The Role of Health Teams in Achieving a Successful Vaccination Campaign

"A poorly-planned vaccination campaign - without awareness for the cultural environment or strong local leadership - may risk failing to reach minimum coverage levels."

This chapter in a book published by the Sabin Vaccine Institute looks at resistance to vaccines in the Latin American region and proposes communication strategies to address the problem.

According to the author, journalist Ana María Morales, the resistance is influenced by various factors: dissemination of dubious or contradictory information on the part of the media and social networks; decrease in risk perception of diseases prevented by vaccines; immunisation programmes whose importance has not always been properly communicated to the public; greater knowledge about side or adverse effects as well as accidents or errors in supply; pressure of opinion leaders; lobbying by anti-vaccination groups; and mistrust toward pharmaceutical companies.

As Morales explains, in 2013, one example of the impact of anti-vaccination lobbying campaigns was seen in Chile with the passing of the law prohibiting thimerosal as a preservative in vaccines. The influence of these sectors resulted in a group of parliamentarians from different political paths presenting a bill that was approved by Congress, notwithstanding the fact that stewardship around this issue belongs to the Ministry of Health. The initiative was voted on without consideration for the concerns raised by the Pan American Health Organization (PAHO) and the scientific associations, and the law had to be vetoed by the President of the Republic. The incident led to a loss of confidence in the national immunisation programme, as evidenced by a decrease in coverage figures. There were disputes between parents who refused to have their children vaccinated and the health services, which had to be settled in court.

Noting that communities are increasingly demanding trustworthy and specialised evidence regarding vaccines, Morales stresses that education campaigns should transmit accurate information while also stimulating, listening, and transferring responsibility for self-care to the public. In planning such campaigns, it is a mistake to assume that whatever worked in other countries is perfectly applicable to the local situation, without considering the distinct idiosyncrasies at the local level. For example, the inclusion of a new vaccine in an immunisation plan, such as the human papillomavirus (HPV) vaccine, without previously assessing all local scenarios is a setup for failure.

The communication strategy for a vaccination campaign should involve the following actions, according to Morales:

• Review the situation before introducing a new vaccine into the immunisation plan or changing a pre-established schedule.
• Identify the problems and implement actions to anticipate an eventual challenge by other stakeholders opposing the measure. Within this context, assess the level of prejudices in connection with the vaccines within a specific population.
• Define a work strategy with constant communication strategies to create conditions fostering a policy change and a constant assessment of the actions.
• Designate strategic allies or partners to technically endorse the work being developed, such as international agencies, scientific associations, professional associations, civil society organisations, or other public or private agents. Ask them to participate in the campaign and speak independently.
• Design the health network so that every technical team manages the same information promptly; determine the tasks to be completed by the authorities and technical officials in the field.
• Hold a press conference to provide context for the significance of vaccination and to show cases of people impacted by the disease or the adverse effects; visit various health centres to verify immunisation coverage and focus the message on the groups that are lagging the most; and add credible spokespersons supportive of the initiative to the campaign.
• Promote strategies that bring vaccination closer to people through discussions at schools or other educational institutions, grassroots organisations, elderly care centres, and patient associations so that individuals can ask questions and have their doubts addressed.
• Reach out to people where they are rather than waiting for them to go to the health clinic. Depending on the intended population, this can be achieved through mobile vaccination units or visits to neonatal wards, preschools, schools, or elderly care centres.
• Deliver information to the public not only through the national media but also through community media outlets. Provide communications material for them to use, promote interviews with technical spokespersons as part of radio programmes, and develop key messages that can be replicated on social networks and web pages.

When communicating, the following are important to keep in mind, per Morales:

• Address individuals' concerns in form and substance; this entails active listening.
• Use straightforward, clear language, and define key phrases for people to remember - in particular, the importance of protecting the family.
• Choose spokespeople who are credible, empathetic, and honest when faced with an adverse situation; challenges need to be acknowledged.

Click here for the 6-page chapter in English in PDF format.
Click here for the 6-page chapter in Spanish in PDF format.