Since 2016, the European Region has experienced large-scale measles outbreaks. Several measles outbreaks in England during 2017/18 specifically affected Romanian and Roma Romanian communities. In this qualitative interview study, we looked at the effectiveness of outbreak responses and efforts to promote vaccination uptake amongst these underserved communities in 3 English cities: Birmingham, Leeds and Liverpool. Semi-structured in-depth interviews were conducted with 33 providers involved in vaccination delivery and outbreak management in these cities. Interviews were analysed thematically and factors that influenced the effectiveness of responses were categorised into five themes: 1) the ability to identify the communities, 2) provider knowledge and understanding of the communities, 3) the co-ordination of response efforts and partnership working, 4) links to communities and approaches to community engagement, and 5) resource constraints. We found that effective partnership working and community engagement were key to the prevention and management of vaccine-preventable disease outbreaks in the communities. Effective engagement was found to be compromised by cuts to public health spending and services for underserved communities. To increase uptake in under- vaccinated communities, local knowledge and engagement are vital to build trust and relationships. Local partners must work proactively to identify, understand and build connections with communities.
Bibliographical noteFunding Information: The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England (PHE). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England.
Open Access: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Copyright © NIHR Health Protection Research Unit in Immunisation at LSHTM, 2020. Published by Cambridge University Press.
Citation: Bell S, Saliba V, Evans G, Flanagan S, Ghebrehewet S, McAuslane H, Sibal B, Mounier Jack S (2020). Responding to measles outbreaks in underserved Roma and Romanian populations in England: the critical role of community understanding and engagement. Epidemiology and Infection 148, e138, 1 8.