S1 Table -

A. Sociodemographic characteristics of study population by country. B. Vaccine Trust Index scores by sociodemographic characteristics of the study population. C. Unadjusted association between Vaccine Acceptance Index Score and Vaccine Receipt. D. Adjusted association between Vaccine Acceptance Index Score and Vaccine Receipt. (XLSX)</p

Unadjusted associations between Vaccine Acceptance Index score and intent to receive the influenza vaccine in the next influenza season*.

Unadjusted associations between Vaccine Acceptance Index score and intent to receive the influenza vaccine in the next influenza season*.</p

Vaccine Trust Indicator items.

Improved uptake of adult vaccinations could substantially reduce the burden of infectious disease worldwide, however very few countries achieve high coverage of recommended adult vaccinations. Vaccine hesitancy is an important driver of low vaccine uptake among adults but no measure currently exists to capture general vaccination attitudes in this population accurately and efficiently. We utilize data from two surveys of adult vaccine attitudes and uptake conducted in fifteen countries to evaluate the Vaccination Trust Indicator (VTI). The VTI is a six-item measure intended to capture general vaccine attitudes. We utilized multivariable logistic regression to examine the association between VTI scores and self-reported receipt of the seasonal influenza vaccine, receipt of a tetanus toxoid-containing vaccine and intent to receive the flu vaccine in the next season. In the five countries with self-reported vaccine receipt data, we found that a ten-point increase in VTI score was associated with a 50% increase in odds of influenza vaccine receipt (OR = 1.55, 95% CI = 1.48, 1.62) and 25% increase in the odds of tetanus vaccine receipt (OR = 1.26, 95% CI = 1.21, 1.30). Strong associations between VTI score and vaccine receipt were found in each country except China. A strong association between VTI score and intent to receive the influenza vaccine was found in all fifteen countries. The VTI is a promising tool for assessing adult immunization attitudes with clear and immediate uses for immunization programs globally.</div

Odds of influenza and tetanus vaccine receipt by VTI score category overall and by country *reference group = low trust in vaccines.

Odds of influenza and tetanus vaccine receipt by VTI score category overall and by country *reference group = low trust in vaccines.</p

Vaccine Acceptance Index Scores by country and sociodemographic characteristics.

Vaccine Acceptance Index Scores by country and sociodemographic characteristics.</p

sj-pdf-1-bsx-10.1177_23794607231192690 – Supplemental material for Using communication to boost vaccination: Lessons for COVID-19 from evaluations of eight large-scale programs to promote routine vaccinations

Supplemental material, sj-pdf-1-bsx-10.1177_23794607231192690 for Using communication to boost vaccination: Lessons for COVID-19 from evaluations of eight large-scale programs to promote routine vaccinations by Heather Barry Kappes, Mattie Toma, Rekha Balu, Russ Burnett, Nuole Chen, Rebecca Johnson, Jessica Leight, Saad B. Omer, Elana Safran, Mary Steffel, Kris-Stella Trump, David Yokum and Pompa Debroy in Behavioral Science & Policy</p

Additional file 1 of MomsTalkShots, tailored educational app, improves vaccine attitudes: a randomized controlled trial

Additional file 1: Appendix 1. Impact of MomsTalkShots on Vaccine KABs of Women One Month After Their Infant's Birth individual survey items, organized by constructs, stratified by baseline vaccine intentionsa, dichotomous analysisb. Appendix 2. Impact of MomsTalkShots on Vaccine KABs of Women One Year After Their Infant's Birth individual survey items, organized by constructs, stratified by baseline vaccine intentionsa, dichotomous analysisb. Appendix 3. Impact of MomsTalkShots on Vaccine KABs of Women One Month After Their Infant's Birth individual survey items, organized by constructs, stratified by baseline vaccine intentionsa, continuous analysisb. Appendix 4. Impact of MomsTalkShots on Vaccine KABs of Women One Year After Their Infant's Birth individual survey items, organized by constructs, stratified by baseline vaccine intentionsa, continuous analysisb. Appendix 5. Impact of MomsTalkShots on Women's Perceived Risk of Infant Pertussis One Month After Their Infant's Birth individual survey items, stratified by baseline vaccine intentionsa and Tdap vaccination, dichotomous analysisb. Appendix 6. Impact of MomsTalkShots on Women's Perceived Risk of Infant Pertussis One Year After Their Infant's Birth individual survey items, stratified by baseline vaccine intentionsa and Tdap vaccination, dichotomous analysisb. Appendix 7. Survey Initiation and Completion stratified by study arm. Appendix 8. Follow-Up Survey Completion stratified by maternal and infant vaccine intentions at baseline. Appendix 9. Response Rates for Vaccine KAB Constructs at Each Study Timepoint. Appendix 10. Maternal and Infant Vaccine Intentions at Baseline stratified by 4 study arms

Second dose COVID-19 vaccination coverage in the 25 city districts in Pakistan during the study.

Second dose COVID-19 vaccination coverage by city district during the study period. The vertical lines at week 18 and 24 mark the start and the end of the intervention period.</p

Associations between the intervention and self-reported COVID-19 vaccine uptake in Ukraine.

Associations between the intervention and self-reported COVID-19 vaccine uptake in Ukraine.</p

Questionnaire for Ukraine.

Social media platforms have a wide and influential reach, and as such provide an opportunity to increase vaccine uptake. To date, there is no large-scale, robust evidence on the offline effects of online messaging campaigns. We aimed to test whether pre-tested, persuasive messaging campaigns from UNICEF, disseminated on Facebook, influenced COVID-19 vaccine uptake in Ukraine, India, and Pakistan. In Ukraine, we deployed a stepped-wedge randomized controlled trial (RCT). Half of the 24 oblasts (provinces) received five weeks of the intervention, the other half ten weeks of the intervention. In India, an RCT with an augmented synthetic control was conducted in five states (Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan), whereby 40 out of 174 districts were randomized to receive six weeks of intervention. In Pakistan we deployed a pre-post design, whereby 25 city districts received six weeks of the intervention. Weekly COVID-19 vaccination data was sourced through government databases. Using Poisson regression models, the association between the intervention and vaccine uptake was estimated. In Ukraine we conducted a survey among Facebook users at three time points during the RCT, to ascertain vaccination intentions and trust in vaccines. The campaigns reached more than 110 million Facebook users and garnered 2.9 million clicks. In Ukraine, we found that the intervention did not affect oblast-level vaccination coverage (Relative Risk (RR): 0.93, 95% Confidence Interval (CI) 0.86–1.01). Similarly, in India and Pakistan we found no effect of our intervention (India: RR 0.85, 95% CI 0.70–1.04; Pakistan: RR 0.64, 95% CI 0.01–29.9). The survey among Facebook users in Ukraine showed that trust in vaccines and information sources was an important predictor of vaccination status and intention to get vaccinated. Our campaigns on Facebook had a wide reach, which did not translate in shifting behaviours. Timing and external events may have limited the effectiveness of our interventions.</div