Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers

What works in practice to build vaccine confidence?

Reda Sadki Global public health

This is the content of a poster presented today by The Geneva Learning Foundation (LinkedIn | YouTube | Podcast | Twitter)  at the International Social and Behavior Change Communication Summit 2022 (#SBCCSummit) held 5-9 December 2022 in Marrakech, Morocco. What is the Geneva Learning Foundation? Get the full reportRead the preface by Heidi Larson

From responding to the initial shock of the pandemic to preparing COVID-19 vaccine introduction

Over 6,000 health professionals joined the COVID-19 Peer Hub in July 2022, part of the Geneva Learning Foundation’s (TGLF) global immunization learning-to-action platform.

  • From August to October, they focused on developing and implementing recovery plans.
  • In November 2020, members of the COVID-19 Peer Hub decided to launch a reflective exercise to prepare COVID-19 vaccine introduction, after three months on early recovery implementation.
  • The exercise took place between 9 November and 18 December 2020.

We asked a simple question: Can you think of a time when you helped an individual or group overcome their initial reluctance, hesitancy, or fear about vaccination?

  • Each participant developed a case study to describe and analyze such a situation.
  • They then peer reviewed each other’s case studies, giving and receiving feedback to learn from each other.

Who participated?

Local practitioners from 86 countries:

  • 81% (n=591) in West and Central Africa
  • 11% (n=80) in Eastern and Southern Africa
  • 6% (n=43) in South Asia

Health system levels:

  • 18% (n=131) national
  • 29% (n=213) sub-national
  • 29% (n=214) district
  • 20% (n=144) facility

So what?

What was the significance of the experience for participants?

Transformation: “I can tell you this experience changed my life. It has changed my practice and made me think differently about the way I work, considering things I did not think about before.”

Defying boundaries: “It was a opportunity like I have never had before… I have studied with peer from my country. Having a lot of people from other countries sharing their experience was something else.”

What we learned from local practice

  1. Vaccine hesitancy is a complex problem that blanket recommendations or prescriptive guidelines are unlikely to solve.
  2. Instead, we should strive to recognize that solutions must be local to be effective, leveraging the ability of local staff to adapt to their context in order to foster confidence and acceptance of vaccines.
  3. Supporting health workers, already recognized as trusted advisors to communities, requires new ways of listening and learning.
  4. It also requires new ways of fostering, recognizing, and supporting the leadership of immunization staff who work at the local level under often difficult conditions.

4 targeted intervention approaches that worked

  1. targeted individual counselling at the individual or household level;
  2. community outreach for larger groups;
  3. formal meetings (usually for community and religious leaders); and
  4. organized training sessions in which particular subgroups were involved (e.g., training for religious teachers, health workers, youth groups, women’s groups).

2 key determinants that changed minds and behaviors

  1. The tone and delivery of the interventions were as critical to the success of the immunization as the activities themselves.
  2. The positive effect of using multiple approaches: high degree of understanding and compassion; navigating sensitive dynamics, grieving families, and issues related to vulnerable communities affected by displacement or war.

Anthrologica performed the qualitative analysis of the case studies and developed the report for the Geneva Learning Foundation.