Virtual Meeting on Improving Vaccine Uptake - Issues of Access and Hesitancy

This video recording - along with presentation slides - emerges from a virtual meeting on vaccine access and hesitancy, and the causes and effects of declining confidence in vaccines. Organised by the Forum on Microbial Threats of the National Academies of Sciences, Engineering, and Medicine (National Academies), the meeting is the first of a series of two workshops examining the current state of vaccine-preventable diseases (VPDs) and the impact of vaccine access and hesitancy globally.

The virtual workshop featured invited presentations on questions of improving access to vaccines, creating demand for vaccines, and understanding vaccine hesitancy. Speakers gave particular attention to the role of social determinants of vaccine use and equitable distribution of vaccines. The presentations and moderated panel discussion that followed covered the following topics:

• The global impact of declining immunisation rates on VPDs due to lack of access and confidence;
• Trends and indicators to monitor attitudes surrounding vaccine safety and efficacy, including a focus on regional and cultural differences;
• The complex determinants of vaccination that hinder or promote vaccine uptake;
• The role of health systems and professionals in improving access, influencing vaccine behaviour, protecting at-risk communities from VPD outbreaks, and preserving and building confidence in immunisation strategies and practices;
• The role of media, anti-vaccine networks, and online misinformation in reinforcing anxieties about vaccine safety and drivers of vaccine hesitancy;
• Strategies to enhance community-based approaches and community engagement efforts for improving access and reducing vaccine hesitancy;
• Communication approaches that could help assuage anxieties about vaccine safety and strengthen public trust in science and health professionals;
• The ethics and effectiveness of legislation that aim to address vaccine hesitancy; and
• Potential priority actions, as well as partnerships and collaborations among policymakers, health professionals, national and international health organisations, parents, and community groups, to increase immunisation access and vaccine confidence.

Specifically, the agenda included:

• Welcome remarks: Peter Daszak, Chair of the Forum on Microbial Threats, and President of EcoHealth Alliance
• Workshop overview and goals: Matthew Zahn, Workshop Co-Chair, and Medical Director, Division of Epidemiology and Assessment, Orange County Health Care Agency
• Vaccine Access and Creating Demand: Robin Nandy, Principal Advisor & Chief of Immunizations, United Nations Children's Fund (UNICEF) - click here in order to download Dr. Nandy's slides in PDF format (25 pages). Dr. Nandy calls for, in part for:
  • Tackling inequities to address stagnation and target areas with greatest burden of disease;
  • Addressing supply and demand together to overcome barriers to vaccination; and
  • Trying to "reimagine" immunisations and "build back better" in light of the fact that the COVID-19 pandemic will set the effort back on coverage and equity substantially. This will entail, for example, regaining erosion of trust in health systems and holistically addressing the needs of the most vulnerable.
• Understanding Vaccine Hesitancy: Eve Dubé, Senior Researcher, National Institute of Public Health of Quebec, and Invited Professor, Laval University, Department of Anthropology - click here in order to download Dr. Dubé's slides in PDF format (29 pages). A few points from her presentation:
  • Vaccine hesitancy is an important public health challenge - much more so than vaccine refusal or the anti-vaccine movement.
  • Though information and education are important, they are not enough to address this issue. For example, stories can be powerful because they are authentic, contain a narrative, and are from someone with whom parents can identify.
  • Healthcare providers' role is crucial, and they need to be supported (some of them being vaccine hesitant themselves).
  • Vaccine hesitancy is context-specific, so we need to identify areas with low vaccination coverage, investigate reasons for this, and address underlying issues (not always individual-based).
• Improving Access to Vaccines: Lessons from the US Immunization Program: Nancy Messonnier, Director, National Center for Immunization and Respiratory Diseases, United States (US) Centers for Disease Control and Prevention (CDC) - click here in order to download Dr. Messonnier's slides in PDF format (31 pages). She discusses, among other topics, Vaccinate with Confidence, which is the CDC's strategic framework for strengthening vaccine confidence and preventing outbreaks of VPDs in the US. Among the priorities for 2020 are to:
  • Leverage diverse data sources to find and protect communities at risk;
  • Expand resources for working with communities;
  • Build and foster a culture of immunisation in healthcare practices;
  • Provide technical assistance to funded partners and further invest in vital partners; and
  • Strengthen communication strategies - for example, they are disseminating messages about the importance of well-child visits and routine immunisations during the COVID-19 pandemic and working to understand public perceptions and develop communications messages in preparation for future COVID-19 vaccines.
• Panel discussion with speakers: Heidi Larson, Workshop Co-chair and Moderator; Professor of Anthropology, Risk and Decision Science, London School of Hygiene & Tropical Medicine; and Director, The Vaccine Confidence Project.

The second part of the workshop, to be held online August 17-20 2020, will explore health systems, research opportunities, communication strategies, and policies that could be considered to address access, perceptions, attitudes, and behaviours toward vaccination. To learn more about the virtual event and to register, click here.