Table 1.

Mitigation measures aligned to the evaluation framework

Risk groupActions and mitigating measures
DisabilityAdditional use of mobility devices. Volunteers to direct and support service users.
Mental healthStaff and volunteers: identify anxious individuals and offer them fast tracking. Early morning appointments. Promoted vaccinations for mental health needs service users, through links with Patient Advice and Liaison Service (PALS), volunteers, staff and word of mouth. Individual private area.
AccessibilityResources available in Braille, extra-large font, prompt cards, pictorial, easy to read and in approximately 25 languages. Easy-access folder system with resources.
Visual impairmentVolunteers available at all points in the vaccination centre service flow. Carers and guide dogs enabled to accompany service users. Alterations to improve furniture visibility. Clinical assessment and vaccination by one clinician to reduce movement. Large font laminated information cards.
Hearing impairmentLaminated information cards. Laminated signs created for reception: key questions to prompt service user.
ParenthoodBreastfeeding private space: screened seating area with potable water. Pregnant women offered fast tracking. Information leaflet on vaccination in pregnancy developed with specialist maternity nurses. Tailored options for service users attending with children.
CultureProactive measures for under-served groups providing specific clinics and invitations. Bespoke community clinics co-created with community ambassadors from specific ethnic minority and religious groups. Operations managers proactively strengthened links and relationships with community ambassadors to invite and tailor vaccination clinics. Community ambassadors were asked to advise on culturally appropriate processes, languages and support.
CarersCarers attending with a clinically vulnerable person were offered vaccination.
HomelessTailored invitation for individuals experiencing homelessness with drop-in access for vaccination. Outreach vaccination clinics at a local homeless hostel. Information delivered via charities promoting vaccination.
Deprivation levelFree taxi service to and from vaccination centres communicated widely. Outreach vaccination events positioned in areas of higher deprivation.
Vaccine hesitancyQuestions encouraged from people expressing hesitancy with the vaccination. Discussion provided by clinical team to enable informed choice.
AddictionIn self-reported substance misuse, clinical assessment taken to ensure consent. Service users offered fast tracking.
Uncertain residency statusProactive engagement of vaccination centre staff with community ambassadors to provide reassurance and provision of COVID-19 vaccination for undocumented migrants and those of uncertain residency status.
Extremely vulnerableDrop-in slots provided to ensure urgent access to vaccination. Service users were identified as extremely vulnerable with a rapid access referral form, identified to the operational manager and fast tracked.
Specific clinicalStaff and volunteers actively encouraged to identify anyone showing anxiety, distress or those who self-identify as needle phobic. Fast tracking and support offered to the service user throughout attendance according to need. Use of recovery area with couches that are quieter and away from other service users if required for vaccination.