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Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers

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EXECUTIVE SUMMARY

Introduction

The COVID-19 Scholar Peer Hub is a digital network hosted by The Geneva Learning Foundation (TGLF). In April 2020, during the COVID-19 outbreak, a group of more than 600 national and sub-national immunisation staff who were graduates of TGLF’s immunisation programme (in which learners are referred to as ‘Scholars’) were mobilised to co-design the Peer Hub. The project called on colleagues working on immunisation at sub-national and national levels whose activities had been affected by the pandemic. After three months of development, the COVID-19 Peer Hub launched in July 2020. It connects over 6,000 health professionals from 86 countries, across system levels and national and organisational boundaries, to contribute to strengthening skills and supporting implementation of country COVID-19 plans of action.

Following launch of the hub, a first peer-reviewed exercise was conducted, focusing on recovery from disruption of immunisation services. In October 2020, TGLF determined that COVID-19 vaccine introduction would become a critical focus of action for the network. As a result, COVID-19 Peer Hub participants, working closely with TGLF and its global partners, developed a second peer review exercise to develop case studies based on network members’ practical experience overcoming barriers to vaccine acceptance. Over four weeks in November 2020, 734 Peer Hub participants developed, peer reviewed, and revised case studies describing and analysing a situation in which they had helped an individual or group overcome initial hesitancy or fear of vaccination, leading to vaccine acceptance. The primary purpose of the case studies was to foster reflective learning between peers, many of whom were likely to become involved in COVID-19 vaccine introduction.

In developing their case studies, participants were instructed to refer to a rubric that combined instructions and guidance, reflective questions, and checklists to guide the exercise. The rubric was designed to support the participant to tell their story so that ‘a complete stranger should be able to make sense of your situation, what you did, when and where, how, and why’. Each case study recorded specific demographic information, including the participant’s country, organisational affiliation, health system level and, where possible, the GIS coordinates of the locality described in the case study. Guided by the rubric, participants were required to critically analyse aspects of the experience they described, including the context, innovation of their approach, limitations and risks, generalisability and insights. Each case study was peer-reviewed by three other participants. Participants who successfully completed their own case study and peer reviewed three other case studies were awarded a Level 1 certificate of participation from TGLF’s COVID-19 Peer Hub.

Although the case studies were primarily a tool to foster reflective peer learning, the first-person narratives they included are a valuable body of evidence, capturing the realities of how local health professionals achieve acceptance of vaccines and vaccination with individuals and groups in the communities they serve.