Inside London’s vaccine blackspots – the next health crisis waiting to happen

“It makes more sense in my head when someone’s completely antivax, especially post Covid. I think that’s where a lot of this antivax stuff has come from. I hadn’t realised that there’s still a lot of anti-MMR specific feelings in the community.”There has yet to be a feared explosion in measles, but the impact of London’s patchy MMR coverage is being felt: 128 cases of the disease were detected in England in the first half of 2023, compared with 54 last year, with 66 percent of those detected in the capital, according to UKHSA.Although antivax sentiments are likely to be playing a large role in driving down uptake of the vaccine, it’s not the full story. Cultural barriers, linked to London’s ethnically diverse populations, and major problems with GP access are also having an influence, experts say.These nuances are on display across Enfield, Camden and Hackney, the three worst-protected boroughs in London against MMR, where coverage rates stand at 64.8, 63.6 and 56.3 per cent, respectively.Dr Sandra Husbands, the director of public health for City and Hackney council, said the borough’s low coverage rate was “understandable and unsurprising” given it is home to many ethnic minority groups whose first language isn’t English.Roughly 40 per cent of the diverse population in the borough are black and minority ethnic groups – with the largest group, approximately 20 percent, being black or black British. “As a council, we have been working with our diverse communities to understand barriers to vaccinations and how we can best address them,” said Dr Husbands.Lack of trustThe African Development and Advocacy Centre (AFRIDAC) and the Community African Network (CAN) are both dedicated to tackling this issue, helping run vaccination clinics across the borough.Oladapo Awosokanre, executive director of AFRIDAC, said that a lack of trust of medical systems among Hackney’s ethnic minorities was helping fuel vaccine hesitancy.“They have a lack of trust in the content of the vaccination and how it can adversely affect people, especially young people and babies,” he said “They worry whether it will have a dangerous effect on them, or concerns that there is some sort of an agenda to have a negative effect on them, especially ethnic minority children.”He added: “Some believe that these vaccinations aren’t necessary or useful if children are born in third world countries and not in the UK, they feel if they aren’t born here, that they won’t have issues around measles, mumps or rubella.”Janet Murungi, chair of CAN and a volunteer at her local GP surgery, said that for many families where English is not their first language, they don’t have a clear understanding of why it’s important for children to be vaccinated.“We need information in language and a culturally appropriate format to improve access to health services, especially for the hard-to-reach communities,” she said.Problems with language barriers hindering access to healthcare is an issue that reverberates across the borough.Pierre Palluet, Manager of the Vietnam, Laos & Cambodia centre in Hackney, said a lack of public health messaging around vaccinations was paving the way for the spread of disinformation among the borough’s southeast Asian communities.“This can include false claims about the ingredients of the vaccines, their development process, or their long-term effects. Communication barriers also contribute to limited access to accurate and up-to-date information about the vaccines,” said Mr Palluet. To address this, Hackney council has been partnering with local volunteer services to strengthen vaccine messaging and encourage take up of the MMR jab.Earlier this year, multiple pop-up vaccine clinics were erected in the north east of Hackney to target the borough’s Charedi Orthodox Jews.Within this community, use of the internet and access to the news is limited due to both digital poverty and cultural precedent, with only a very small number of families allowing computers in their homes.“Many people will not be online and mainstream media just fails to reach them,” said Sarah Weiss, chair of the Interlink Foundation for the Orthodox Jewish.

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