Sociocultural and behavioural features of anticipated COVID-19 vaccine acceptance in Papua New Guinea: a mixed methods study proposal

BACKGROUND: Coronavirus disease 2019 (COVID-19) was characterised by the World Health Organisation (WHO) as a pandemic in 2020. Papua New Guinea (PNG) has remained on high alert ever since its National Control Centre continues to coordinate national preparedness and response measures guided by its Emergency Preparedness and Response Plan for COVID-19. As part of the WHO, Gavi and other global partners' COVAX program, PNG received several COVID-19 vaccine doses. A national-wide vaccine roll-out for COVID-19 was initiated in PNG in May 2021. Despite the availability of vaccines and the capacity of health systems to vaccinate frontline workers and community members, including high-risk groups, questions on vaccine safety, confidence, and acceptance remain critical for the effectiveness of the COVID-19 vaccination campaign. Evidence from studies on COVID-19 vaccine acceptance and demand in low- and middle-income countries (LMICs) suggests that sociocultural factors of the community and behaviours of different vaccine stakeholders, including vaccine recipients, vaccine providers and policymakers, determine the effectiveness of vaccination interventions or strategies. OBJECTIVE: This study will examine sociocultural determinants of anticipated acceptance of the COVID-19 vaccine in the population of urban and rural areas of different regions in PNG, and healthcare providers' views on vaccine acceptance. METHODS: The study design includes a mixed methods approach to implement in PNG's coastal and highlands regions. The first research activity will use a qualitative methodology in which the epistemological foundation is based on constructivism. This design elicits and listens to community members' accounts of ways culture as a rich source provides meaning to the COVID-19 pandemic, adherence to 'niupela pasin' (New normal) and vaccination acceptance. The second activity will be a cross-sectional survey to assess the distribution of features of vaccine acceptance, priorities and practices. The third activity will be in-depth interviews of healthcare providers actively involved in either COVID-19 clinical management or public health-related pandemic control activities. RESULTS: The project proposal has been reviewed and approved by the Medical Research Advisory Committee of Papua New Guinea. The qualitative data collection started in December 2022 and the survey will begin in May 2023. The findings will be disseminated to the participated communities later this year followed by the publications. CONCLUSIONS: Proposed research on community views and experience concerning sociocultural and behavioural features of anticipated acceptance of the vaccine will provide a better understanding of communication and education needs for vaccine action for COVID-19 control in PNG and other LMICs. The research also considers the influence of healthcare providers' and policymakers' roles in the awareness and use of the COVID-19 vaccine. INTERNATIONAL REGISTERED REPORT: PRR1-10.2196/44664

Antenatal influenza vaccination in urban Pune, India: clinician and community stakeholders' awareness, priorities, and practices

The World Health Organization (WHO) recommends antenatal influenza vaccination (AIV) for pregnant women at any stage of pregnancy. This study assessed fundamental aspects of AIV acceptance and demand among key stakeholders in urban Pune, India. Semi-structured interviews for rapid ethnographic assessment of AIV-related awareness, priorities, and practices were used to study clinicians and their communities of practice. A qualitative survey was conducted among 16 private clinicians providing antenatal care (ANC) in slum and middle-class areas of Pune. Following the survey, clinicians were informed about authoritative AIV recommendations. A qualitative community survey was also conducted with 60 women aged 20-35 years and 30 spouses from the same slum and middle-class practice areas of the ANC providers. Subsequently, a second clinician survey was conducted to assess changes in clinicians' awareness, priority, and vaccination practice. After this interview, clinicians were informed of community survey findings. Most community respondents were unaware of AIV, in contrast with well-known and widely used antenatal tetanus vaccination. They expressed confidence in vaccines and trust in the clinicians. Clinicians' advice was reportedly the most important determinant of community vaccine acceptance. Clinicians were confident of the safety of AIV and they anticipated patients' acceptance if recommended. The second clinician interview showed increased awareness of AIV policy, but clinicians were more skeptical about the severity of maternal influenza in their practice. Our findings indicate community acceptance though not demand for AIV. We recommend five essential elements for vaccination program strategies to improve coverage with AIV and other ANC vaccines