Winter vaccination programme for people experiencing homelessness 

Public Health Scotland selected organisations to take part in an explorative session on the 21st of July 2022. Derek Holliday, Involvement Lead with Homeless Network Scotland, provides an outline of the session.

Last week Public Health Scotland held an event with housing and homelessness organisations to consult on how to support Health Boards to plan for the autumn/winter Covid-19 and flu vaccination programme. At the heart of this work was the drive to encourage better uptake among specific groups, including people experiencing homelessness and rough sleeping, by learning from their previous experiences and barriers to uptake.

Session aims were to:

  • Support Health Boards plan for the Autumn/Winter Covid-19 and Flu inclusive vaccination programme.
  • Capture the experiences and opinions from front line organisations and services that work with people experiencing homelessness and rough sleeping.
  • Learn more from target groups, where vaccine uptake has been lower.
  • Support Health Boards to explore inequalities issues and discuss practical responses.

The group worked through a number of topics identified within Health Boards’ vaccinations strategies, relating to people experiencing homelessness and rough sleeping, including:

  • Working collaboratively
  • Outreach work
  • Mass vaccination centres/clinics
  • Communications

And focused on the following questions:

  • What worked well/not so well during lockdown to increase uptake of vaccinations?
  • Any new ways of working to consider as a result of this learning?

Suggestions shared for improving uptake:

  • Outreach and trusted relationships have been identified as the ‘best working’ model for encouraging vaccine uptake and flu jabs in communities with those experience homelessness or rough sleeping alongside complex unmet health needs.
  • Mass vaccination centres and reminder letters do not encourage vaccine uptake within the community, a person-centred approach through trusted relationships and place-based approach is the best working model.
  • Better coordinated communications were needed from Public Health Scotland to the 3rd sector/voluntary organisations, especially around vaccine resources in other languages and alternative formats.
  • – specific groups and communities’ resources
  • – vaccine resources in alternative languages.
  • The group agreed that there were inefficiencies with the Patient Transport Services which did not meet the desired hope during the lock down. The group agreed that there may be better outcomes from supporting community organisations to deliver this service.
  • A centralised hub for accessible information for organisations supporting those experiencing homelessness/rough sleeping, especially around access to interpreters.
  • Taking advantage of opportunities to have a positive intervention as they arise, being better placed to take advantage of ‘will’ and not allow system made barriers.
  • Buy-in and agreement from Health Boards and Public Health Scotland in relation to vaccine waste, a vaccination bottle of Pfizer can only be transported once and only opened if all 10 persons are booked in to use all the vaccine dosages per bottle. However, Astra Zeneca was able to be transported multiple times and this allow Public Health Scotland runners to ensure no vaccine dosage was lost and allowed health workers to respond to the ‘will’ and opportunistic vaccine request from those experiencing homelessness and rough sleeping.
  • Hunter Street had great success in accessing over 50 Homeless service sites, being able to access the Turas System made the difference, the ability to see who had been vaccinated and to be able to update the system created great efficiencies and collaborative working.
  • Through the same framework, Hunter Street have vaccinated of 250 individuals with flu doses, delivering double the flu vaccines than any previous campaigns.
  • More pharmaceutical collaboration with city street teams to support community vaccine outreach, this was highlighted as an incredible bold model that allowed health needs to be identified and supported especially around those experiencing rough sleeping who often do not access mainstream services.
  • Vaccinations administered through assertive outreach in hostel accommodation and supported accommodation was rated as a great success

Next steps

The write-up, conclusions and recommendations from the session are being firmed up by Public Health Scotland in collaboration with those at the session. Once finalised, Public Health Scotland will share the findings with the 8 Health Boards across Scotland.