The NHS has been warned it is putting lives at risk after the service admitted it was not collecting data on who was not accepting invitations to be vaccinated and why.
Early research has shown vaccine take-up was twice as high among white people compared with black people in the first five weeks of the rollout, with lower rates among people with severe mental illness, dementia and learning disabilities.
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Jeanelle de Gruchy, the president of the Association of Directors of Public Health, which brings together all local authority public health leads, said the NHS had a duty to collect data on those who are not taking up the offer.
Local authorities can then target these people, she said, for example by addressing people in their own languages and offering help if getting to a vaccine site is a problem. The vaccine programme must put addressing health inequalities “at its heart”, she said.
Prof Dominic Harrison, the director of public health (DPH) at Blackburn-with-Darwen council, said the failure to follow up those who have not responded to their vaccine invitation “could be a matter of life or death” for older people.
He implored NHS England to collect the data and share it with DPHs, who he said could set up teams of “vaccine tracers” to ensure everyone who wanted the vaccine received it.
A spokeswoman for NHS England confirmed to the Guardian that the organisation was not gathering data on those not taking up vaccine invitations. She said Harrison “can request that from and get that from his local GP groups who are leading the vaccination programme in his borough”.
Some GP clinics were actively following up with patients who did not respond, but they were not feeding the information into the national system. Others simply moved on to the next group in their list if they received no response.
De Gruchy said: “Directors of public health have the knowledge and insights to be able to ensure the reasons [for no-shows], from inaccessible locations and language barriers to misinformation, are tackled through local plans and communication. However, this depends on receiving timely and high-quality data.”
Harrison said: “It is surely inconceivable that the NHS could have planned and rolled out such an important vaccination programme without a system to identify those missed and a process to ‘vaccinate trace’ those lost to the system. It is critical that this list of those who miss their slot, for whatever reason, are chased up.”
Harrison said he was particularly concerned about elderly people with depression who may miss their invitation because they do not open their post, which is common in those with depressive symptoms.
He proposed that councils establish a team of vaccine tracers to knock on the doors of those in the most vulnerable categories who have not responded to their invitation. Many councils had a similar system to track down those who had not engaged with NHS test and trace.
Prof Martin Marshall, the chair of the Royal College of GPs, said: “At a primary care network level, GPs and our teams will have a good understanding of vaccine take-up and will be able to identify patients who haven’t come forward for their vaccine when invited.
“This will allow practices to put initiatives in place to follow up with these patients, for example with a phone call, to discuss any concerns the patient may have and ultimately ensure as many patients as possible are coming forward.
“High take up of the Covid-19 vaccine is essential to protect patients and start getting life back to normal. To achieve this, it is important that we can identify groups of patients in which uptake is low and the reasons for this, so that patient concerns can be addressed, and hopefully they can be encouraged to get vaccinated.”
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