Tina D Purnat

Public health

Health misinformation

Infodemic management

Digital and health policy

Health information and informatics

Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat

Public health

Health misinformation

Infodemic management

Digital and health policy

Health information and informatics

Blog Post

With maturity, immunization programmes become more vulnerable to the information environment

Next week I’ll be at Les Pensiers for a symposium on lessons learned from COVID-19 pandemic and promotion of vaccine demand. As always, I run all vaccine and related topics by Elisabeth Wilhelm.

Here’s a slide we’ve come up with.

The figure is often used to describe the evolution of an immunization programme, from introduction of a new vaccine through to the eradication of the disease.

I put the red marks on the time points where investment into communication and engagement is usually made – at the vaccine introduction, during an outbreak, and in last-mile efforts toward eradication.

But there’s several challenges with this.

Vaccine coverage plateaus the closer it is to full coverage and eradication. When the coverage dips because of complacency, supply and access issues this triggers an outbreak, which is often accompanied by loss of confidence in the vaccine.

At the same time, as more people get vaccinated, more adverse events following immunization become publicized, and the disease becomes rarer which affects risk perception of the population and their attitudes towards vaccination. For example, many people still question why they need to get their children vaccinated against polio, even if polio cases have not been seen for decades in their country.

The irony is, the more successful the immunization progamme is, the more out of sight out of mind the diseases are that are prevented through vaccination. This means that when an outbreak does occur or an AEFI is sensationalized, news and information about these events can stir up confusion, misinformation, concerns and questions.

Because they are rare, they become “newsworthy” or “worthy of sharing”. If left unmanaged, this can snowball into narratives that ultimately erode confidence in vaccines, health workers and the health system, and can make it seem that elimination or eradication is a pipe dream.

People in the polio programme know this very well. Unfortunately, the long march towards the eradication of this paralyzing disease has been going on for decades and, still, misinformation and harmful narratives continue to perpetuate, affecting campaigns.

Bottom line, we would be managing this a lot better if we had better, rapid and continuously available subnational data on social listening for infodemic insights and socio-behavioral factors that would inform rapid and more effective communication and community engagement.

More importantly, listening and understanding individual family and community information needs and perceptions can also help health programmes design more responsive and acceptable services and prevention programmes.

Going back to the polio example, they did exactly this.

In some places, where the polio virus was still circulating, some communities were subject to endless-seeming polio campaign rounds, where they were told each time that their children were receiving safe and effective doses of vaccines that prevented polio. This led to a loss of trust because a lot of other health and development needs were going unmet even if polio vaccines arrived like clockwork. And this damaged the relationship between these communities and the health system.

In response, giving people what they were asking for (other social, health and development services), such as safe water, nutrition, access to education, and other child health services, proved to be effective.

This is an example of social listening at its best because social listening was followed by systemic action that actually met people’s needs.

I wrote this blog as part of preparation of my talks at a Vaccine Confidence symposium at Le Pensiers, Fondation Merieux.