Community engagement to increase vaccine uptake: Quasi-experimental evidence from Islamabad and Rawalpindi, Pakistan

Abstract

Developing countries have been facing difficulties in reaching out to low-income and underserved communities for COVID-19 vaccination coverage. The rapidity of vaccine development caused a mistrust among certain subgroups of the population, and hence innovative approaches were taken to reach out to such populations. Using a sample of 1760 respondents in five low-income, informal localities of Islamabad and Rawalpindi, Pakistan, we evaluated a set of interventions involving community engagement by addressing demand and access barriers. We used multi-level mixed effects models to estimate average treatment effects across treatment areas. We found that our interventions increased COVID-19 vaccine willingness in two treatment areas that are furthest from city centers by 7.6% and 6.6% respectively, while vaccine uptake increased in one of the treatment areas by 17.1%, compared to the control area. Our results suggest that personalized information campaigns such as community mobilization help to increase COVID-19 vaccine willingness. Increasing uptake however, requires improving access to the vaccination services. Both information and access may be different for various communities and therefore a “one-size-fits-all” approach may need to be better localized. Such underserved and marginalized communities are better served if vaccination efforts are contextualized.

COVID-19 Vaccine Acceptance, Attitude and Perception among Slum and Underserved Communities: A Systematic Review and Meta-Analysis

“…Infodemic management, risk communication and continued vaccine education to clear safety concerns are, thus, warranted. Moreover, considering flexible vaccination options such as mobile vaccination units where people can be vaccinated at their homes or workplace would solve access barriers faced among slum and underserved communities [ 46 , 50 ].…”

Barriers and enablers to implementation of COVID‐19 vaccine programs in a rural and regional Queensland: A provider perspective

“…Community engagement was identified as an important enabler to COVID‐19 vaccination programs which mirrored other international studies 32–36 . Tjilos et al, 34 a qualitative study of community‐engaged conversations about COVID‐19 vaccinations in New England, USA, found that community leaders suggested utilising existing social networks and trusted community leaders to disseminate credible information.…”

“…Community engagement was identified as an important enabler to COVID-19 vaccination programs which mirrored other international studies. [32][33][34][35][36] Tjilos et al, 34 a qualitative study of community-engaged conversations about COVID-19 vaccinations in New England, USA, found that community leaders suggested utilising existing social networks and trusted community leaders to disseminate credible information. This is particularly important in rural areas where such engagement plays an important role in public health responses 23 and can be utilised to ensure that programs are targeted to specific community needs rather than using a 'one size fits all' approach that often excludes marginalised groups.…”

Using Social Marketing to Promote COVID-19 Vaccination Uptake: A Case Study from the “AUBe Vaccinated” Campaign

“…According to the World Health Organization’s technical advisory group on behavioral insights and sciences for the health [ 46 ], community engagement can be beneficial in pre-designing vaccination methods and messaging, sharing timely information about vaccine strategies, fostering trust, and addressing false information. For example, community engagement was essential to increase COVID-19 vaccination awareness and uptake in small communities in Pakistan [ 47 ]. In addition, researchers leveraged community leaders to improve vaccine willingness by changing residents’ behavioral intentions [ 47 ].…”

“…For example, community engagement was essential to increase COVID-19 vaccination awareness and uptake in small communities in Pakistan [ 47 ]. In addition, researchers leveraged community leaders to improve vaccine willingness by changing residents’ behavioral intentions [ 47 ].…”