Ebola vaccine? Family first! Evidence from using a brief measure on Ebola vaccine demand in a national household survey during the outbreak in Sierra Leone

Jalloh, Mohamed F.; Wallace, Aaron S.; Bunnell, Rebecca; Carter, Rosalind J.; Redd, John T.; Nur, Sophia A; Zeebari, Zangin; Ekström, Anna Mia; Nordenstedt, Helena

doi:10.1016/j.vaccine.2020.03.044

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…The high level of vaccine acceptance in this HCW population is consistent with prior research and might be explained by several reasons ( 24 , 38 ). HCWs likely had multiple opportunities to get vaccinated given that Beni, Butembo, and Mabalako were all frequent epicenters during the outbreak and vaccination teams were likely present in the communities at multiple points during the 22-month outbreak.…”

Section: Discussionsupporting

confidence: 89%

“…Additionally, a fractional dose was offered to preserve vaccine supply ( 9 ) and a second vaccine, offered as a two dose regimen, was given in areas near the active outbreak ( 44 ). During the West African EVD outbreak in 2014–2016, HCWs expressed concerns about the experimental status of the vaccine ( 19–21 , 24 ). Despite necessary, these changes mid-outbreak may have led to confusion and distrust in the vaccine and the process ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

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Ebola vaccine uptake and attitudes among healthcare workers in North Kivu, Democratic Republic of the Congo, 2021

Doshi,

Garbern,

Kulkarni

et al. 2023

Front. Public Health

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IntroductionDuring the 2018–2020 Ebola virus disease (EVD) outbreak in the eastern part of the Democratic Republic of the Congo (DRC), prevention and control measures, such as Ebola vaccination were challenging by community mistrust. We aimed to understand perceptions regarding Ebola vaccination and identify determinants of Ebola vaccine uptake among HCWs.MethodsIn March 2021, we conducted a cross-sectional survey among 438 HCWs from 100 randomly selected health facilities in three health zones (Butembo, Beni, Mabalako) affected by the 10th EVD outbreak in North Kivu, DRC. HCWs were eligible if they were ≥ 18 years and were working in a health facility during the outbreak. We used survey logistic regression to assess correlates of first-offer uptake (i.e., having received the vaccine the first time it was offered vs. after subsequent offers).ResultsOf the 438 HCWs enrolled in the study, 420 (95.8%) reported that they were eligible and offered an Ebola vaccine. Among those offered vaccination, self-reported uptake of the Ebola vaccine was 99.0% (95% confidence interval (CI) [98.5–99.4]), but first-offer uptake was 70.2% (95% CI [67.1, 73.5]). Nearly all HCWs (94.3%; 95% CI [92.7–95.5]) perceived themselves to be at risk of contracting EVD. The most common concern was that the vaccine would cause side effects (65.7%; 95% CI [61.4–69.7]). In the multivariable analysis, mistrust of the vaccine source or how the vaccine was produced decreased the odds of first-time uptake.DiscussionOverall uptake of the Ebola vaccine was high among HCWs, but uptake at the first offer was substantially lower, which was associated with mistrust of the vaccine source. Future Ebola vaccination efforts should plan to make repeated vaccination offers to HCWs and address their underlying mistrust in the vaccines, which can, in turn, improve community uptake.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Ebola vaccine uptake and attitudes among healthcare workers in North Kivu, Democratic Republic of the Congo, 2021

Doshi,

Garbern,

Kulkarni

et al. 2023

Front. Public Health

Self Cite

View full text Add to dashboard Cite

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“…Ebola vaccine acceptance among health workers and the general public in Guinea, Sierra Leone, Liberia and the Democratic Republic of Congo were driven by complex factors, including perceptions around safety and effectiveness, 53 institutional trust, 54 notions of fairness and equity 55 and subjective norms. 56 Similar to the introduction of new Ebola vaccines, emerging evidence regarding intentions to accept COVID-19 vaccines point to potential hurdles in attaining optimal uptake among the general public 57 58 and health workers. 59 Getting ahead of the curve in addressing misinformation and concerns regarding COVID-19 vaccines can be greatly enhanced through well planned, bottom-up engagements with communities, using online and offline platforms on an ongoing basis.…”

Section: Sustainability and Spill-over Effectsmentioning

confidence: 99%

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond

Jalloh

Nur

et al. 2021

BMJ Glob Health

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Human behaviour will continue to play an important role as the world grapples with public health threats. In this paper, we draw from the emerging evidence on behaviour adoption during diverse public health emergencies to develop a framework that contextualises behaviour adoption vis-à-vis a combination of top-down, intermediary and bottom-up approaches. Using the COVID-19 pandemic as a case study, we operationalise the contextual framework to demonstrate how these three approaches differ in terms of their implementation, underlying drivers of action, enforcement, reach and uptake. We illustrate how blended strategies that include all three approaches can help accelerate and sustain protective behaviours that will remain important even when safe and effective vaccines become more widely available. As the world grapples with the COVID-19 pandemic and prepares to respond to (re)emerging public health threats, our contextual framework can inform the design, implementation, tracking and evaluation of comprehensive public health and social measures during health emergencies.

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Are malaria transmission-blocking vaccines acceptable to high burden communities? Results from a mixed methods study in Bo, Sierra Leone

McCoy

Weldon

Ansumana

et al. 2021

Malar J

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Background Malaria transmission-blocking vaccines (TBVs) could help break the cycle of malaria transmission by conferring community rather than individual protection. When introducing new intervention strategies, uptake is dependent on acceptability, not just efficacy. In this exploratory study on acceptability of TBVs in Sierra Leone, it was hypothesized that TBVs would be largely acceptable to adults and health workers in areas with relatively few ongoing malaria interventions, and that (i) knowledge of malaria and vaccines, (ii) health behaviours associated with malaria and vaccines, and (iii) attitudes towards different vaccines types could lead to greater TBV acceptability. Methods This study used a mixed methods approach in Bo, Sierra Leone, to understand community knowledge, attitudes, and practices related to malaria and vaccination in general. This included: (i) a population-based cross-sectional survey (n=615 adults), (ii) 6 focus group discussions with parents, and (iii) 20 key informant interviews. The concept of a TBV was explained to participants before they were asked about their willingness to accept this vaccine modality as part of an integrated malaria elimination programme. Results This study found that most adults would be willing to receive a TBV vaccine. Respondents noted mostly positive past experiences with adult and childhood vaccinations for other infectious diseases and high levels of engagement in other malaria prevention behaviors such as bed nets. Perceived barriers to TBV acceptance were largely focused on general community-level distribution of a vaccine, including personal fears of vaccination and possible costs. After an explanation of the TBV mechanism, nearly all focus group and interview participants believed that community members would accept the vaccine as part of an integrated malaria control approach. Both parents and health workers offered insight on how to successfully roll-out a future TBV vaccination programme. Conclusions The willingness of community members in Bo, Sierra Leone to accept a TBV as part of an integrated anti-malarial strategy suggests that the atypical mechanism of TBV action might not be an obstacle to future clinical trials. This study’s findings suggests that perceived general barriers to vaccination implementation, such as perceived personal fears and vaccine cost, must be addressed in future clinical and implementation research studies.

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Ebola vaccine? Family first! Evidence from using a brief measure on Ebola vaccine demand in a national household survey during the outbreak in Sierra Leone

Cited by 4 publications

References 25 publications

Ebola vaccine uptake and attitudes among healthcare workers in North Kivu, Democratic Republic of the Congo, 2021

Ebola vaccine uptake and attitudes among healthcare workers in North Kivu, Democratic Republic of the Congo, 2021

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond

Are malaria transmission-blocking vaccines acceptable to high burden communities? Results from a mixed methods study in Bo, Sierra Leone

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