Approaches to vaccine delivery: learning from Gloucestershire ICB’s Covid-19 vaccine programme

Context

Rates of vaccination – one of the most effective public health interventions – are declining in the UK. 

During the pandemic, Covid-19 vaccination rates in Gloucestershire were among some of the highest in the country. Since the pandemic, they have been rated as the integrated care board (ICB) with the highest uptake rates for adult vaccines.  

The King’s Fund evaluated the programme to see how well the ICB achieved these high uptake rates, despite facing challenges including a mix of rural and urban communities, health inequalities, and an older population. 

Why did Gloucestershire do so well? 

Vaccines delivered locally through GP-led networks and familiar community venues, instead of mass-vaccination centres, made access easier, more trusted and more convenient. 

Real-time data helped spot gaps in uptake and guide outreach. 

Tailored outreach services, such as pop-up clinics and mobile 'jab vans', along with targeted support and messaging, helped to reach more hesitant groups. 

Strong relationships across health teams and community organisations enabled quick and innovative collaboration. 

Flexibility and learning from what worked helped adapt delivery based on patient feedback and sharing knowledge across teams. 

Gloucestershire’s approach mirrors ‘best practice’ as seen in the literature

Vaccine uptake is often hindered by several key factors, such as safety concerns, cultural beliefs, mistrust and misinformation, as well as practical access barriers, such as transport and digital exclusion. 

Uptake rates improve when delivery involves tailored messaging, data-driven planning, trusted community engagement, clear information, and easy access through flexible options such as walk-ins and mobile clinics. 

Gloucestershire ICB ended up doing all of these things. Its success shows that doing ‘what works’ really does work.  

Challenges faced, and where improvements could still be made

Running many smaller vaccine sites instead of one or two mass-vaccination centres led to greater set-up, logistical and IT challenges. 

Even though outreach efforts improved uptake, some groups still faced language barriers, and held perceptions based on mistrust and misinformation. 

Engagement often depended on a few community leaders, making relationships fragile. 

Balancing efficiency and safety and avoiding vaccine waste while ensuring access was a constant challenge. 

What’s applicable outside of a pandemic context?

The context has changed since the pandemic: financial incentives and capacity, which were in greater supply during the pandemic, have reduced. 

Mutual aid for vaccine sharing has been relied upon less. 

Collaboration between the system, pharmacies and voluntary sector partners has shifted back to less integrated ways of working.  

However, the ICB has maintained data-led decision-making, local delivery models, targeted outreach, improved data systems, and efficient clinic practices to keep vaccine uptake high. 

Looking ahead – lessons for the future

Lessons for strengthening vaccine campaigns: 

• Accessibility and convenience are key determinants of uptake. Vaccines should be offered in familiar, local venues to make getting vaccinated easy. 

• Targeted and tailored approaches for hesitant or underserved groups are essential. 

• Investing in trust-building to build long-term relationships with communities outside crisis periods is crucial. 

• Strong working relationships across the system and with partners are key to efficient and flexible delivery. 

Lessons for future pandemics:  

• Set up local sites and mobile clinics instead of big mass-vaccination centres to increase accessibility and familiarity. 

• Give local teams control so they can decide what works best for their communities and use the funding quickly. 

• Share learning quickly through regular check-ins. 

• Build strong relationships early with health teams, community groups, and partners to support collaboration. 

• Work with trusted local voices to build confidence and fight misunderstanding and misinformation.