Mérieux Foundation event

From package to protection: how do we close global coverage gaps to optimize the impact of vaccination?

September 22-24, 2014 - Les Pensieres Center for Global Health, Veyrier-du-Lac (France)

Summary

Vaccination coverage in both developed and developing world is still far from the expected/recommended rates. Suboptimal vaccination uptake increases not only individual risk but could also precipitate epidemics in communities and hospitals. Vaccination programs face two major challenges: coverage gaps and coverage erosion.

Access and affordability are major determinants of the former while the latter is rather influenced by awareness and acceptance. Individual attitude towards vaccination is a complex combination of several determinants, such as beliefs, perceived severity of the disease, understanding of vaccine effectiveness, socioeconomic status, past experience, etc. which together converge to subjective judgement. The attitude of physicians with regard to vaccination and the role of media could also influence individual attitudes. A better understanding of social and cognitive determinants of vaccination would allow the set-up of intervention strategies to optimize vaccine coverage.

Fondation Mérieux organized from September 22-24, 2014, the conference entitled: ’From package to protection- How do we close global coverage gaps to optimize the impact of vaccination’ in Annecy-France (hosted at “Les Pensières” Conference Center). A multi-disciplinary group of experts drawn from academia, industry, international organizations and national public health institutes, gather to explore the best options to address coverage gaps and erosion in vaccination.

The panel expert has reviewed and discussed various issues including:

  • The psychology of risk perception, decision making and emotional barriers and drivers of vaccine acceptance;

  • Ongoing studies of tools that aim at identifying drivers and barriers of vaccination:

    • The MOTIV (Motors of Trust in Vaccination) tool, a collaborative, patient centric project

    • The MoVac and MoVAds scales for vaccination motivation and vaccination advocacy among health care professionals (HCPs)

    • The PACV (Parent Attitudes about Childhood Vaccine) survey that aim at identifying, understanding and talking to hesitant parents

    • The V-ABC (Vaccine Attitudes Beliefs and Concerns) framework to measure parental vaccine acceptance

    • The 5A vaccination coverage framework that started to lay out a structured approach to a complex program with an evidence base.

  • Intervention strategies that could influence vaccine coverage such as motivational interviews between HCPs and patients, vaccine advocacy campaigns, the RED (Reaching Every District) strategy developed by the WHO;

  • Evidence-based approaches to effective communication on vaccine risk and benefits.

After the review of the current situation, the expert panel identified the following lessons learnt and the main challenges to be addressed with high priority:

Lessons learnt

  • Drivers and barriers are vaccine-dependant and should be therefore addressed by vaccine and population to tailor responses.

  • Connection with HCPs and public to meet their needs is crucial:

    • HCPs are still key to decision-making;

    • The public ask for being active partners in their decisions to be vaccinated and/or to vaccinate their children. To ensure actions that guarantee better vaccination acceptance, dialogue needs to be tailored according to the public’s needs and expectations.

  • Public health is communication.

Effective and well-oriented communication could improve awareness and vaccine acceptance. HCPs should be trained to have appropriate and essential communication skills. The public is dramatically unmoved by data; adequate communication frame is therefore important for successful understanding. Reporting numbers when communicating on benefices and risks of vaccines are necessary, but they should be few, consistent, in an adapted format with emotion.

Challenges

  • Foster a dynamic, multidisciplinary and better connected community of practice;

  • Establish vaccination acceptance as a legitimate discipline for theoretical and applied research;

  • Ensure adoption of standardized and validated tools to measure barriers and drivers of vaccine acceptance and the impact of intervention;

  • Bring all tools and manuals to ’the Matrix’;

  • Grow rigorous qualitative, quantitative, culturally and geographically balanced evidence-based on i) drivers and barriers to coverage and acceptance; ii) intervention options and iii) measuring impact of interventions;

  • Develop better communication strategies and improve communication frame.

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Program

Day 1 Monday 22 September

Day 2 Tuesday 23 September

Day 3 Wednesday 24 September

  • 18:50 - 19:30

    Keynote address: Bringing science to life, and death to pseudoscience - lessons learnt as an irreverent blogger

    Olivier BERNARD

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Session 1 Why do people get vaccinated? Time to drop our assumptions and pick up the evidence

Bruce GELLIN

  • 08:30 - 08:50

    The social and cognitive determinants of adult vaccination: a psychometrically validated tool

    Bruno RIGOLE

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  • 09:05 - 09:25

    Measuring attitutes of HCPs to vaccination and to advocating for vaccination

    Marianne PROMBERGER

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  • 09:40 - 10:00

    Identifying, understanding and talking to vaccine-hesitant parents

    Douglas OPEL

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  • 10:45 - 11:05

    Mapping vaccine hesitancy: roots, determinants and scope

    Eve DUBE

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  • 11:20 - 11:40

    A proposed measure of parental vaccine acceptance : The V-ABC

    Hal WILLABY

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  • 13:30 - 13:45

    Demonstration of the MOTIVgATE community of pratice

    Laura MILLET

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Session 2 Stop talking in tongues - engaging with the public on health & science

John PARRISH-SPROWL

  • 13:45 - 14:05

    How can we help people to make wise decisions?

    Eugenius LAURINAITIS

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  • 14:20 - 14:40

    How should society respond to the risk of vaccination hesitancy?

    David ROPEIK

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  • 14:55 - 15:15

    Bringing the public voice to the public

    Danny DARCHE

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  • 15:30 - 15:50

    Leading with the values: an intervention in a vaccine-hesitant community

    Katie ATTWELL

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Session 3 Bringing it all together : Building a practical framework to close vaccination gaps

Bruce GELLIN

  • 16:30 - 16:50

    Tools for identyfying root causes of children remaining unvaccinated

    Rudi EGGERS

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  • 17:05 - 17:25

    The 5As vaccination coverage framework: reaching target coverage through evidence-based advocacy

    Angus THOMSON

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  • 17:40 - 18:00

    Update on the NVAC working group on vaccination hesitancy

    Vish VISHWANATH

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Session 4 What works? Social & behavior change interventions that actually impact vaccination coverage

Douglas STOREY

  • 08:30 - 08:50

    Evidence based approaches to communicationg risks and benefits

    Ellen PETERS

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  • 09:05 - 09:25

    What works: strategies to close the vaccination coverage gap

    Julie LEASK

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  • 09:40 - 10:00

    Interventions for reducing parental vaccine refusal and vaccine hesitancy

    Saad OMER

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  • 15:00 - 15:20

    Equity and emerging issues in political economy in immunization in Nigeria

    Emmanuel ABANIDA

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