Guidance

Appendix 5: Additional resources for the planning and co-design phase

Published 10 June 2026

A literature review was carried out to populate the table below, highlighting some examples of strategies that may be effective at directly increasing vaccination uptake among population groups with poorer access to healthcare and/or lower coverage.

PubMed was searched for review-level evidence (i.e. systematic reviews and meta-analyses, scoping reviews and narrative reviews) including the words ((immunis[Title/Abstract]) or (vacc[Title/Abstract])) and ((improv) or (increas)) and ((cover) or (uptak)) and ((strateg) or (interv))).

Searches also included specific search terms for each population group: (refugee) OR (migrant) OR (asylum) or (deprive) or (poverty) or (poor) or (socioeconom) or (ethnic) or (minorit) or (Black) or (Asian) or (chronic) or (condition) or (learn) or (disabil) or (difficult) or (pregnan) or (adolesc) or (young) or (child) or (gay) or (bisexual) or (MSM) or (GBMSM) or (LGBT) or (trans) or (transgender) or (binary) or (“sex worker”) or (drugs) or (homeless) or (inclusion) or (marginali) or (vulnerable) or (prison) or (underserve) or (exclusion) or (criminal) or (older) or (elder) or (rural) or (coast) or (urban) or (city) or (worker) or (healthcare) or (staff) or (care) or (home). Results were restricted to items published between 2022 (post-COVID and post-NICE reviews) and the end of March 2026.

Existing UK guidance on how to increase immunisation uptake was also incorporated, where available, including NICE evidence ([1] - [16]). It is important to note that this review is not comprehensive and did not include an assessment of study quality and there may be some interventions more relevant to specific immunisation programmes (for example, seasonal immunisation). Results are presented in no particular order.

Strategies which may increase vaccination uptake in underserved groups

Population group	Strategies and interventions to increase vaccination uptake
Socio-economically deprived communities ([17] - [20])	• home visits • outreach or mobile clinics • partnership with trusted community organisations and peer workers • tailored and translated communication in simple language • reminders and recall systems • information delivered through posters, handouts, consultations or phone call conversations • opportunistic discussion and/or provision during routine health appointments • data infrastructure and quality-improvement strategies  • training of healthcare providers  • patient-focused digital technology • verbal rather than written consent
Ethnic minorities [17], [19] - [25])	• trained peer health educators and credible sources within the community to promote uptake  • culturally appropriate and translated materials in simple language  • flexible clinic hours and appointments  • bilingual medical staff  • health visitors to reinforce messaging  • vaccination in community venues (for example, churches)  • recommendations from trusted healthcare professionals  • outreach or mobile clinics  • home visits  • pharmacy provision  • education sessions, for example, information in English classes  • patient reminders sent by trusted healthcare workers  • call and recall systems  • partnership with community organisations and community and faith leaders to build trust  • co-designed interventions  • training of healthcare providers  • data infrastructure and quality-improvement strategies   • creative communication channels, such as videos by local community representatives  • patient-focused digital technology interventions  • verbal rather than written consent
Migrants, refugees, asylum seekers ([17], [18], [20], [26] , [27])	• outreach or mobile clinics  • collaboration between accommodation providers and local health services  • consistent provider recommendations  • provider prompts, for example, integrated into electronic medical records  • education sessions to address misinformation  • co-designed, culturally appropriate and translated materials  • clear messaging on entitlement to care, including vaccination  • flexible or extended clinic hours  • multilingual, diverse staff  • outreach or mobile clinics  • vaccination without general practice (GP) registration  • interpreters  • home visits  • peer-education and community mobilisation  • staff training, including for cultural awareness and trauma-informed care  • integration with other services  • partnership with community organisations, leaders and ambassadors to build trust  • patient recall and reminders  • community champions  • information provision  • digital interventions, for example co-developed social media campaigns
People with long-term conditions ([13], [14], [20], [23], [28] - [31])	• opportunistic hospital vaccination (inpatient or outpatient visits)  • co-design of interventions  • patient reminders  • provider prompts, for example, integrated into electronic medical records  • use of health navigators  • communications tailored for specific conditions  pharmacy provision  • proactive call–recall  • face-to-face advice on eligibility and importance  • extended clinic hours  • pay for performance targets
People with learning disabilities ([20], [23], [32] - [34])	• better recording of learning disabilities • co-designed easy-read materials • reasonable adjustments such as longer appointments and quiet clinics • individual immunisation plans • mobile clinics • staff training • management of fear of needles clear messaging regarding entitlement, including carers • • interactive education sessions • peer-led approaches
Pregnant women ([2], [5], [15], [35]-[42]	• midwife-led vaccination in antenatal clinics • strong provider recommendation • safety and benefit messaging • reminders in maternity pathways • education - pamphlets, websites, and brief one-to-one education • provider continuity • tailored face-to-face interactions, addressing concerns and dispelling myths • education of healthcare professionals about vaccines’ safety and effectiveness  • reminder for providers to offer vaccinations routinely • financial incentives • digital interventions
Children, young people and adolescents ([2]-[4], [8], [12], [14] [17]-[19], [34], [35], [43]-[77]	• call and recall system • clinician recommendation • school-based education and provision programmes • mobile and outreach clinics • home visits • provider prompts built into electronic medical records • parental reminders in a variety of formats including letters and text messages • catch-up clinics • education sessions for parents and youth • opportunistic hospital vaccination, including emergency departments • community engagement, including partnership with trusted community organisations • data infrastructure and quality-improvement strategies  • incentives • digital interventions, using mobile, wireless technologies to deliver information (mHealth) • provider education • provider audits and feedback • stage‐of‐change‐tailored interventions • motivational interviewing
Gay, bisexual and other men who have sex with men ([16], [23]	• digital interventions, such as text message reminders • opportunistic discussion and/or provision during routine health appointments • partnership with trusted community organisations
Inclusion health groups ( [20], [78]-[80)	• partnership with community organisations and people with lived experience to build trust • peer advocates • reminders incentives • outreach clinics at shelters, drug services and/or prisons • mobile clinics • vaccination at first appointment if no immunisation history or serological status known (if clinically safe) • staff training for working with inclusion health groups • improving housing and financial support • ensuring no out-of-pocket costs • nurse-led vaccination community clinics or inclusion health settings • flexible and/or extended clinic hours • opportunistic vaccination at hospital attendance • integration with other health services • accelerated hepatitis B immunisation schedules
Older adults ([2]-[5], [28], [29] [35], [52] [81]-[87)	• patient reminder and recall by letter plus leaflet • nurses educating and vaccinating patients home visits • opportunistic hospital vaccination, including emergency departments • education • information provision
Rural and coastal communities ([18], [20] [23], [88])	• educational sessions • information resources call and recall system • opportunistic vaccination during routine appointments • community pharmacy provision promotion • co-designed promotional material • outreach or mobile clinics, including at schools • healthcare provider training • partnership with trusted community organisations • drop-in clinics
Urban residents ([19] [23])	• reminders • incentives • home visits • call and recall system • mobile and outreach clinics • simple translated educational material • data infrastructure and quality-improvement strategies • training of healthcare providers • patient-focused digital technology
Healthcare workers ([10], [14], [35], [89]-[93])	• education sessions, including those online printed materials such as posters and leaflets • opt-out policies • staff immunisation champion • hospital campaigns • incentives • training for peers to vaccinate their co‑workers • support from high-profile organisational leaders • staff reminders, including by email • workplace and/or mobile vaccination clinics with extended hours • actively identifying and inviting susceptible individuals for vaccination
Social care workers ([10], [14])	• education sessions • provision of resources on vaccine effectiveness and safety • on-site vaccination in care homes • opt-out policies • incentives • prompts and reminders in various printed and digital formats • staff immunisation champion • training for peers to vaccinate their co‑workers • support from high-profile organisational leaders • workplace and/or mobile vaccination clinics with extended hours

Note: there were no studies identified relevant to interventions for gender minority populations

Existing resources to assist in designing intervention components

Resource	Description of resource
Cross‑cutting and/or multicomponent approaches
UKHSA: Insights from people with lived experience to inform inclusive approaches to health protection ([94])	Summarises insight from people with lived experience of social exclusion, offering principles to design more inclusive health protection approaches, including immunisation.
Association of Directors of Public Health (ADPH) London: Increasing vaccine uptake – a checklist for local authorities ([95])	Provides local authorities with a recap of practical solutions that local authorities can implement to support increasing vaccine uptake, covering governance, communication, partnerships and community engagement.
NHS England South East: Human papillomavirus (HPV) vaccination resources toolkit ([96])	A curated set of materials to support local promotion of HPV vaccination, including messaging, visual assets and guidance for engaging different audiences.
Communication and community‑centred messaging
Department for Health and Social Care (DHSC): Vaccination campaign resources (including communication toolkits) [97]	National campaign assets including posters, leaflets, social media content and messaging guidance to support consistent, accessible vaccine communication.
UKHSA: Measles communications toolkit ([98])	A comprehensive toolkit providing background information, key messages and ready‑to‑use communication materials to support consistent public messaging on measles and measles, mumps and rubella (MMR) vaccination, including social media assets, template statements and guidance for engaging diverse audiences during periods of increased measles risk.
Association of Directors of Public Health London: Vaccine engagement checklist ([99])	A practical checklist to support local systems to develop coordinated, equity‑focused immunisation campaigns.
European Centre for Disease Prevention and Control (ECDC): Translation is not enough - Cultural adaptation of health communication materials ([100])	Guidance on adapting health communication materials to ensure cultural relevance, rather than relying solely on translation.
Friends, Families and Travellers: Vaccination information for people from Gypsy, Roma and Traveller communities ([101],[102])	Culturally tailored vaccination information in accessible video formats, co‑produced with Gypsy, Roma and Traveller communities.
Groundswell: Co-developing key messages to support vaccine uptake amongst people experiencing homelessness ([103])	Co‑produced messaging and communication materials shaped by people with lived experience of homelessness, focusing on relevance, trust and accessibility.
Tackling mis- and dis-information
NHS England South West: Vaccine confidence hub ([104])	A hub providing myth‑busting resources, communication tools and training to support non-clinical staff to have meaningful conversations about vaccines.
UNICEF: Vaccine misinformation management guide ([105])	Practical guidance for identifying, monitoring and responding to misinformation using evidence‑informed communication strategies.
Outreach and community engagement models
NHS England: Checklist for delivering effective outreach ([109])	Provides key considerations for planning and delivering outreach vaccination models, including workforce, logistics and community partnership.
Office for Health Improvement and Disparities (OHID): Community champions programme: guidance and resources ([106])	An overview of evidence, guidance and resources to inform and support setting up community champion programmes to enhance trust, engagement and health literacy in local areas.
COVID Legacy and Equity Partnership: Toolkit to support the delivery of health and wellbeing stands ([107])	Practical guidance for planning and operating health stands in community settings, including engagement approaches and materials.
NHS England: Bite size guides to participation ([108])	Short, practical guides designed to help commissioners to involve people and communities effectively. They provide quick‑reference advice on participation methods, inclusive engagement and building stronger relationships with communities.
Public Health England and NHS England: A guide to community-centred approaches for health and wellbeing ([110])	A comprehensive guide outlining evidence‑based community‑centred approaches, frameworks and models that strengthen community capacity, build local partnerships and support more inclusive public health practice.
Leicestershire Communities: Guidance/tools to support community engagement ([111])	A set of practical tools, templates and advice to help local organisations plan, deliver and evaluate community engagement activities in accessible and culturally sensitive ways.
South East London Integrated Care System: Community organising approaches ([112])	Guidance introducing community organising principles, with practical examples of how to mobilise local residents, build community power and support collaborative action around health priorities.
Service delivery and person-centred approaches
Public Health England: Making every contact count (MECC) ([113])	A behaviour‑change framework supporting staff to use routine interactions to promote healthier behaviours, including immunisation.
CareOregon: Implementing trauma-informed care at vaccine clinics ([114])	Provides practical actions for embedding trauma‑informed practice into immunisation services, enabling empowerment and safety for underserved groups. This resource was developed in the United States but has relevance to the UK context and has been referenced in the absence of a similar UK-specific guidance.
Other
RIVER-EU - Reducing Inequalities in Vaccine uptake in the European Region – Engaging Underserved communities ([115])	A European project exploring how evidence‑based interventions can be transferred and adapted to different underserved populations.

Note: Other community engagement resources can be found in the ‘community engagement and involvement’ section of the toolkit.

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