3 research outputs found
Misinformation, infighting, backlash, and an âendlessâ recovery; policymakers recount challenges and mitigating measures after a vaccine scare in the Philippines
Background Vaccine scares undermine longstanding global health achievements. Remarkably little data has documented the lived experiences of policymakers working amidst vaccine scares and navigating their fallout. As a result, chances and challenges of large-scale national recuperation efforts are poorly understood. Objective This study aims to explore the perspectives of policymakers involved in ongoing efforts to boost vaccine confidence in the Philippines following a 2017 Dengvaxia scare and the current COVID-19 pandemic. Methods Between August and November 2020, we conducted 19 semi-structured narrative interviews with purposively selected policymakers from governmental agencies and non-governmental organizations in the Philippines. Interviews were conducted online, transcribed, and analyzed following the tenets of reflexive thematic analysis. Results We present results as an emerging model that draws on a chronology conveyed by policymakers in their own words. The Dengvaxia scare proved âa decisive wedgeâ that splintered Filipino society and pitted governmental agencies against one another. The scare stoked distorted vaccination narratives, which were âaccelerated rapidlyâ via social media, and ignited feelings of uncertainty among policymakers of how to convey clear, accurate health messaging and how to prevent drops in care-seeking more broadly. Conclusions Efforts to regain trust placed exceptional burdens on an already-strained health system. Respondent-driven recommendations on how to reinforce vaccine confidence and improve vaccination rollout include: developing clear vaccine messages, fostering healthcare providersâ and policymakersâ communication skills, and rebuilding trust within, toward and across governmental agencies. Further research on how to build enabling environments and rebuild trust in and across institutions remains paramount
Human-centred design bolsters vaccine confidence in the Philippines: results of a randomised controlled trial
Background The publicâs confidence in vaccinations has eroded, and anti-vaccination movements have gained traction around the world, including in the Philippines. âSalubongâ, a Filipino term, refers to welcoming someone back into oneâs life and elicits ideas about friendship and family relationships. We extended this concept to vaccines in efforts to design an intervention that would re-welcome vaccines into homes.Methods Using human-centred design, we developed and refined a story-based intervention that engages Filipino families, community leaders and community health workers. We conducted a randomised controlled trial among 719 caregivers of small children to test the developed intervention against a control video. We assessed the binary improvement (improvement vs no improvement) and the amount of improvement in vaccine attitudes and intentions after intervention exposure.Results Although the intervention group began with marginally higher baseline vaccine attitude scores, we found that 62% of the intervention group improved their vaccine attitude scores versus 37% of the control group (Fisherâs exact, p<0.001). Among individuals whose scores improved after watching the assigned video, the intervention group saw higher mean attitude score improvements on the 5-point scale (Cohenâs d=0.32 with 95%âCI 0.10 to 0.54, two-sided t-test, p<0.01). We observed similar patterns among participants who stated that they had previously delayed or refused a vaccine for their child: 67% of 74 in the intervention group improved their vaccine attitude scores versus 42% of 54 in the control group (Fisherâs exact, p<0.001). Among the subset of these individuals whose scores improved after watching the assigned video, the intervention group saw higher mean attitude score improvements on the 5-point scale that were marginally significant (Cohenâs d=0.35 with 95%âCI â0.01 to 0.70, two-sided t-test, p=0.06).Conclusions Our results provide solid evidence for the potential of co-designed vaccine confidence campaigns and regulations
âRespect my opinion and I'll respect yours!â: Exploring the challenges, concerns, and informational needs of vaccineâhesitant caregivers and pregnant women in the Philippines
Abstract Background Despite the instrumental role of vaccines, public confidence is declining, and antiâvaccine movements have increased worldwide. With the goal of informing policy decisions and the development of interventions, we explore the concerns and challenges related to vaccine uptake (of childhood, maternal, and COVIDâ19 vaccines) among parents or caregivers of underâtwo children and pregnant women in urban and rural communities in the Philippines. Methods Between May and June 2022, we conducted combined inâperson and online interviews with purposively selected caregivers and pregnant women in the Calabarzon region (Naic, Cavite and Tanay, Rizal), and National Capital Region (Pasay and Muntinlupa Cities), Philippines. A total of 43 interviews were completed, audioârecorded, transcribed, and analyzed according to the tenets of hermeneutic phenomenology. Results Our results, grounded on the social ecological model, underlined the interplays of contextual or logistical challenges on vaccine uptake, respondentsâ overarching concerns about vaccines, and their informational needs that affected their vaccine decisionâmaking. Respondents described that the longâestablished maternal and childhood vaccines no longer represent a highârisk concern but highlighted their fears and hesitancy particularly to newer vaccines. Conclusion Our findings underscore the multilayered challenges in vaccine decisionâmaking among caregivers and pregnant women. The volatility of vaccine decisionâmaking necessitates rethinking the current immunization process, recalibrating the health workforce, and reinvigorating the health information delivery channels for more inclusive and responsive health care