\n<\/p>\n
F<\/span>or people living and working in Enfield, the current measles outbreak is a shock \u2013 but not a surprise. The borough has struggled with low vaccine uptake for years, fighting against vaccine hesitancy, online misinformation and health inequalities.<\/p>\n Working closely with communities to persuade them to come forward for vaccinations is an \u201congoing public health challenge\u201d, which Enfield \u2013 like many boroughs \u2013 is grappling with, said Enfield council\u2019s director of public health, Dudu Sher-Arami.<\/p>\n \u201cThis has not come as a surprise to us. We\u2019ve been trying to work to increase vaccination uptake for many years. And so we do reach into various communities,\u201d she said, citing Edmonton, the focal point of the measles outbreak.<\/p>\n Similar to other areas with low vaccine uptake, Edmonton has high levels of deprivation. \u201cWe can all understand that if people are in a position where they have three jobs, low income, insecure housing, then vaccination is not going to be on the top of their to do list,\u201d said Sher-Arami, adding that the \u201cchurn of the population\u201d was another factor.<\/p>\n The most effective interventions were school-based immunisation programmes, though \u201chaving faith leaders and community leaders on board with accurate positive information also works\u201d, she said.<\/p>\n At present, Enfield was \u201cworking very hard\u201d scouring its database to find children who had missed one of their jabs and calling up their parents, said Sher-Arami. A special vaccination clinic has been set up in the school with the most cases, along with increased capacity across the borough, including additional slots at GP surgeries.<\/p>\n She added that it could be a challenge to persuade people to come. \u201cIn the UK, there\u2019s a huge amount of misinformation about vaccination. Over many years there\u2019s been a bit of a reduction in trust of scientific information, the NHS, certainly local authorities, our state bodies, with regard to vaccination.\u201d<\/p>\n Sher-Arami said the borough has tried many different approaches to get into hard-to-reach communities, and evaluates which are having an impact. \u201cIt\u2019s clear we can\u2019t just continue doing the same thing,\u201d she said, noting that she is hoping that an upcoming government-funded pilot project to look into opportunities for health visitors to provide vaccination will improve the situation.<\/p>\n Philippa Vincent, a GP at Carlton House Surgery, which was running the vaccine catchup clinic in Enfield on Monday, had seen figures showing that one in four measles cases in the borough had been hospitalised, and that the cases were all among children who have not been vaccinated.<\/p>\n Following the news reports at the weekend, the clinic has started to see an increase in demand for the vaccine, including among adults, though numbers remained low. The surgery is not permitting any child who is not vaccinated and has possible symptoms to be in the waiting room.<\/p>\n She has seen \u201ca lot of vaccine hesitancy\u201d in the community, exacerbated by Covid. \u201cI don\u2019t think it\u2019s about the autism stuff any more,\u201d she said. Instead, people are \u201cgenuinely afraid about the contents of vaccines\u201d, and \u201cbelieve the nonsense put out there by non-scientific pressure groups\u201d on social media.<\/p>\n Parents who spoke to the Guardian outside Carlton House Surgery said they had been contacted about measles by their children\u2019s nurseries and primary schools. One parent said he had asked the doctor if his preschool children could have their third jab expedited due to the outbreak. \u201cThey said \u2018no, don\u2019t worry about it\u2019, wait until they\u2019re three years.\u201d<\/p>\n Map of MMR vaccination coverage in England<\/p>\n Another parent, Pan, said: \u201cMy children are both vaccinated so I\u2019m not too concerned about my kids, we\u2019ve done the right thing. I\u2019m just thinking why the uptake is so low to be honest. Our group we mix with are all pro-vaccines.\u201d<\/p>\n Prof Azeem Majeed, the head of primary care and public health at Imperial College London, said the makeup of the local population was most likely to affect vaccine uptake, and that all the main factors were present in Enfield, including the prevalence of people from ethnic minorities who also had lower levels of education, deprivation, and how often residents moved between different addresses and countries.<\/p>\n <\/span>Carlton House Surgery in Enfield Town, north London. One in four measles cases in the borough had been hospitalised.<\/span> Photograph: Sophia Evans\/The Guardian<\/p>\n All these factors intersect with online misinformation and distrust of local authorities. He added: \u201cCertain communities have distrust of authority because of bad experiences with councils, in health, education, welfare or housing.\u201d<\/p>\n He noted that vaccine uptake has been steadily falling since 2012, which he linked to overstretched GP surgeries having less time to spend on preventive work, along with the rise of social media misinformation.<\/p>\n However, he noted that media coverage of outbreaks drives more people to come forward for vaccination. \u201cI wouldn\u2019t expect vast numbers of cases,\u201d he said, while noting that official numbers were \u201clikely underestimates\u201d.<\/p>\n Ronny Cheung, of the Royal College of Paediatrics and Child Health, said solutions included expanding who can deliver vaccines, such as the \u201creally promising\u201d health visitor pilots, as well as engaging local communities through targeted messaging and trusted voices \u2013 which at present is too \u201cpatchy\u201d despite its effectiveness.<\/p>\n He has found that many people have struggled to access appointments, and have not been given the information needed to prioritise them, something he felt health professionals needed more training to address.<\/p>\n \u201cMost conversations I have with parents who are labelled as vaccine hesitant actually are very positive and at the end of it, are happy to go get the vaccines. It\u2019s not the deep-seated scepticism people think of,\u201d he said.<\/p>\n","protected":false},"excerpt":{"rendered":" For people living and working in Enfield, the current measles outbreak is a shock \u2013 but not a surprise. The borough has struggled with low vaccine uptake for years, fighting against vaccine hesitancy, online misinformation and health inequalities. Working closely with communities to persuade them to come forward for vaccinations is an \u201congoing public health<\/p>\n","protected":false},"author":1,"featured_media":44664,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[914,23140,1661,2419,3192,16154,242,153,10913,2133],"class_list":{"0":"post-44663","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-council","9":"tag-hesitancy","10":"tag-london","11":"tag-lot","12":"tag-measles","13":"tag-mmr","14":"tag-north","15":"tag-outbreak","16":"tag-responding","17":"tag-vaccine"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/44663","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=44663"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/44663\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/44664"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=44663"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=44663"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=44663"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}