Increasing uptake of vaccinations in populations where there is low uptake

Research specification

The Public Health Research (PHR) Programme would like to draw researchers’ attention to the research specification below. This was first advertised in 2021 and has been updated to include additional priority population groups, as it remains an area of research interest in which we would like to invite applications. 

Vaccination is a highly cost-effective health intervention. Key to the CORE20PLUS5 national NHS England approach to healthcare, vaccination can reduce health inequalities, increase access to health services and even reduce poverty. Ensuring vaccination coverage is essential not only overall, but also within underserved communities and groups in which uptake is low, to help prevent disease and promote health. 

On 17 May 2022, NICE published guidance on ‘Vaccine uptake in the general population’ [NG218]. Although the guidance aims to increase the uptake of all vaccines by everyone who is eligible to support the NHS Long Term Plan, it highlights gaps in the evidence around how to engage with and increase vaccine rates in populations with low uptake, in support of The National Healthcare Inequalities Improvement Programme (HiQiP).

We would like to commission research evaluating population level interventions delivered in non-NHS settings, which impact the uptake of existing vaccinations already available through a UK vaccination programme. More information on UK vaccination and screening programmes can be found by registering with the FutureNHS platform. 

Please refer to the guidance notes, paying particular attention to the points highlighted below:

Population (P) – While PHR Programme funding opportunities are broad, applicants need to specify and justify their choice of population. We recognise that interventions are likely to impact different (sub)populations in different ways. We are particularly interested in vaccine uptake in: older people aged 65+, boys, school age children including children who are home-schooled, pregnant women, people with physical or learning disabilities, underserved communities and groups. 

Intervention (I) – We are predominantly interested in the evaluation of interventions that operate at a population level rather than at an individual level. The PHR Programme does not fund research into the treatment of disease but is interested in research that addresses the wider determinants of health. Evaluations could include larger scale and structural initiatives, if evaluating smaller scale interventions, researchers need to ensure these are generalisable to wider settings and populations.

Comparator (C) – While we recognise that conducting a randomised controlled trial is not necessarily possible or appropriate in many situations, we encourage applicants to consider including a suitable comparator.

Outcomes (O) – The primary outcome must be a health outcome. Researchers will need to clearly describe and justify their choice of primary and secondary outcomes. Researchers will need to specify how outcomes will be measured in the short, medium, and long term. Where a primary health outcome is not feasible then intermediary and proxy outcomes are accepted, if appropriately justified. 

Health inequalities - Of particular importance to the PHR Programme is an understanding of inequalities in impact of policy and access to services. Evaluations of interventions seeking to reduce health inequalities are also of specific interest.

For some proposals, underpinning or development work to understand the epidemiology and inform the evaluation of interventions might be beneficial. We are willing to consider applications that include a maximum six-month period of underpinning or development work. Likewise, we also recognise that researchers at times need to conduct rapid baseline data collection, as well as other feasibility work, within a very tight timeframe. If this is the case, please contact us before applying to discuss further, or read more about the Public Health Research Programme Rapid Funding Scheme. Applicants are strongly encouraged to familiarise themselves with the PHR remit. 

In researching how interventions increase uptake of vaccinations, it would be valuable to understand how the intervention works in a particular area, as well as for whom, and under what circumstances. Making the findings more generalisable will support decision-makers to take evidence-based action to improve population health.

Applications for research into the development of new vaccines or evaluation of the effectiveness of existing vaccines should be directed to the NIHR’s Efficacy and Mechanism Evaluation (EME) or Health Technology Assessment (HTA) Programmes respectively. 

Research topics of interest/key questions include (but are not limited to):

• what are the most effective ways of increasing uptake in populations or groups with low routine vaccine uptake in the UK? 
• what are the most effective ways of reaching underserved groups and removing stigma and barriers to access existing vaccination programmes? 
• what are the important messages regarding vaccines and how should the messages be tailored and delivered to encourage and sustain uptake in specific groups? How do we reduce negative perceptions about vaccination and increase acceptability and understanding of their benefits?
• what changes implemented to facilitate increased access to the Covid-19 vaccine (e.g. vaccine centres, buses, pop-up locations etc.) could be adapted and/or adopted to increase uptake of other vaccinations e.g. flu vaccination and children’s vaccinations (e.g. MMR)?
• what elements of a community-based/community-led programme work best for which populations? How and when should they be delivered and who by? 
• what interventions involving non-health stakeholders, for example education, housing, transport, schools, volunteers, are most effective at increasing vaccine uptake?

Application design 

A range of study designs can be used. Innovative methodologies are welcomed. Researchers should clearly describe their methodological approach, and the rationale for this approach. We are particularly interested in any natural experiment evaluations of recently implemented, innovative interventions to reduce concerns, hesitancy and facilitate vaccine uptake. Applications are welcomed for linked studies (e.g. pilot + main evaluation, evidence syntheses + modelling). Secondary analyses of existing epidemiological data and/or impact modelling studies may also be funded. In all cases a strong justification for the chosen design and methods must be made.

We recognise that this funding opportunity is broad and expects researchers to be targeted in their research. Applicants are expected to be aware of other relevant studies and/or investments in their area of research, to identify the gaps in the existing evidence base, if relevant, researchers are encouraged to clearly identify how a wide range of existing evidence outputs can be combined with their study to deliver a whole societal approach. The research must also articulate why their research is important for decision makers. For this funding opportunity we are particularly interested in evidence which can readily be translated into practice, theory of change, as well as realist models exploring mechanisms and outcomes. 

In line with the NIHR principles of inclusion, you must consider inclusion throughout the research lifecycle, and ensure that these considerations are costed appropriately. This includes (but is not limited to): your research design; the participants you recruit and how you have considered diverse, under-served groups and health inequalities, and justified exclusion criteria; research methods; data and statistical analysis; and knowledge mobilisation and dissemination of findings. NIHR welcomes partnerships between research active and other less active institutions and those located in geographical areas of deprivation. We encourage applications from people from all backgrounds and communities bringing diverse skills and experiences.

Health economics – Understanding the value of public health interventions - whether the outcomes justify their use of resources - is integral to the PHR Programme, where resources relating to different economic sectors and budgets are potentially relevant.  The main outcomes for economic evaluation are expected to include health (including health-related quality of life) and the impact on health inequalities as a minimum, with consideration of broader outcomes welcomed. Different approaches to economic evaluation are encouraged as long as they assess the value and distributive impact of interventions. Applications that do not include an economic component should provide appropriate justification.

Pathways to impact – We are focused on the impact of the research we fund. Researchers are encouraged to maximise the impact of their research by explaining how they will mobilise knowledge and share their findings, to ensure that it is used, with the relevant policy makers, public health officers, special interest groups, charities, community audiences and other stakeholders. 

Some examples of related studies within the existing PHR portfolio are:

• Interventions to increase vaccine uptake: Systematic review and component network meta-analysis to identify the most effective strategies
• FluCare: Estimating the effectiveness and cost-effectiveness of a complex intervention to increase care home staff influenza vaccination rates
• Interventions to increase Covid-19 vaccination uptake and reduce vaccine hesitancy

Application guidance

Please read our Domestic Outline Application guidance to help you complete all aspects of your application. You must read this alongside the information below, which details specific requirements our PHR Programme looks for in applications. You can also check our PHR Programme page for details about the Programme’s scope and remit. 

Research Plan

Your Research Plan must be a maximum of four A4 pages. Please include the following when writing your Research Plan. 

Methodology/plan

Include the below detail in your methodology/plan:

Application process

Find out how to apply for this funding opportunity and what you need to do to get your application ready.

How to apply 

When you are ready to apply, you will need to log in to our application system to apply. This funding opportunity is on our new Awards Management System and you will need to create a new account to apply.

The closing date is 25 April 2025 at 1pm. Applications received after 1pm on the closing date will not be considered. 

Please read the following guidance before submitting an application:  

• all of the application guidance detailed in the 'Application guidance' section in this funding opportunity

Download application form template

You can download a Word document template of the application form below. Please use this template as a guide only, to help you prepare your application. For example, to see how many characters are accepted in each section and to see how information in the form is laid out. Please do not try to use this as an application form; it cannot be submitted as an application. You must submit your application online via our Awards Management System.

Research inclusion and reasonable adjustments

At NIHR we are committed to creating a diverse and inclusive culture. We encourage applications from people from all backgrounds and communities bringing diverse skills and experiences. If you need any reasonable adjustments throughout the application process, please contact the programme team via the information in the Contact Details tab.

Research Support Service

Got a research idea and not sure how to turn it into a funding application? The free NIHR Research Support Service (RSS) supports researchers in England to apply for funding. It can help you develop and deliver clinical and applied health, social care and public health research post award.

Please speak to the NIHR Specialist Centre for Public Health (SCPH) about the design of your research as soon as possible by completing their online form. A successful application takes a long time (several months) to develop.