ON SUNDAY 25 July, Northern Ireland surpassed the milestone of 70% of the adult population having been fully vaccinated.

As most of those who wanted the vaccine have already come forward to receive it, there are now worries about the vaccination rate of younger age cohorts.

The head of Northern Ireland’s vaccination programme, Patricia Donnelly, told Stormont yesterday that vaccination uptake among the 18-29 age cohort has been “incredibly slow”.

She said it was a cause of “enormous concern” that the pace of the vaccination programme “went off a cliff” in June when it opened to this younger age group.

With the proportion of 18 to 29-year-olds in Northern Ireland who have received their first dose at just 59.4%, as of 29 July, questions about how to increase the vaccine uptake of this age group have arisen. 

 The next lowest uptake rate is 70% for the 30-39 year olds. All the age cohorts over the age of 60 have a 100% uptake rate.

Minister of Health for Northern Ireland, Robert Swann has also spoken about the need to increase vaccine uptake rates even further.

“If we can make a concerted effort to increase vaccine uptake in the next week or so, this can help make a decisive difference, in terms of preventing serious illness and hospitalisations,” said Swann. 

Health officials in Northern Ireland have stated that there will be an effort made to encourage those under 30 to sign up for the vaccine.

Some of the experts The Journal spoke to raised concerns about young people not getting vaccinated as they believed contracting Covid-19 would not affect them as badly as older age groups.

Vaccination selfies

Patricia Donnelly said behavioural experts had advised that the reluctance of young people to come forward was more about convenience than due to any safety concerns.

She said officials had undertaken a number of initiatives to encourage young people to come forward, including providing areas in vaccine centres where they could take selfies.

“We realised that if we didn’t allow the opportunities for selfies, it may not actually even be seen as an important event so we created those areas within the centres,” she said.

Donnelly said 31,000 more people would need to get vaccinated to get Northern Ireland to 85% of adults having first doses. She expressed hope this could be done by the end of August but said “hard yards” would been needed to achieve it.

She said while 90,000 people a week were getting vaccinated earlier in the roll out, the programme has slowed to the extent where it would be “lucky” if 1,000 to 2,000 people were getting jabbed each day. 

Dr Alan Stout, Northern Ireland GP Committee chair, also pointed to misinformation spread on social media, and work commitments, as further reasons contributing to the lower vaccine uptake in this age group. 

“It can be slightly more inconvenient for them. A lot of things have restarted again, they are at work and doing various other things so it becomes harder for them to prioritise,” he told The Journal.

Vaccination rates are slowing down across the North, with mass vaccination centres closing for first doses on 31 July. This follows the opening of mobile vaccination clinics in a wide array of towns. This move marks a concerted effort by the health service in Northern Ireland to increase local walk-in clinics that are more accessible to the general public. 

Targeted walk-in clinics have been successful in previous months in Northern Ireland as Stout highlights: “We know there are areas and communities that have a very low uptake and actually just sending a vaccine team out to those areas, there has been some quite significant success with that.”

Stout also noted the role of health inequality in explaining why some areas had a lower vaccination rate. “A lot of the historical determinants of health inequalities play a factor here so we do see a lower uptake in some of the more socially deprived areas.” 

Northern Ireland’s vaccination rate is the lowest in the UK with 83.22% of the population partially vaccinated as of 29 July. Only 59.4% of people aged 18 to 29 have received at least one dose of the vaccine, this is slightly lower than England where 68.3% of 18 to 29-year-olds have received at least one dose. However, it is much lower than both Scotland and Wales at 72.0% and 74.6% respectively.  

Encouraging vaccine uptake

Prof Helen Dolk, Professor of Epidemiology and Health Services Research at Ulster University, told The Journal that discussions with young people were needed as part of the vaccination roll out. “Young people need to be fully consulted in deciding how to go forward.”

“Increased freedoms for vaccinated people, especially for travel, is likely to influence uptake, but coercion can be counterproductive in some circumstances,” she added.  

Dr Andrew Kunzmann from Queen’s University Belfast noted that some young people “just feel too busy at work”, highlighting the importance of supporting time off for workers to get vaccinated.

There are also worries surrounding the messaging that young people are low risk. Kunzmann notes his concerns that such messaging “is counterproductive for achieving a high uptake in younger adults, as they may perceive less benefit in getting vaccinated,” he told The Journal.

The Belfast Health Trust has put in place walk-in clinics on Queen’s University Campus with the aim of improving accessibility of vaccines to students in the area. 

Alison Donnelly, a senior nurse who is part of the Belfast Trust Vaccination Team told The Journal that vaccination rates for young people in Northern Ireland “are lagging behind”. 

The vaccination team at Belfast Trust have been opening up mobile vaccination clinics in targeted areas alongside handing out flyers and increasing media and communications to encourage vaccination uptake among the younger cohort. 

“We are trying everything we can and to get the message out there. We have pop up clinics to make the vaccines accessible to them, that’s certainly helped over the past two weeks,” Donnelly added.

She went on to note how the accessibility of the pop-up vaccination clinic at Queen’s was a key component in encouraging students to come and get vaccinated. 

The Belfast Trust also has plans to introduce more pop up vaccination clinics at local leisure centres throughout the city as well as upcoming concerts, in a bid to push for a higher vaccine uptake among young people.

A different scenario across the border

In the Republic, the picture for vaccination rates among cohort looks set to be different.

Darragh O’Reilly, Secretary General of The Irish Pharmacies Union told The Journal that there was an “immediate clamour for vaccination among young people” as soon as Health Minister Stephen Donnelly announced the distribution of Johnson & Johnson vaccines to 18 to 34-year-olds in pharmacies across the country.

“We are seeing really strong demand and I would say enthusiasm for vaccination among young adults,” O’Reilly added.

Almost a month on from Donnelly’s announcement of the Johnson & Johnson vaccine roll out, O’Reilly notes that “there is still a strong demand and the only limiting factor that we have seen so far is the availability of vaccines”.

On Monday 26 July, Taoiseach Micheál Martin urged young people to register for their vaccine as the daily Covid-19 cases remain at over 1,000.

“I would appeal to the age cohorts who can register on the portal – please take up the opportunity of getting vaccinated.” 

The Government hopes the majority of young adults will be fully vaccinated before the start of the new academic year.

Walk-in vaccination centres will be open over the bank holiday weekend. The accessibility of vaccination centres is thought to be a factor in the success of vaccine roll outs.

Kunzmann emphasises the importance of having a variety of means through which the public can access vaccination. “Having a mix of large vaccination centres, local walk-in clinics, pharmacies and GPs can all boost uptake.”

Contains reporting from PA