As thousands of people across Manchester receive their second Covid-19 jabs, the Manchester Evening News spoke to health leaders about the vaccine roll-out in the city.
Jennifer Williams had a discussion with Dr Manisha Kumar, Medical Director of Manchester Health and Care Commissioning, and David Regan, Director of Public Health for Manchester.
They spoke of how they are combatting vaccine 'hesitancy', possible side effects including rare blood clots, Ramadan, unregistered patients, as well as infection rates, which tests people should be taking - and the impact of the 'road map' to opening up.
Here is what was said during the interview on Tuesday.
Q: How is the effort to address vaccine hesitancy going and which communities in particular seem to be nervous? How are you making sure everyone gets equal access to the vaccine?
David : I think we recognise, given the diversity of the city, that we have to have a targeted approach to all our communities.
We’ve had a really good success story with our Bangladeshi community which shows that we can do it in terms of really increasing the uptake among certain groups. We need to do that with all communities in the city and we’ve got some plans in place to make sure we can repeat the success in the Bangladeshi community.
Manisha : I think there’s been so much information on the media about vaccination that people are understandably confused and unsure where to go for information.
The individual conversation is really important, so what we are doing is making sure we’ve got a data driven approach so we really understand some of the numbers. But also that personal approach is important because it’s individual risk and how people feel about the vaccination based on their own experience, of covid but also of precious vaccinations.
We are making sure everyone has that personal conversation where we can understand what their worries are, work through those worries with them, if they want to wait understand why, and personally revisit each and every conversation across the city.
That takes time because there are over half a million people, so what we are doing is working with all our teams across the city - with the city council, with local care organisations, healthcare coordinators, spiritual leaders, faith leaders, political leaders, representatives from different groups where we know we’ve had more conversations about vaccine hesitancy.
Together we are trying to create that unified, single version of the truth message.
Some of the issues are practical and some are more complex than that. There’s still a way to go but we are seeing greater uptake, particularly in those communities we want to work with.
We could see more pop-up vaccination centres down the line.
Q: There have been rumours and concerns round the side effects of the jab - around fertility, cancer, and since then there’s obviously been have been a lot of headlines around blood clots as well. What reassurance can you give to people worried about that?
David : In terms of providing updated information to all our GPs and frontline staff, whenever we get guidance from the Joint Committee on Vaccination and Immunisation we make sure that’s circulated widely.
We do know issues around the Oxford-AstraZeneca vaccine may have affected confidence in the city. But we know for the under-30s and people at risk we can offer alternatives.
But we are also seeing evidence saying that in the over-30s the Oxford-AstraZeneca vaccine is safe and we want people to get their second dose as planned.
We have seen it with our flu vaccine every year. There are concerns raised, it’s making sure we communicate with the public and are really transparent. It’s making sure people have that one-to-one conversation with their GP, if people have concerns.
Manisha : Like with any new medicine or vaccine we are really asking for reporting of all possible side effects. The number of blood clots that have happened in relation to vaccination or for people who have recently had a vaccination is four or five per million.
There have beenn 79 blood clots in over 20m AstraZeneca vaccinations given. For the majority of the population the risks of Covid are much higher than the risk of having a blood clot.
If you are worried or have a history of blood clotting, or have been told you have low platelets then you will be signposted to a different vaccination. If you are worried then you can speak to a GP, or when they go through the checklist with you to make sure you are not at increased risk of clots. The majority of people, unless you have a higher risk of clots, the AstraZeneca vaccination is absolutely fine and what we want to do is prevent Covid.
Q: We are in Ramadan, does getting a jab or test affect that at all?
David : The British Islamic Council have been very clear. Please continue to present for vaccination appointments. We’ve seen a great turn out even in the last week at some of our pop-up clinics. The message is getting across, all guidance from faith leaders is 'please continue to present for vaccination during Ramadan'.
Manisha : We have worked to soundboard evening appointments in very short window before people are fasting again. But people have said they are happy to come for vaccination because it doesn't break our fast and that message needs to go out across the whole city. If you are delaying the second dose then let us know and we will try and get it to you as soon as possible. We’ve had really good support from our faith leaders on this one.
Q Can you just explain to people the different types of testing available and when they should go and have them and what they are for?
David : The PCR Test is if you’ve got symptoms of Covid. We’ve got a number of PCR testing sites, at the Etihad, the airport, at Belle Vue, on Denmark Road near the city centre. If you’ve got symptoms that’s still the recommendation.
We have a number of Lateral Flow Device (LFD) sites for asymptomatic people, for people who are going back out to work. We’ve got those at FC United, the Rates hall, the town hall and in Moss Side Leisure Centre, to give a few examples. That’s to encourage that twice-a-week testing.
As people will be aware, following the Prime Minister’s announcement on April 5, we’ve seen a universal offer of LFD tests for the whole population that involves collecting tests at 59 pharmacies, 10 of our libraries or LFD direct, where people are going online for kits to be delivered to their home. It seems to be working well in terms of that particular process.
We have also seen the LFD programme in our schools over the last month. Given that a third of people may carry the virus without symptoms, we really need this.
While we have relatively low numbers at the moment we need to find out who they are but if people have symptoms then they will lose our PCR testing site.
Where it can get a bit confusing is that we have used PCR testing for our surge testing in Moss Side, Hulme and Moston. That’s because it’s only with PCR tests that we can do genomic sequencing where we can identify the variants. But in normal day to day business, it’s PCR tests if you have symptoms, LFD tests if you don’t.
Q: If somebody is worried about their immigration status and they are worried that means they can’t or shouldn’t go and get the vaccine, is there any reassurance around that?
David : From a purely public health point of view we really really want to make sure anyone concerned comes and gets their vaccine. Public health is a priority and we have to protect the wider health of our communities so we really want people to come forward.
Manisha : Primary care has always been opened to anyone regardless of imigration status, I know sometimes that message hasn’t always got through to some of our communities but it’s really important to reiterate that because there are so many health needs people have beyond Covid that I'd like to make sure they are accessing medical help.
In terms of covid vaccination, it is absolutely available for everyone, the issue for people not registered is we can’t contact them in the same way. We can't call them, or test them.
This is where Pop-Ups are really useful. I was working at a Pop-Up at Asda last week and quite a few people who were unregistered came up. We said we can absolutely get you vaccinated, take a phone number and contact you back for your second.
It’s just really really important that people don’t think vaccinations are closed off for any reason. If you struggling get in touch, Pop-Ups are great for that, because we know where they are, they are in the community and people can just walk in.
Q: Clearly the virus is still in circulation. What trends are you seeing in the city with infection rates?
David : So the good news is we are back under 50 per 100,000. Back in September, if you went over a threshold of 50 per 100,000 you were in what we called the red zone. Very quickly towards winter we saw the numbers increase. Many of will remember the student peak back in October for Manchester.
Currently the rate is 45.9 per 100,00. We’d still like it to be lower, but the more important rate for us is the over-60s rate, which is down to 22.5, which is definitely the lowest it’s been for a long long time.
We actually haven't got all the evidence yet but we definitely think the vaccine programme has provided that protective effect in terms of hospital admissions and the transmission rates in the over 60s.
We’ve also seen the number of beds occupied by Covid patients come down significantly in the last few weeks. We did see a minor increase in transmission rates in our primary and secondary school children from March 8 but even before half term they started to come down again.
We will monitor those now children are back at school this week. We are also seeing non- essential retailers and outdoor hospitality so we will be tracking the rates in those cohorts aged 18 through to 60 years olds just to see if there are any patterns emerging.
The Road map says on May 10, the week before the next step, all data will be assessed. So we will be tracking our local data from a public health point of view. Just being able to protect the over-60s and seeing those rates come down to a much lower level is what we've been looking for.
Also while rates are low it gives the opportunity, if we do identify cases, to use our local test and trace service which can provide that bespoke advice. If people follow that advice, we’ll keep those transmission rates as low as they can be.
I’ll be really honest, we are, in most of of the North West, particularly Greater Manchester and Lancashire, an area of enduring transmission and certainly we want to see rates come down in some of our communities where they have been consistently high but actually at the moment it’s a much more optimistic picture but we are monitoring it very closely.
Q: Has any impact from reopening happened so far?
David: Not anything discernable at this stage. The advice is two weeks - so at the end of this Friday, if we have any impact we will start to see it. We saw that with the schools, but it'll be this Friday and early next week that we’ll know what impact the latest step two has had on our rates.
Manisha : Just to remind people to come up for a second vaccination. Things are opening up at a time when the most vulnerable are due their second jabs. So the first lot of people who were vaccinated at the end of December and early January. We’ve had quite a few people who haven’t turned up for their second vaccination and we are phoning them up.
It’s really important for people to remember they are most protected two weeks after their second vaccination so if we are going to keep rates low, please do come forward and have your second jab as well, that will really help.
