

The webinar is free and open to all. No registration is required.

For more details or to join the webinar please see:

https://www.lshtm.ac.uk/newsevents/events/disabled-people-uk-and-impact-covid-19

Are you a frontline health or social care worker in the UK?

We would like to hear about your COVID-19 vaccine views and experiences in our 10-minute survey.

Please click this link for more details and to take part before 8 February 2021: https://lshtm.qualtrics.com/jfe/form/SV_0pst28dLEW7z6dv

As COVID-19 has hit minority ethnic groups hardest, we would particularly like to hear the view of health and social care workers from minority ethnic backgrounds.

Your participation will help us identify ways of improving how COVID-19 vaccines are communicated and delivered to health and social care workers.

This research is being conducted by the NIHR Health Protection Research Unit in Immunisation, a research partnership between the London School of Hygiene and Tropical Medicine (LSHTM) and Public Health England, in collaboration with the NHS Race and Health Observatory and the Royal College of Nursing.

Virtual Café Discussion: Experiences of vaccinating your child during the coronavirus (COVID-19) pandemic

The Health Protection Research Unit (HPRU) in Immunisation, a research partnership between the London School of Hygiene & Tropical Medicine and Public Health England, warmly invites parents and guardians to join our first virtual café event. Come along to our café to discuss the findings of our research, where we looked at the number of children vaccinated and views and experiences of getting children vaccinated during the coronavirus (COVID-19) pandemic.

The café is aimed at parents and guardians – particularly those with young children - who have an interest in childhood vaccinations.  Speakers will include representatives from the London School of Hygiene and Tropical Medicine and Public Health England. We hope that you can make the discussion, don’t forget to grab a cuppa and some treats before you join!

Date: Tuesday 6th October 2020

Time: 10.30-11.15am

Location: Online discussion via Zoom

Please click here to register your attendance. Registrants will be emailed the Zoom link for the café a day or two ahead of the event.

If you would like to know more or have any questions about the event please contact Sadie Bell: sadie.bell@lshtm.ac.uk

Six years of a national immunisation research partnership: highlights from the NIHR HPRU in Immunisation

The National Institute for Health Research (NIHR) Health Protection Research Unit in Immunisation, established in 2014, is a research partnership between the London School of Hygiene & Tropical Medicine and Public Health England. From modelling the role of vaccines in preventing antimicrobial resistance to understanding factors affecting vaccination access amongst underserved communities, the HPRU in Immunisation has conducted wide-ranging research to support the national immunisation programme policy and delivery. 

To celebrate our partnership over the last six years and share the outcomes of our work, we hosted an Open Science event for members of the public and researchers alike on Thursday 12 March 2020. 

The event started with research highlights from the last six years of the HPRU, covering:

• Theme 1: Electronic Health Record Research 
• Theme 2: Modelling, Economics, Evidence-synthesis
• Theme 3: Vaccine Delivery and Confidence
• Public and Patient Involvement and Engagement  

These highlights were followed by a timely lecture by Professor Mark Jit on "What are LSHTM scientists doing to help us understand and prepare for COVID-19?” with an opportunity for questions afterward.

Follow along to some of the evening's presentations through the LSHTM Vaccine Centre's Twitter account @LSHTM_Vaccines on Twitter here.