The Drum Beat 834 - Inspiration on the Cusp of World Immunization Week

• 1.Language Barriers in Polio Vaccine Campaigns in Somalia: Focus on Maay Speakers in Banadir
• In Somalia, repeated cycles of conflict, famine, and floods have led families from the Southern regions, who predominantly speak Maay, to flee to internally displaced person (IDP) camps around the capital city of Mogadishu. Health and other humanitarian services are usually provided in the Mahaatiri language within these IDP camps. This collaborative report, published by Minority Rights Group International, finds that those who speak only or primarily Maay do not fully understand the messages on polio and polio vaccination presented within vaccination promotion campaigns that use Mahaatiri. Some of those who speak only Maay do not sign up for vaccination outreach programmes, which frustrates efforts to reach 100% vaccination rates to eradicate polio in the area. [Nov 2023]
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• 2.Caregivers' Perceptions on Routine Childhood Vaccination: A Qualitative Study on Vaccine Hesitancy in a South Brazil State Capital
  by Camila Carvalho de Souza Amorim Matos, Marcia Thereza Couto, Elizabeth O. Oduwole, and Charles Shey Wiysonge
• Brazil's National Immunization Program has faced significant challenges regarding vaccination coverage due, in part, to vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, the Santa Catarina state capital. "Contact with other hesitant families proved to be the main trigger for questioning routine vaccination." The study highlights the fragility of the family-health professional relationship, which is essential for effective communication in health and should be at the centre of immunisation policies, per the researchers. [Jan 2024]
   
• 3.Highlighting Heroes and Ignoring Villains: Visual Framing of Polio and Polio Vaccine in Newspapers
  by Muhammad Ittefaq, Taufiq Ahmad, and Shafiq Ahmad Kamboh, et al.
• This study investigates how leading Pakistani English newspapers visually portrayed polio and polio vaccine from 2010 to 2022. The results show that the selected newspapers used images to frame polio as an issue that requires significant international collaboration and has benefitted from the heroism of healthcare workers. However, "the focus on government officials, politicians, and international partners may inadvertently convey that polio is solely a concern of the government and its global allies, rather than an issue necessitating active engagement at the grassroots community level..." Among the suggestions: Photojournalists should emphasise the communal aspect of polio, and it is imperative to ensure that visuals featuring written messages are presented in the Pashto language. [Feb 2024]
   
• 4.Thinking Outside of the [Cold] Box: Implementing a Human-Centered Design Approach to Understand Barriers and Craft Solutions to Cold Chain Equipment Maintenance in Niger
  by Wendy Prosser, Nicole Danfakha, and Brittany Thurston, et al.
• Vaccines require cold chain equipment (CCE) to ensure quality and potency, yet the risk of CCE failure is well documented. This human-centred design (HCD) study in Niger sought to better understand the gap in maintenance approaches from the technicians' perspectives and to collaboratively identify forward-thinking solutions. Reflecting on the process, the researchers note that the co-creation workshops "created an opportunity for stakeholders to be involved in a constructive, creative and inclusive process that encouraged contributions and ideas from different perspectives. The key insights and challenges identified during data collection and synthesis informed the overarching principles of design and the concepts developed by participants during co-creation." [Nov 2023]
   

• 5.Building Confidence in Routine Immunization in the Philippines
• In 2021 and 2022, the United Nations Children's Fund (UNICEF), Meta, the Yale Institute for Global Health, and the Public Good Projects engaged in a collaborative effort to impact vaccine attitudes in the Philippines by applying data insights to develop, test, and scale online vaccine communication interventions. The 2021 social media campaigns reached over 17.9 million people, and every campaign achieved a statistically significant lift in post-campaign results about both the importance of childhood vaccines and the likelihood that people would recommend childhood vaccination to others. The 2022 campaigns reached over 46 million people, generating over 171 million overall impressions. The initiative led to over 332,000 people clicking on the UNICEF Philippines routine immunisation web page featuring information about why, where, and how to access vaccines for children.
   
• 6.MOMENTUM Routine Immunization Transformation and Equity Project
• This project works to increase equitable immunisation coverage in United States Agency for International Development (USAID)-supported countries around the world. Operating in 20 countries globally during the period of 2020-2026, MOMENTUM Routine Immunization Transformation and Equity supports efforts that are meant to be participatory, specific to context, and sensitive to gender equity imperatives. The project features active use of HCD and co-creation methods that focus on the perceptions, needs, and circumstances of a range of stakeholders. The project works with partners to strengthen capacity to implement solutions, incorporating gender considerations into all phases of the programme cycle.
   
• 7.Polio Supplementary Immunization Activities (SIAs) during the COVID-19 Pandemic: Experience from Penampang District, Sabah, Malaysia
• During the COVID-19 pandemic, polio supplementary immunisation activities were carried out in Penampang, Sabah, Malaysia, in response to a vaccine-derived poliovirus disease outbreak that was declared in December 2019. Prior to this, Malaysia had been polio-free for 27 years. A series of planning, healthcare staff training, advocacy, and community engagement activities were conducted to support administration of oral polio vaccine over the period of one year in an effort to reach 22,096 children aged 13 years and below. High vaccine uptake was attributed to good inter-agency collaboration, community engagement, intensified health promotion activities, and a drive-through vaccination campaign.
   

• 8.Increase in Institutional Delivery and Child Immunisation Coverage through an Appreciative Inquiry-based Community Dialogue Intervention in Afghanistan
  by Shafiqullah Hemat, Sharifullah Alemi, Sadia Ahmady, and Keiko Nakamura
• In Afghanistan's hard-to-reach Kandahar province, a community dialogue intervention with an appreciative inquiry approach was undertaken to improve child immunisation coverage, as well as institutional delivery. The intervention involved helping people see themselves as change catalysts, after which they take on more responsibilities owing to their increased motivation; they require less external assistance, supervision, and monitoring to achieve their goals. Full immunisation coverage among children aged 12-23 months and 24-35 months significantly increased from 26.4% to 76.9% (p < 0.001) and from 40.0% to 78.6% (p < 0.001), respectively, in the intervention district, whereas coverage significantly decreased in the non-intervention district. [Oct 2023]
   
• 9.The Effect of mHealth on Childhood Vaccination in Africa: A Systematic Review and Meta-analysis
  by Girma Gilano, Sewunet Sako, and Berihun Molla, et al.
• The researchers conducted a systematic review and meta-analysis for studies published from 2000 to 2023 applying mHealth in Africa for vaccination decisions. Eighteen articles [14 randomised controlled trials and 4 quasi-experiments] fulfilled the eligibility criteria, accounting for a total sample size of 21,070 [11,246 mHealth and 9,824 usual care]. Except for one study, all mHealth studies showed an improvement in childhood vaccination outcomes compared to usual care. Specifically, mHealth increased childhood vaccination by more than double (2.15 times). MHealth is more effective in less developed regions and when an additional incentive is offered with the messaging system. [Feb 2024]
   
• 10."We're Potentially Worsening Health Inequalities": Evaluating How Delivery of the 2022 London Polio Booster Campaign Was Tailored to Orthodox Jewish Families to Reduce Transmission Vulnerability
  by Ben Kasstan, Sandra Mounier-Jack, and Ana Zuriaga-Alvaro, et al.
• A 2022 polio booster campaign seeking to reach all children aged 1-9 across London, United Kingdom, was part of a national enhanced poliovirus incident response following multiple detections of vaccine-derived poliovirus type 2 isolates. Orthodox Jewish (OJ) children were particularly vulnerable to transmission. This study aimed to evaluate how the polio booster campaign was tailored to increase uptake and enable access for OJ families in northeast and north central London boroughs. Priorities emerging from this evaluation include: (i) developing messaging strategies with communities that effectively convey transmission risk and urgency to vaccinate while avoiding stigmatisation and (ii) strengthening primary care and valued delivery pathways to improve persistently low coverage rates. [Nov 2023]
   

• 11.We need a gold standard for randomised control trials studying misinformation and vaccine hesitancy on social media
  by Sander van der Linden
• "...Vaccine hesitancy and the spread of misinformation on social media have been recognised by the World Health Organization as an urgent threat to public health....However, systematic reviews show that real world interventions on social media are few and far between....Notably, the field also lacks a gold standard for randomised controlled trials (RCTs) conducted on social media. This lack of standardisation poses fundamental challenges to causal inference, raises major ethical questions, and is riddled with inequities in data access and coverage outside the global north..." [May 2023]
   
• 12.Censorship of vaccine misinformation is heavy handed and risky
  by Julie Leask
• "...Global concern about misinformation and disinformation has greatly increased in recent years....Censorship has been promoted as a method to reduce people's exposure to misinformation and disinformation. I believe this is not the answer to the misinformation problem. This blog...argue[s] that the basis for censoring anti-vaccination messages in social media is flawed, the process is prone to error, and the outcomes can be perilous. Rather, we need strategies that address the root causes of the anti-vax appeal, build trust with communities and that engage rather than alienate..." [Oct 2023]
   
• 13.Pros and Cons of Chatbot Counselling for Vaccine Hesitancy
  by Anastasiya Nurzhynska
• "...Though identified as the most trustworthy source of information on vaccination, some health workers are not proactive and vocal enough in promoting vaccination due to limited resources and weak counselling capacities. In this context, it is important to understand whether the trusted messenger role, fulfilled by doctors, may be played by chatbots....Healthcare stakeholders associate chatbot use with psychological, behavioural, health, and administrative benefits...but express concern about their [chatbots'] ability to recognise patients' emotions and respond appropriately....Health chatbots should be a supplementary service rather than a replacement of professional health expertise." [Jun 2020]
   

• 14.Why Gender Matters for Immunization: IA2030 - Second Webinar Series
• Building upon the first (2023) webinar series organised by the World Health Organization (WHO), TechNet-21, and Immunization Agenda 2030, this second series aims to further improve awareness and understanding of how gender-related barriers impact immunisation. The next webinar, which will be held on May 16 2024 (15h-16h CET), explores the topic of advancing gender equality and increasing coverage through integrated services and collaboration across sectors. Available here are registration details, access to materials from previous sessions, and information about upcoming sessions.
   
• 15.Building Alliances in Global Health: From Global to Local
• This hands-on online course, which can be started at any time, is designed to prepare learners to overcome the challenges associated with alliance building within the global health sector. It covers themes of political advocacy, policymaking, health communication, and community engagement, while exploring the interpersonal relations and political considerations required to build a global health programme. The course uses as a case study the Global Polio Eradication Initiative (GPEI). [Nov 2023]
   
• 16.VARN 2023: When Communities Lead, Global Immunization Succeeds
• In June 2023, the Sabin Vaccine Institute and UNICEF, in partnership with Gavi, the Vaccine Alliance, hosted the Vaccination Acceptance Research Network (VARN) 2023 Conference in Bangkok, Thailand. Highlighting research and policy and programmatic challenges, opportunities, and strategies related to vaccine acceptance, demand, and delivery, this conference report features examples (with hyperlinks) and case studies. In addition, all VARN2023 conference presentation recordings, posters, and other materials are available here. [Jan 2024]
   

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