Strengthening Confidence in Vaccines, Demand for Immunization and Addressing Vaccine Hesitancy

"Health workers in Europe and Central Asia have stated that they need more support to work with vaccine hesitancy caregivers..."

Reasons for vaccine hesitancy or poor vaccine uptake vary across communities and contexts. Although there may be a multitude of factors leading to vaccine hesitancy among caregivers/vaccine recipients, health workers have the power to influence some of these factors. Developed by the United Nations Children's Fund (UNICEF) Europe and Central Asia Regional Office (ECARO), this regional guidance is intended to build health workers' interpersonal communication (IPC) competencies to strengthen confidence in and demand for immunisation and identify and address vaccine hesitancy. It is part of a training package on IPC for immunisation that was developed and tested in collaboration with John Hopkins Center for Communication Programs in 2018. The goal is to address health workers' bias, build on participants' experiences, promote step-by-step skills building, and reinforce skills and self-efficacy through practice.

The guidance provides techniques, tools, algorithms, and tips that users can use at any point before, during, and/or after interactions to strengthen the consultation between themselves and their clients, build trust, and reinforce themselves as reliable and accessible source of information. For example, some of the tips provided in the section of the guidance titled "Algorithm for Communication and Engagement" include: Open Door, Open Ears; Opt-Out Approach; Strong Recommendation Phrases; CASE Approach; Open-Ended Questions; Elevator Phrases; and Door Handle Phrases. Strategies such as use of non-verbal communication and reflective listening are also covered, and examples are provided throughout.

Expected results include: understanding and applying the key principles on communicating with caregivers/vaccine recipients; learning and practicing skills to listen and engage in conversations aimed at increasing vaccination uptake; improving health workers' confidence and ability to effectively respond to caregiver/vaccine recipient needs and concerns regarding vaccine safety and effectiveness, based on evidence; and increasing use of dialogue-based communication to increase immunisation rates.

The document could be a resource for trained frontline workers (FLWs) to refer to if and when they need clarification. In addition to health workers-caregiver interaction, these proposed approaches and tools are also valid for the health workers-COVID-19 vaccine recipient interaction, as well as other potentially new vaccines, with consideration of audiences, their concerns, informational needs, and expectations.