Global disruptions to routine vaccination occurred during the COVID-19 pandemic setting vaccination programs back decades, risking future disease outbreaks and resurgence of vaccine preventable diseases. Sixty-seven million children missed one or more vaccines during the pandemic and vaccine confidence has declined globally. The pandemic also highlighted gaps in vaccine infrastructures and their ability to meet people where they are. Resilience of vaccine programs is critical to achieving and protecting high vaccination rates in the face of adversity, such as political unrest, as well as public health and natural disasters. This will require a coordinated effort across stakeholders, which is why on April 3, 2023, the World Vaccine Congress hosted a workshop to discuss this pressing issue.
This session brought together varied voices to discuss key barriers and identify opportunities for action to improve vaccination coverage rates (VCRs). The nearly 100-person audience represented individuals across sectors including government, academia, non-profit, consulting firms, and more.
To ground the discussion, the audience reported what concerned them most about the current state of the vaccination ecosystem.
Consistently, attendees highlighted four key areas of concern:
- Misinformation about vaccination
- Low coverage rates and missed cohorts due to the pandemic
- Politicization of vaccination
- Roll-back of and threats to foundational vaccination policy
Keeping these concerns in mind, the session transitioned to a discussion surrounding solutions, to improve VCRs. To ignite thinking, a panel representing diverse organizations presented innovative strategies their respective organizations are leading across these very issues.
The core themes of each panelist presentation:
- Vaccine promotion through community-based efforts at schools as a center of health access and education; Diana Martin, Alliance for a Healthier Generation
- Prioritization of adolescent vaccination through consistent, confident, and concise recommendations; Judy Klein, UNITY
- Improving equity by creating a vaccine movement that moves to drive action and meets diverse stakeholders where they are; Synovia Moss, National Council of Negro Women
- Resilient immunization programs that can withstand shocks to the system through resource availability, awareness, adaptiveness, integration, and self-regulation; Aomesh Bhatt, Oxford University
- Immunization related training for pediatricians to improve response to vaccine hesitancy; Janna Patterson, American Academy of Pediatrics
Following the panel, the session further explored strategies to achieve and maintain VCRs via five breakout groups centered around key themes: Confidence, Resilience, Data-informed Strategies, Equity, and Stakeholder Engagement.
The following areas were identified as critical enablers to achieving and maintaining high VCRs:
- Diversity of partnerships is key
- Ensure diverse voices are reflected in decision making and that leaders across different backgrounds are empowered to be the voice of the equity movement.
- Data is critical
- Enhance, leverage, and sustainably resource immunization information systems (vaccine registries) to be able to accurately determine patient vaccination needs at the point of clinical care. It is equally important that immunization information systems actively track and monitor vaccination rates to understand gaps within communities at the population health level.
- Vaccination should be a no-brainer
- Ensure vaccination services are conveniently accessible (e.g., expanded hours; vaccine only visits; complimentary sites like pharmacies; pop-up clinics).
- The message and the messenger matters
- Ensure campaigns and messages are tailored to meet the audience’s needs, resonating with their values, and further delivered by existing trusted messengers (e.g., community health works; community leaders; school leaders etc.).
- Realization requires resources
- Ensure immunization programs, providers, and diverse partners are adequately and sustainably resourced and staffed to meet community vaccination needs. Programs require robust supply chains and distribution networks to make sure vaccines are accessible to all populations and different access points.
 UNICEF. (2023). “The State of the World’s Children.” https://www.unicef.org/reports/state-worlds-children-2023.
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