‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England

Objectives This study explored vaccination attitudes and behaviours among Polish and Romanian communities, and related access to primary healthcare services.Design A qualitative study using in-depth semistructured interviews with Polish and Romanian community members (CMs) and healthcare workers (HC...

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Main Authors: Mary Ramsay, Michael Edelstein, Sadie Bell, Mateusz Zatoński, Sandra Mounier-Jack
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e028228.full
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author Mary Ramsay
Michael Edelstein
Sadie Bell
Mateusz Zatoński
Sandra Mounier-Jack
author_facet Mary Ramsay
Michael Edelstein
Sadie Bell
Mateusz Zatoński
Sandra Mounier-Jack
author_sort Mary Ramsay
collection DOAJ
description Objectives This study explored vaccination attitudes and behaviours among Polish and Romanian communities, and related access to primary healthcare services.Design A qualitative study using in-depth semistructured interviews with Polish and Romanian community members (CMs) and healthcare workers (HCWs) involved in vaccination in areas with large Polish and Romanian communities. CMs discussed their vaccination attitudes and their experiences of accessing vaccinations in England. HCWs shared their experiences in vaccinating Polish and Romanian communities.Setting Recruitment focused on three geographical areas in England with large Polish and Romanian populations (in London, Lincolnshire and Berkshire).Participants 20 Polish and 10 Romanian CMs, and 20 HCWs. Most CMs were mothers or pregnant women and were recruited from London or Lincolnshire. HCWs included practice nurses, health visitors and school nurses recruited from the targeted geographical areas.Results Although most CMs reported vaccinating according to the UK schedule, obstacles to vaccination were highlighted. CMs experienced difficulties navigating and trusting the English primary healthcare system, and challenges in accessing credible vaccination information in Polish and Romanian. CM vaccination expectations, largely built on knowledge and experiences from Poland and Romania, were often unmet. This was driven by differences in vaccination scheduling and service provision in England, such as nurses delivering vaccines instead of doctors. CMs reported lower acceptance of the influenza vaccine, largely due to perceptions around the importance and efficacy of this vaccine. HCWs reported challenges translating and understanding vaccination histories, overcoming verbal communication barriers and ensuring vaccination schedule completeness among families travelling between England and Poland or Romania.Conclusions This study identified vaccination uptake and delivery issues and recommendations for improvement. HCWs should discuss health service expectations, highlight differences in vaccination scheduling and delivery between countries, and promote greater understanding of the English primary healthcare system in order to encourage vaccination in these communities.
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spelling doaj-art-34865ddcb796455d847bdb099742d4bf2025-08-20T02:27:46ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2018-028228‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in EnglandMary Ramsay0Michael Edelstein1Sadie Bell2Mateusz Zatoński3Sandra Mounier-Jack4Immunisation and Countermeasures Division, Public Health England, London, UK2 Department of Immunisation, Hepatitis and Blood Safety, Public Health England, London, UKDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK3 European Observatory of Health Inequalities, Kalisz, PolandNational Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Vaccinations and Immunisation, London School of Hygiene & Tropical Medicine, London, UKObjectives This study explored vaccination attitudes and behaviours among Polish and Romanian communities, and related access to primary healthcare services.Design A qualitative study using in-depth semistructured interviews with Polish and Romanian community members (CMs) and healthcare workers (HCWs) involved in vaccination in areas with large Polish and Romanian communities. CMs discussed their vaccination attitudes and their experiences of accessing vaccinations in England. HCWs shared their experiences in vaccinating Polish and Romanian communities.Setting Recruitment focused on three geographical areas in England with large Polish and Romanian populations (in London, Lincolnshire and Berkshire).Participants 20 Polish and 10 Romanian CMs, and 20 HCWs. Most CMs were mothers or pregnant women and were recruited from London or Lincolnshire. HCWs included practice nurses, health visitors and school nurses recruited from the targeted geographical areas.Results Although most CMs reported vaccinating according to the UK schedule, obstacles to vaccination were highlighted. CMs experienced difficulties navigating and trusting the English primary healthcare system, and challenges in accessing credible vaccination information in Polish and Romanian. CM vaccination expectations, largely built on knowledge and experiences from Poland and Romania, were often unmet. This was driven by differences in vaccination scheduling and service provision in England, such as nurses delivering vaccines instead of doctors. CMs reported lower acceptance of the influenza vaccine, largely due to perceptions around the importance and efficacy of this vaccine. HCWs reported challenges translating and understanding vaccination histories, overcoming verbal communication barriers and ensuring vaccination schedule completeness among families travelling between England and Poland or Romania.Conclusions This study identified vaccination uptake and delivery issues and recommendations for improvement. HCWs should discuss health service expectations, highlight differences in vaccination scheduling and delivery between countries, and promote greater understanding of the English primary healthcare system in order to encourage vaccination in these communities.https://bmjopen.bmj.com/content/9/7/e028228.full
spellingShingle Mary Ramsay
Michael Edelstein
Sadie Bell
Mateusz Zatoński
Sandra Mounier-Jack
‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
BMJ Open
title ‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
title_full ‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
title_fullStr ‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
title_full_unstemmed ‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
title_short ‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
title_sort i don t think anybody explained to me how it works qualitative study exploring vaccination and primary health service access and uptake amongst polish and romanian communities in england
url https://bmjopen.bmj.com/content/9/7/e028228.full
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