A presentation delivered to practitioners and members of the public about a feasibility study led by Public Health England in Luton to drive up flu vaccinations by offering injections at local schools as an alternative to the nasal spray. Delivered between 2017-2020, this partnership included Public Health England, Essex Partnership University NHS Foundation Trust and the Bedfordshire, Luton & Milton Keynes (BLMK) Integrated Care System, the Discover Islam centre, Luton Mosques and InspireFM.

1. THE POWERPOINT PRESENTATION
MYSTIFYPowerPoint Presentation
NOVEMBER 2019
WEBINAR

2. Why
VACCINATE
ِ‫ه‬َّ‫ل‬‫ال‬ َ‫د‬‫َا‬‫ب‬ِ‫ع‬ ‫ْا‬‫و‬َ‫و‬‫َا‬‫د‬َ‫ت‬"
" َ‫م‬َ‫ر‬َ‫ه‬ْ‫ل‬‫ا‬ َّ‫ال‬ِ‫إ‬ ً‫ء‬‫َا‬‫ف‬ِ‫ش‬ ُ‫ه‬َ‫ع‬َ‫م‬ َ‫ع‬َ‫ض‬َ‫و‬ َّ‫ال‬ِ‫إ‬ ً‫ء‬‫َا‬‫د‬ ْ‫ع‬َ‫ض‬َ‫ي‬ ْ‫م‬َ‫ل‬ ُ‫ه‬َ‫ن‬‫َا‬‫ح‬ْ‫ب‬ُ‫س‬ َ‫ه‬َّ‫ل‬‫ال‬ َّ‫ن‬ِ‫إ‬َ‫ف‬
‘Seek treatment, O slaves of Allah!
For Allah does not create any disease but He also creates with it the cure, except for old age.’
Sunan Ibn Majah

3. www.floraladdress.com
Narrated 'Amir bin Sa`d bin Abi
Waqqas that he heard Usama bin
Zaid speaking to Sa`d, saying,
"Allah's Messenger (‫)ﷺ‬ mentioned
the plague and said,
'It is a means of punishment with
which some nations were punished
and some of it has remained, and it
appears now and then.
So whoever hears that there is an
outbreak of plague in some land,
he should not go to that land, and if
the plague breaks out in the land
where one is already present, one
should not run away from that land,
escaping from the plague.”
[Sahih al-Bukhari 6974]
‫وسلم‬ ‫عليه‬ ‫اهلل‬ ‫صلى‬ ِ‫ه‬َّ‫ل‬‫ال‬ ‫ُول‬‫س‬َ‫ر‬
‫َال‬‫ق‬َ‫ف‬ َ‫ع‬َ‫ج‬َ‫و‬ْ‫ل‬‫ا‬ َ‫ر‬َ‫ك‬َ‫ذ‬
ُ‫ض‬ْ‫ع‬َ‫ب‬ ِ‫ه‬ِ‫ب‬ َ‫ب‬ِّ‫ذ‬ُ‫ع‬ ‫ـ‬ ٌ‫ب‬‫َا‬‫ذ‬َ‫ع‬ ْ‫و‬َ‫أ‬ ‫ـ‬ ٌ‫ز‬ْ‫ج‬ِ‫ر‬‫‏‬"
ُ‫ب‬َ‫ه‬ْ‫ذ‬َ‫ي‬َ‫ف‬ ،ٌ‫ة‬َّ‫ي‬ِ‫ق‬َ‫ب‬ ُ‫ه‬ْ‫ن‬ِ‫م‬ َ‫ي‬ِ‫ق‬َ‫ب‬ َّ‫م‬ُ‫ث‬ ،َِ‫مم‬ُ‫أل‬‫ا‬
ِ‫ه‬ِ‫ب‬ َ‫ع‬ِ‫م‬َ‫س‬ ْ‫ن‬َ‫م‬َ‫ف‬ ،‫َى‬‫ر‬ْ‫خ‬ُ‫أل‬‫ا‬ ‫ِي‬‫ت‬ْ‫أ‬َ‫ي‬َ‫و‬ َ‫ة‬َّ‫ر‬َْ‫مل‬‫ا‬
َ‫ن‬‫َا‬‫ك‬ ْ‫ن‬َ‫م‬َ‫و‬ ،ِ‫ه‬ْ‫ي‬َ‫ل‬َ‫ع‬ َّ‫ن‬َ‫م‬َ‫د‬ْ‫ق‬َ‫ي‬ َ‫ال‬َ‫ف‬ ٍ‫ض‬ْ‫ر‬َ‫أ‬ِ‫ب‬
"‫‏‬ ُ‫ه‬ْ‫ن‬ِ‫م‬ ‫ًا‬‫ر‬‫َا‬‫ر‬ِ‫ف‬ ْ‫ج‬ُ‫ر‬ْ‫خ‬َ‫ي‬ َ‫ال‬َ‫ف‬ ‫َا‬‫ه‬ِ‫ب‬ َ‫ع‬َ‫ق‬َ‫و‬ ٍ‫ض‬ْ‫ر‬َ‫أ‬ِ‫ب‬

4. AMWAS
PLAGUE
638-639

5. Ŵ
ALEX SCHON
Ut et pulvinar odio. Nam condimentum
nisl at ante euismod else. Nulla facilisi.
CHRISTINA SCOTT
Ut et pulvinar odio. Nam condimentum
nisl at ante euismod else. Nulla facilisi.
⎝
ALASTER SMITH
Ut et pulvinar odio. Nam condimentum
nisl at ante euismod else. Nulla facilisi.
ALISIA HAMILTON
Ut et pulvinar odio. Nam condimentum
nisl at ante euismod else. Nulla facilisi.
℘
That time of year
Contagious respiratory illnesses caused by viruses

6. Flu kills!

8. In total, 2,182 people in the UK had to be admiWed to an intensive care unit (ICU)
or high-dependency unit (HDU) because of flu in 2019.
That is more than the 2,045 who needed such care in the same period last year,
when the virus was much more prevalent.
Flu has killed 195 in winter 2018, though that is down on the 241 deaths that
occurred in the same period in 2017-18.
A

9. FACT 1 in 5 of the popula`on get flu most
years, and this includes healthy people.
MYTH
buster
Healthy
people don’t
get flu.

10. Why do we need it every year?
DRIFT
small changes (or
muta`ons) in the
genes of influenza
viruses that can lead
to changes in the
surface proteins of
the virus
SHIFT
abrupt, major change
in an influenza A
virus
e.g. impact from
animal origin viruses
such as swine or bird
flu
Genetic changes in flu

11. MYTH
buster
The flu
vaccine
doesn’t work.
FACT The flu vaccine remains the best way to protect against flu,
generally protec`ng 6 in every 10 who receive them.

13. Eligibility of flu vaccine 2019/20
1. All those aged two to ten on 31 August 2019
2. People aged six months to under 65 years in clinical risk groups
3. All pregnant women (including those who become pregnant during flu
season)
4. People aged 65 years and over by 31 March 2020
5. People living in long-stay residen`al care homes or other long-stay care
facili`es
6. carers
7. Household contacts of immuno-compromised individuals
8. Frontline health and social care workers

16. Is it a cold or the flu?

17. Source: Centers for Disease
Control and Preven`on.
© Na`onal Jewish Health, 2019

18. I’ll be OK
…wont I?

20. The Royal College of GPs showed that more than 30,000 people visited a GP in a
single December week as a result of influenza-like illness, an increase of more than
9,000 compared with the first week of January.
Flu affected nearly 22,000 pa`ents in general prac`ce in the first week of 2018,
according to the latest figures from the Royal College of General Prac``oners'
Research and Surveillance Centre.
A

21. Hence the massive burden to an
already struggling care service
An overcrowded A&E department at peak of NHS winter crisis

23. The number of people eligible for an NHS flu vaccine has topped 25 million in
2019, as the offer of the vaccine is now extended to all primary school aged
children – an extra 600,000 children.
A

24. MYTH
buster
Flu vaccine
gives you flu.
FACT No, the flu vaccina`on only contains inac`ve par`cles of the
flu viruses so it can't cause flu. If you get flu immediately aker receiving
the flu vaccina`on it is likely to be because the vaccina`on has not yet
become fully effec`ve.

25. Do you need
any more
reasons to
get the flu
vaccine?

26. Porcine gelatine
The nasal spray flu vaccine contains a highly
processed form of gela`ne (porcine gela`ne)
to keep the vaccine viruses stable so the
vaccine provides the best protec`on against
flu.
Gela`ne is a substance derived from the
collagen of animals (found in tendons,
ligaments, bones and car`lage) and porcine
gela`ne comes from collagen in pigs which
some faith groups consider to be forbidden.

27. 27
SLIDE SECTION
www.floraladdress.com
THE
LUTON
STUDY

28. A collaboraGve study to understand and meet the needs of the Luton Muslim
community to influence flu vaccinaGon uptake
1. Improve flu vaccina`on uptake by between 5% and 10% compared to base year for years one to three
2. Improve flu vaccina`on uptake by between 5% and 10% for the same cohorts across the school group
as a whole.
3. Improve parental response rate.
4. Gain evidence regarding reasons for non-consent, to help understand the barriers to vaccina`on.
Members
School representa`on ( Headteachers, Family workers)
Parent Governor
Representa`ves from the Luton Council of Mosques
Essex Partnership University Trust Provider Immunisa`on Team
Objectives of the study
Working group
Led by PHE Screening and
Immunisa`on Team

29. 0
10
20
30
40
50
60
70
80
LUTON MILTON KEYNES BEDFORD CENTRAL BEDFORDSHIRE HERTFORDSHIRE MIDLANDS & EAST TEAM ENGLAND
Parecntage
Area
Year 1 % uptake 2015/16 Year 1 % uptake 2016/17 Year 2 % uptake 2015/16 Year 2 % uptake 2016/17 Year 3 % uptake 2016/17
Childhood Nasal Flu uptake in Luton

30. LOCAL AUTHORITY Year 1 %
uptake
2015/16
Year 1 %
uptake
2016/17
Year 2 %
uptake
2015/16
Year 2 %
uptake
2016/17
Year 3 %
uptake
2016/17
LUTON
28.4 32.7 28.3 28.3 26.8
MILTON KEYNES 58.8 55.3 56.2 53.5 51.4
BEDFORD 55.8 46.0 55.9 47.8 46.0
CENTRAL BEDFORDSHIRE 60.1 70.1 65.6 67.8 63.0
HERTFORDSHIRE 62.1 60.9 60.3 59.0 56.0
MIDLANDS & EAST TEAM
53.0 53.0 53.3 51.3 48.6
ENGLAND
54.4 57.0 52.9 55.0 52.7
Comparative uptake regionally

31. The Bury Park area

32. School No:
eligible
children
No: returned
consent forms
No:
refusals
No: consent forms
not returned
No:
children
vaccinated
%
uptake
one 360 91 22 269 (74%) 60 16.6%
two
300 91 22 209 (70%) 42 14.0%
Three
446 48 0 398 (89%) 48 10.8%
Four 270 86 30 184 (68.1%) 54 20.0%
Five
210 53 10 157 (74.7%) 38 18.1%
Maidenhall
270 63 7 207 (76.6%) 48 17.8%
Target school: Maidenhall primary

33. 91 91
48
86
53 63
22 22 0 30 10 7
269
209
398
184
157
207
60
42 48 54 38 48
0
50
100
150
200
250
300
350
400
450
1 2 3 4 5 Maidenhall
Number of children
Schools
returned consent forms returned consent forms consent forms not returned consent forms not returned
Consent form returns

34. Muslim population in Luton Wards
Ward Muslim populaGon % increase from
2001 census
Biscot 64.6% 58.7%
Dallow 61.6% 49.8%
Saints 55.1% 94.0%
Challney 34.4% 185.3%
Leagrave 19.0% 185.3%
Icknield 11.9% 207.8%
Crawley 9.2% 56.0%
Sundon 7.9% 75.2%
Bramingham 5.2% 96.3%
Wigmore 3.2% 58.6%
Stopsley 3.1% 40.6%
Luton 24.6% 85.4%
England 4.8% ---

35. 0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
1 2 3 4 5 Maidenhall
Refusal due to porcine gelaGne content Other refusal reason (not stated) GP vaccinaGng Personal reasons Unable to clarify
Research findings in year 1c

36. Pilot an alternaGve vaccine in one school in 2018/19
• Con`nua`on of the present project to sustain uptake
• Share this project with other NHS England Screening and Immunisa`on
Teams
• The importance of parent consulta`ons
• Working collabora`vely with schools and the whole staff group
• Expanding the use of the family workers in parent engagement sessions
Year 2: addressing the concerns

37. • 700+ pupils on role
• 638 Muslim pupils (91%)
• 92% of pupils have English as an Addi`onal Language
• 30% of families speak Pahari (primarily a spoken language)
• Top 10% area of depriva`on
• 360 children on safeguarding register (13 serious cases)
• 191 medical condi`ons
Context of Maidenhall school

38. VaccinaGon sessions
Schools encourage return forms
DVD
Parent engagement sessions
Family worker informaGon sessions
Pictorial Supplement
Improved consent Form
Delivery model
Parent engagement
• Exis`ng rela`onship/trust with the
parents and school staff.
• Endorsed by the Head Teacher and
key staff at school opportunity to
discuss best clinical op`on nasal flu
vs inac`vated op`on.
• Direct contact with parents and
carers, being able to answer
ques`ons straight away.
• Emphasised the importance of
protec`ng children against flu but
also others in the wider
community.

39. 05
04
03
02
01 Improved actudes to service delivery
Overcoming access barriers
Improved family learning
Appreciated choice opGons
Improved outcomes
Improved collaboraGon & family partnership
Insights from the
Muslim community

41. 25.3%
57.4%
Success!

42. Showcase: 2019 National
Immunisation conference
Full slide deck from NIN conference hWps://lutonmosques.org/non-porcine-flu-vaccine-par`cipa`on-in-luton-feasibility-study

43. THANK YOU