Stories

Tag: vaccine confidence

  • What works in practice to build vaccine confidence?

    What works in practice to build vaccine confidence?

    This is the content of a poster about vaccine confidence presented today by The Geneva Learning Foundation (LinkedIn | YouTube | Podcast | X/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 report… Read the preface by Heidi Larson…

    Vaccine confidence: 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 in relation to vaccine confidence: 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 joined this peer learning exercise about vaccine confidence:

    • 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 about vaccine confidence

    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 to strengthen vaccine confidence

    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 about vaccine confidence

    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.

  • Heidi Larson: “So much remains determined by the capacity of people on the frontlines to explain, advocate, and respond in ways that are almost entirely dictated by context”

    This is the preface by Heidi Larson for the report “Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers”. This report is 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 report… Read the preface by Heidi Larson…

    My own consciousness of the fragile equilibrium sustaining vaccine confidence came from working with immunization programmes and local health workers to defuse rumors that threatened to derail vaccination initiatives. Twenty years ago, this meant traveling to countries to meet, build relationships with, and work side-by-side with frontliners.

    Since that time, the corpus of research on the topic has grown tremendously. Elaborate behavioral science frameworks, supported by robust monitoring and evaluation, are now available to guide policy makers, donors, and other decision makers, for those who have the time and resources to implement them. 

    Nevertheless, there remains a gap in our understanding of how the complex dynamics of change actually happen, especially at the most local levels. For this we need to listen to the local experiences and voices of those at the front lines who can tell the real-life stories of how these complex dynamics are navigated.

    I found the idea of this report fascinating: 734 health professionals from all levels of the health system took time out from their demanding daily duties to reflect on their practice, describing and then analyzing a situation in which they successfully helped an individual or a group accept or gain confidence that taking vaccines would protect them from disease. Furthermore, they did this during four weeks of remote collaboration at a very crucial historical moment, months before the first doses of COVID-19 vaccine were to arrive in Ghana and Côte d’Ivoire.

    Reading this report, I experienced a sense of discovery. The stories shared reminded me of my early work with colleagues working at the local levels, and gave me renewed appreciation of   these health professionals who faced even greater challenges in the face of a deadly pandemic. I could feel how hard it is to remain that ‘most trusted adviser’ to communities, and how so much remains determined by the capacity of people on the frontlines to explain, advocate, and respond in ways that are almost entirely dictated by context, in this case a highly uncertain and evolving pandemic.

    I could also feel the tensions due to the imperfection of a participatory methodology that did not neatly fit the conventions and norms of expert-led research. Conventional research has seldom been able to access such local narratives, and even less so with such a large and diverse sample. Furthermore, the peer learning methodology used by the Geneva Learning Foundation meant that there was an immediate benefit for participants who learned from each other. Rather than research subjects or native informants, case study authors were citizen scientists supporting each other in the face of a common challenge. The scale, geographic scope, and diversity of contexts, job roles, and experiences are also strengths of this work. 

    Supporting health workers, already recognized as trusted advisors to communities, requires new ways of listening, new ways of supporting, new ways of measuring, documenting and learning.

    It also requires new ways of recognizing the leadership of immunization staff who work at local levels under often difficult conditions. 

    In some cases, it may actually be the lack of prescriptive guidelines that enabled local health staff to draw on their own creativity and problem-solving capabilities to respond to community needs.

    Rather than generalizations, we should therefore strive to recognize that solutions must be local to be effective, recognizing the ability of local staff to adapt to their context in order to foster confidence and acceptance of vaccines, and do all we can to support – letting them be the guide for future efforts.

    Heidi Larson, PhD
    Professor of Anthropology, Risk and Decision Science and
    Founding Director of the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine