Intended for healthcare professionals


Encouraging covid vaccine uptake and safe behaviours—an uphill struggle against government complacency

BMJ 2021; 375 doi: (Published 12 November 2021) Cite this as: BMJ 2021;375:n2773
  1. Linda Patterson, retired consultant physician
  1. UK
  1. @lindajpatt

Community efforts in the UK to improve covid vaccination rates and engage the public in safety measures are being undermined by the government, writes Linda Patterson

Like many doctors who had stepped back from clinical practice, I volunteered to return to the NHS to help deal with the covid-19 pandemic. After much bureaucracy, my contribution has been as a volunteer, working with two other doctors to give training and information as part of the covid-19 Community Champions programme. This initiative arms local volunteers or “champions” with facts about covid-19 and vaccines, so that they can encourage vaccine uptake and safe behaviours in their community. Yet it is increasingly frustrating to see how our efforts to do either are undermined by government messaging.

We know that the virus is still with us. Despite the magical thinking of the government that it is all over, infection rates, mortality data, and the strain on the NHS tell their own story. Although the vaccination roll-out has been very successful, we still need more people to come forward for vaccination and boosters. Indeed, the government’s entire plan for managing covid now rests on vaccination. Only this week, the prime minister Boris Johnson resisted calls for any further mitigation measures, saying that the “key thing” was for people to have their booster vaccines.1 There is a snag in this approach though. When so much of the government's messaging and policies over the past three months has minimised the risks of covid-19, how can we still expect the public to grasp the importance of getting a vaccine against it, or to adopt behaviours to reduce transmission?

The Community Champions programme, which is run through the local council and the local public health department, has done a good job of trying to “seed” accurate information among the general public, and to give the volunteers who help at vaccination and testing centres more information in case they are asked questions. Through the mainly online training for volunteers, we explain what the virus is, how it is transmitted, and why safety measures such as washing hands, limiting contacts, mask wearing, and good ventilation will help to mitigate the spread. If people understand the underlying reasons for these measures, they are more likely to alter their behaviour and to pass that information on to other people too—“spreading the word” among their friends, families, and work colleagues.

We also explain how the vaccines were developed (a frequent question raised is “isn’t it all too quick?”), how they work, the possible very rare side effects, and the latest information on prevention of transmission and waning immunity. Pregnant women and women of childbearing age who are worried about fertility are often particularly concerned, and we have run sessions for religious groups and tried to reach more deprived communities.

We worked with the local teams for health and safety and environmental health to design some information sessions for local businesses. Local social care providers in the private sector and not for profit agencies and local council workers have had workplace sessions delivered. We have given some clinical support to drop-in vaccination centres, including some at a local nightclub, the Acapulco, to try and attract more young people to have the vaccine (“Vacca at the Acca”).

Given that there are now very few legal restrictions in place, the message we’ve had to focus on is assessing risk—both for organisations in the workplace and for individuals at a personal level. We no longer talk about “restrictions,” but call these actions “safety measures”—a reminder that these steps aren’t there to restrict people’s freedom, but to keep people safe.

Despite these multi-pronged efforts in the local community, and even though the volunteers are very committed and want to help, it is getting increasingly difficult to engage with the wider public who want to think “it’s all over.” The response we get is, “if the government thinks it’s over, then that must be right.” You don’t have to look far to guess how people have arrived at this conclusion, when government ministers refuse to wear masks in the House of Commons2 and when our own prime minister toured a hospital this week without one.3

As volunteers at the Community Champions programme, we carry on, knowing that the virus is still with us, but it does feel like a drop in the ocean—a contribution, but not enough. What we need is considered and consistent action from central government: their continued laissez faire attitude, lack of messaging about safety measures, and sole reliance on the vaccination and booster programme will see more deaths and illness. A government’s first responsibility is to protect its population, but this one seems to have abandoned that duty for a strategy that is both inadequate and foolhardy.

We have a hard winter ahead.


  • Competing interests: none declared.


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