Driving vaccination uptake to protect local communities for London Borough of Barking and Dagenham

Vaccine uptake is shaped not just by access and information, but by trust, lived experience and past interactions with institutions. In Barking & Dagenham, this was reflected in inequalities during the Covid vaccination programme and in routine childhood immunisations such as MMR.

Following the pandemic, the council wanted to deliver effective vaccination activity at pace, while also addressing deeper, trust‑based drivers of hesitancy.

This case study brings together two phases of work delivered in partnership with Barking & Dagenham:

• Phase 1: Behaviourally informed campaign – designing and delivering Covid and MMR campaigns using behavioural science to reduce practical barriers and prompt uptake.
• Phase 2: Community‑led conversations – working with Black African and Romanian communities to understand the lived drivers of MMR hesitancy and build confidence for non‑judgemental conversations, informed by Motivational Interviewing techniques.

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Phase 1: Behaviourally informed vaccination campaigns (2022–2023)

Following an initial Covid vaccination campaign in 2022, Barking & Dagenham commissioned Claremont to design and deliver behaviourally informed campaigns focused on the Covid booster and MMR vaccination.

Our approach

We worked closely with the council and community partners to gather local insight and define priority audiences. Using the APEASE framework, we identified barriers and opportunities that were both behaviourally meaningful and feasible to address at pace.

For Covid vaccination, insight highlighted a number of key barriers, including:

• low trust in government and vaccines
• the perception that Covid was no longer a risk
• concerns about side effects
• confusion around eligibility, cost and access

In response, we focused on clear, simple messaging that reinforced the ongoing presence of Covid locally, clarified who was eligible, reassured people that vaccines were free, and emphasised the ease and convenience of local pharmacies and pop‑up clinics.

We delivered a suite of multi‑channel materials – including posters, school communications and behaviourally informed text messages – drawing on behavioural principles such as the endowment effect to prompt action.

Impact

The results were strong:

• 1,107 Covid vaccinations were delivered across 37 pop‑up clinics
• Clinics promoted using behaviourally informed text messages drove almost six times more attendees than those promoted without text messaging

Building on this success, Barking & Dagenham asked us to support an urgent MMR vaccination campaign using the same tested behavioural approach. Messaging highlighted rising local cases, clarified who would benefit from vaccination, and clearly signposted where and when children could be vaccinated.

Evaluation showed that text messages sent to parents were a key driver of attendance. Barking & Dagenham went on to break the London record for vaccinations delivered at a single clinic, with 183 children vaccinated in one day, around 50 receiving their first dose of MMR.

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Phase 2: Reducing vaccine hesitancy through community‑led conversations (2025)

Building on the success of campaign delivery, Barking & Dagenham wanted to address a deeper, longer‑term challenge: how to engage communities where MMR vaccine hesitancy was shaped less by awareness or access, and more by trust, lived experience and social context.

This second phase focused on Black African and Romanian communities living in the borough, where lower uptake had been identified.

Our approach

We took a community‑centred approach grounded in behavioural science, systems thinking and participatory methods. Rather than aiming to drive immediate behaviour change, this phase focused on building understanding and local capability — creating the conditions for more effective, community‑led engagement over time.
Specifically, we set out to:

• understand the lived, local drivers of MMR vaccine hesitancy
• equip trusted community members with skills to have safe, non‑judgemental conversations about vaccination

What we did

Understanding the system around vaccine hesitancy

We started by mapping the wider system shaping vaccination decisions, drawing on existing evidence, local insight and conversations with community organisations. Rather than framing hesitancy as an individual deficit, the map highlighted how attitudes and behaviours are shaped by:

• trust (or lack of trust) in institutions, services and messengers
• past experiences of healthcare, migration and discrimination
• social norms within families and communities
• practical barriers such as language, time and navigation of services
• exposure to misinformation alongside gaps in trusted, relatable information

This systems perspective helped shift the focus away from persuasion, and towards creating the conditions for reflection, dialogue and informed choice

Community workshops informed by Motivational Interviewing

Building on this, we designed and delivered in‑person community workshops grounded in Motivational Interviewing techniques (MI) with Romanian and Black African communities.

Participants were community leaders and trusted members: people who already play an informal role in sharing information, advice and support within their networks.

Informed by motivational interviewing, the workshops focused on practical, empathy‑led techniques such as listening without judgement, exploring ambivalence, and supporting people to reflect on their own motivations, rather than persuading or correcting.

Participants discussed how to listen without judgement, use open questions to encourage reflection, recognise ambivalence as normal, and support people to identify their own motivations without pressure.

Alongside building confidence and skills, the workshops generated rich insight into how vaccination is talked about locally, what language resonates, and when people are most open to discussion.

What we learned

Across both communities, hesitancy was rarely absolute. Uncertainty and mixed feelings were far more common than outright opposition, with trust emerging as a central theme.

The work reinforced the importance of meeting people where they are, separating health conversations from judgement or blame, and equipping local voices with flexible tools, not scripts. Many participants reflected that being encouraged to listen, rather than persuade, felt more realistic, respectful and effective over time.

Outputs and impact

Across the two phases, the partnership delivered:

• behaviourally informed Covid and MMR vaccination campaigns with strong, measurable impact
• a system map outlining the interconnected drivers of MMR vaccine hesitancy in Barking & Dagenham
• tailored community workshops building confidence and capability to hold non‑judgemental conversations about vaccination
• a final report bringing together insights, learning and practical considerations for future community‑led engagement.