How to build vaccine confidence in crisis situations
Heidi J Larson, PhD Professor of Anthropology & Risk Director, The Vaccine Confidence Project London School of Hygiene & Tropical Medicine There are different kinds of crisis
Outbreaks, natural disasters, conflicts and other human-made confidence crises
There are complex, multiple crises
Each has different implications https://www.independent.co.uk/independentpremium/world/covid-vaccine-doses-latest-syria-yemen-b1772464.html Background crises matter
They frame public trust Colombia: Girls fainting after HPV vaccination in Region with history of violence and sexual abuse
HPV vaccine coverage rates and expected number of cases of cervical cancer and of deaths prevented
98% 100 90 88% 88% COLOMBIA 81%
80 (%) 70 2003 88% 61% 60 60% 1 dose coverage→
coverage Full regime 50 45% 4300 cases1900 40 deaths averted
vaccine 30 24%
20 14% HPV HPV 10 5% 0 2012 2013 2014 2015 2016 4th graders: 4th graders: 2007: 5% 4th graders: 9 yo. 9 yo. coverage→ + 9 yo. Catch-up casos 5th-11th graders 220 10-17 yo. averted
Elaboración propia con datos procedentes del Ministerio de Salud Background confidence matters
https://www.theguardian.com/society/2019/jun/19/survey-shows-crisis-of-confidence-in-vaccines-in-parts-of-europe
[email protected] Across Africa, confidence in vaccine safety is well below importance Vaccines are Important? Safe? Vaccines are Important? Safe? Vaccines are Important? Safe?
Algeria 65% 43% Ghana 88% 78% Niger 79% 74% Benin 79 64 Guinea 81 64 Nigeria 91 83 Botswana 91 75 Ivory Coast 76 57 Rep Congo 84 63 Burkina 83 56 Kenya 89 76 Rwanda 94 82 Faso Liberia 92 87 Senegal 87 61 Burundi 95 82 Madagascar 83 73 Sierra Leone 90 84 Cameron 84 58 South Africa 82 68 Chad 68 57 Malawi 95 89 Swaziland 85 58 Comoros 89 79 Mali 82 59 Tanzania 94 85 DR Congo 82 66 Mauritania 81 64 Togo 72 33 Ethiopia 96 86 Mauritius 84 45 Uganda 89 75 Gabon 73 42 Mozambique 85 76 Zambia 84 69 Gambia 89 82 Zimbabwe 90 74 Namibia 84 71 Data collected between 2016-2018 using Vaccine Confidence Index™ Representative sampling by phone, internet or house visit in local language [email protected] 2015 2018
Lancet. 10 Sept.2020. A. de Figueiredo*, C Simas*, E Karafillakis, P Paterson, [email protected] HJ Larson “If a new Coronavirus (COVID-19) vaccine became publicly available, I would take it.” Agree/Disagree 100% 9% 5% 6% 6% 5% 5% 10% 13% 14% 13% 11% 14% 13% 14% 90% 10% 14% 12% 18% 8% 9% 5% 14% 13% 6% 5% 9% 5% 11% 80% 7% 8% 13% 9% 10% 27% 9% 6% 7% 8% 11% 36% 11% 11% 9% 70% 11% 10% 43% 11% 45% 34% 60% 37% 31% 29% 34% 37% 35% 24% 21% 50% 37% 36% 31% 35% 34% 40% 78%
30% 32% 55% 44% 45% 44% 44% 44% 20% 41% 40% 41% 38% 39% 32% 32% 35% 30% 27% 10% 15%
0%
Ecuador Total Ethiopia India SaudiArabia South Korea Nigeria Brazil Argentina UK Lebanon Peru Pakistan Italy Germany USA France DRC
Strongly Agree Agree Disagree Strongly Disagree Don't know
Q11. Imagine a new vaccine for Coronavirus (COVID-19) was fast tracked and approved by medical professionals and regulators. How strongly do you agree or disagree with the following statements - If a new Coronavirus (COVID-19) vaccine became publicly available I would take it. Base = all respondents (Total = 19,243; All countries n = 1000 1,577 except DR Congo = 500; USA = 2,500. All fieldwork conducted between 10 June and 22 July 2020, exact dates vary by country). Values <3% not labelled.
[email protected] Multiple issues will affect public confidence and willingness to vaccine in times of crisis Denialism 2014
2020
Uncertainty, rumours
Media monitoring to track and analyze rumours that suspended two Ebola vaccine trials in Ghana
21 community engagement identification tools mobile technology For participant This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking which receives support from the European Union’s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations (EFPIA). follow up www.imi.europa.eu 22 https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2017/spars-pandemic-scenario.pdf
Risk assessment/Response Unit Mitigating risk, building confidence, saving lives
Case Studies Surveys, Regional In-depth Focal points interviews Research Quarterly Risk Analyses assessment reports (as well as ALERTS) Ongoing monitoring Online monitoring Strategy adaption and listening Responsive/nimble Tailored Recommended action
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[email protected] “Personal stories and emotional testimonies have become the new landscape of ‘evidence’”