Boosting Vaccine Demand and Acceptance: Key Takeaways from the VARN 2023 Conference
Authored by Sunday Oko and Kemisola Agbaoye (Primary Contributors)
Immunization continues to be a highly efficient and beneficial measure in the field of public health in today's world. However, significant occurrences such as the COVID-19 crisis have revealed that people's reluctance to get vaccinated, influenced by false information and other elements, can greatly impede its acceptance. This jeopardizes the advancements made in eradicating diseases like measles and polio through vaccination, potentially triggering a regression.
The second annual Vaccination Acceptance Research Network (VARN 2023) conference took place in Bangkok, Thailand in June 2023, with a major focus on the demand for and hesitancy towards vaccines. With climate change, the rise of new and recurring diseases, limited resources, and an increasing population reluctant to receive vaccines, countries face the challenge of making sure that effective and scientifically-backed public health measures are accessible to those who need them the most. This includes reaching out to groups such as children who have not received any vaccines, women, the elderly, individuals with disabilities, and those residing in conflict zones or remote areas that are difficult to access.
VARN 2023 showcased specialists from more than 50 nations and attendees from various fields, such as worldwide healthcare and policies, government, private companies, funding organizations, non-governmental organizations, and education institutions. The event, with the central theme of "Immunization: The Urgent Need for Fairness," offered a platform for conversations about significant areas of focus and potential growth within the entire range of vaccination initiatives, policies, and procedures.
A group from Nigeria Health Watch participated and delivered two visual presentations to share insights from launching a digital and traditional social monitoring project tested in Niger State to tackle false health information. Numerous other talks, discussions, and main sessions occurred throughout three days, emphasizing strategies to enhance worldwide demand for and acceptance of vaccines.
Here are the three main things to remember from the conference.
The global outbreak of COVID-19 has had a profound effect on crucial vaccination programs, resulting in a notable increase in the number of children worldwide who have not received any vaccinations. This issue is particularly prevalent in Africa. Zero-dose children refer to those who have not yet received their initial dose of the Diphtheria, Tetanus, and Pertussis (DTP1) vaccine and are unlikely to be reached through regular vaccination services. Nearly half of these children reside in urban regions, isolated communities, and areas affected by conflict. The majority of these zero-dose children, approximately two-thirds, can be found in ten countries, predominantly located in Africa.
The first panel discussion, titled "Creating a new strategy to reach underserved communities, conflict zones, and overcome gender barriers," aimed to investigate the underlying reasons for the global gaps in vaccination coverage, particularly among vulnerable groups, and propose suggestions to address them. Although the reasons for the decline in global vaccination coverage are complex, a notable insight from the conversations on vaccine fairness is the significant role that reduced demand has played in exacerbating this divide. Are our current healthcare systems unintentionally excluding these marginalized and vulnerable populations? Are the existing methods, such as supplementary vaccination campaigns, adequate in light of the new challenges posed by the COVID-19 pandemic?
Efficient vaccination initiatives need to be seamlessly integrated into all-inclusive healthcare services, utilizing a comprehensive approach that takes into account both the supply and demand factors. It's no longer enough to have vaccines readily available; we need to ensure that they are actually administered to people. To achieve this, immunization campaigns should focus on effective communication strategies that appeal to the emotions and thoughts of the intended recipients. Moreover, involving the community is vital, as it allows us to benefit from the influence of religious and cultural figures, as well as trusted individuals, in order to increase the acceptance and adoption of vaccines.
It is crucial to recognize and tackle obstacles like distance, expenses, and cultural beliefs to ensure fair access to vaccines. Ways to overcome these barriers could involve setting up mobile vaccination teams to reach far-off regions, reducing or eliminating the cost of vaccines for individuals, and utilizing community health workers to reach underserved communities. Working together with educational establishments would also be advantageous in enhancing immunization rates, especially among school-aged children, such as for the HPV vaccine. These initiatives can be incorporated into current health education plans, utilizing school facilities for vaccination campaigns.
2. Establish credibility: actively participate in conversations and connect with various communities.
The COVID-19 outbreak dealt a heavy blow to public health trust, leaving governments, public health organizations, researchers, and others with the task of restoring trust within their communities and promoting the adoption of life-saving measures like vaccines. The quick dissemination of inaccurate and misleading information during the pandemic, frequently endorsed by respected figures such as politicians, religious leaders, or those following traditional beliefs, as well as through various media outlets, has undermined previous progress in building confidence and acceptance towards vaccines. The restoration of trust is of utmost importance. Nevertheless, the question remains: how can this objective be achieved?
At VARN2023, there were different types of sessions, such as plenary sessions and concurrent poster sessions, that showcased projects where researchers and implementers utilized creative techniques to build trust. These endeavors, which engaged young advocates, healthcare professionals, influential figures in communities, and the media, all had one important element in common when it came to increasing the demand for and acceptance of vaccines — the crucial role of listening.
Moreover, it is vital to connect with societies by reaching out to them on their own terms and conversing in languages they comprehend. The speakers underlined the significance of conveying information with confidence, delivering relevant and captivating messages, employing narratives to establish a human connection, and promptly addressing queries. This is particularly important as misinformation tends to flourish when accurate information is lacking.
Finally, a crucial element of developing trust involves establishing reliability and earning the support of digital and real-life influencers and advocates within communities. By involving these influencers and advocates, their voices can be utilized to encourage vaccine acceptance and generate beneficial public health results.
3. Embrace change: harness the power of technology, focus on upcoming generations, develop skills and capabilities
Methods such as artificial intelligence, game-like elements, moving images, animated content, and comedy have been utilized to increase the acceptance of vaccines during the current COVID-19 outbreak. These approaches have been proven to be effective. It is important to use and incorporate these successful methods into regular immunization campaigns. When designing vaccination initiatives for young individuals and children, the focus should be on increasing their understanding and awareness of the advantages of vaccines. Although consent from parents is usually necessary for HPV vaccines, these programs can aim to empower young people and children with the necessary information to make informed choices. Ultimately, this will result in a generation that is less susceptible to misinformation compared to their parents.
Moreover, it is crucial for governments and enforcers to embrace groundbreaking methods in reaching out to diverse portions of the community, employing efficient tactics to alter social attitudes and behaviors.
One particular technique is motivational interviewing, which focuses on comprehending individuals' reasons behind their stance and giving them the ability to make well-informed decisions. This strategy highlights the value of empathetic listening instead of instantly correcting their viewpoints. It is vital to enhance the capabilities of healthcare workers on the frontlines in using these verified approaches, particularly since communication and techniques for modifying behavior are frequently neglected in the educational programs for physicians and other medical professionals.
Nigeria is positioned as the second highest country worldwide when it comes to the count of children who have received zero doses of vaccines, right after India. Furthermore, Nigeria holds the title for having the largest number of children who have not been vaccinated against measles. The recent occurrence of an outbreak of diphtheria, along with the regular cholera and Lassa fever outbreaks, draws attention to the urgency for Nigeria to learn from these conversations and subsequently take the necessary measures. Additionally, the introduction of the HPV vaccine into the national immunization schedule further underscores the need for Nigeria to act accordingly.
