Four Key Recommendations For Vaccine Acceptance, Demand, and Delivery 

For decades, immunization has been a cornerstone of public health, saving countless lives worldwide. Ensuring that everyone has access to the benefits of immunization and overcoming  vaccine acceptance and demand barriers remains a complex challenge. As 2024 begins, new outbreaks of vaccine- preventable diseases and increasing vaccine hesitancy are identified by the World Health Organization as persistent  problems.

The Sabin Vaccine Institute’s Vaccination Acceptance Research Network (VARN) provides global leadership in the application and advancement of social and behavioral science insights, research, and expertise on vaccination acceptance, demand and delivery. More than 800 VARN members around the world are developing evidence-based solutions to address immunization challenges in low- and middle-income countries. VARN’s 2023 conference, held in Bangkok, Thailand, highlighted the importance of community-centered approaches to achieve vaccine equity, catch-up of routine childhood immunizations, and strengthening life-course vaccination across global settings.

Convened under the theme, “When Communities Lead, Global Immunization Succeeds,” the conference report reflects the scope of research and practice-based findings presented to the 231 attendees from 47 countries. Four key recommendations emerged from the 150 presentations and panel discussions:

Put vaccine equity and inclusion at the heart of immunization programming.

Much of the research and practice highlighted essential pathways to building vaccine confidence, demand, and uptake for all through focused tactics that assured equitable access and distribution of vaccines. Reaching marginalized populations, including persons living with disabilities, adolescent women and girls, the transgender community, indigenous communities and those in conflict settings requires inclusive and tailored solutions. It is also essential for immunizing significant numbers of zero-dose children (those who have received no routine vaccines, as measured by the proxy of a single dose of the diphtheria, tetanus toxoid and pertussis (DTP)-containing vaccine). Concerted global efforts are vital to bridge gaps and ensure these children receive life-saving vaccines, while inclusivity and active partnership with marginalized populations are crucial to breaking down systemic barriers at the core of inequities.

Prioritize communities in immunization service delivery through people-centered approaches and tools.

Narratives surrounding immunization play a pivotal role in shaping public perception. Meaningful change requires listening and being responsive to community concerns. A number of strategies successful in boosting immunization within marginalized populations presented at the conference emphasized the importance of social and behavioral science approaches. For example, human-centered design and motivational interviewing were highlighted as powerful tools to investigate the underlying psychological, sociological, and structural barriers to vaccine uptake and then co-design responsive solutions that meet community needs in a way that is culturally relevant, respectful, and impactful.

Encourage community-centric solutions.

Community-centric programs are pivotal to closing gaps created by COVID-19 pandemic disruptions that left millions of children without essential vaccines. Presenters at VARN2023 shared various community-based strategies to improve essential childhood immunization coverage. These approaches involved engaging social influencers to reach working mothers, deploying community-oriented primary healthcare models, and ensuring outreach to remote communities.

Strengthen life-course immunization through service integration.

Strengthening vaccination across an individual’s life course is increasingly crucial for comprehensive health protection. The integration of routine and life-course immunizations with primary healthcare and service delivery was identified as a key tactic for sustainable vaccination success, especially in light of the increasing introduction of new vaccines and the need for continued pandemic preparedness.

The VARN conference made clear that community-led efforts will be central to understanding community needs and co-creating solutions to boost vaccine acceptance, demand and coverage.