Research On Vaccine Uptake

Understanding the socio-cultural issues around perception and attitudes of the local community towards vaccination.

Background

The Expanded Program on Immunization (EPI) was introduced in Vietnam in 1983, followed by the maternal and neonatal tetanus initiative in 1995: both aiming to eliminate vaccine preventable diseases in infants and children. Reported coverage of these vaccines is high but a continual low-level rate of neonatal tetanus and sporadic outbreaks of other diseases such as diphtheria and measles indicate that there are significant gaps in the vaccination program.

Recent studies by local Preventative Medicine Centre (PMC) and OUCRU indicate that ethnic minority rural communities have the lowest vaccination coverage and that there may be specific cultural and ethical issues surrounding acceptance and uptake of vaccinations, in addition to the practical difficulties in implementing an immunization program in remote communities. We are currently undertaking research to understand the practical constraints and attitudes and cultural issues surrounding vaccination uptake in two rural communities in Binh Phuoc and Dak Lak Provinces.

Better understanding of attitudes and cultural issues around tetanus vaccination may allow the implementation of more effective vaccine-delivery programs and also allow us to understand more about vaccine hesitancy in Vietnam. In 2013, media reports of adverse events following vaccination resulted in an absolute reduction in EPI vaccination in Vietnam of 35%. The public health consequences of this are as yet unknown but are likely to be significant as there is no provision for ‘catch up’ or booster vaccinations. As more vaccines become available it is increasingly important to fully understand beliefs and perceptions about vaccination to be able to address misconceptions and implement effective public health measures.

What we do

Qualitative and quantitative research

Qualitative and quantitative research on perception and attitudes of women of child-bearing age and mothers towards vaccination. We conduct surveys, together with in-depth interviews, key informant interviews and focus group discussions. Our questions include those about vaccination uptake, about the purpose of vaccination, and other health-related behaviours of the target population and the availability of health services within the local area.

Community engagement activities

Based on findings from the research phase public engagement (PE) activities will be designed to communicate about vaccinations. CE activities will be conducted by local PMC health staff in advance of their annual vaccination programme. Engagement activities may include posters and leaflets in local languages, cartoon-based leaflets, translation of health messages into local languages, village meetings or small dramas with school children. CE activities will be low cost so that they can be rolled out to other areas if shown to be effective.

Evaluation of community engagement activities

The effectiveness of community engagement activities will be assessed through a comparison of vaccine uptake rates between 20 communes receiving enhanced CE and 20 communes with regular promotion activities conducted by local health services. A second phase of interviews of women and health staff involved in the vaccination programme will be conducted to inquire about their experience of the enhanced programme.

Highlights

  • In total, there will be more than 500 women surveyed.
  • Over 90 women and key stakeholders will be interviewed.
  • Community engagement activities will be conducted in 23 communes in Binh Phuoc and Dak Lak provinces.