Mobilize to vaccinate: lessons learned from social mobilization for immunization in low and middle-income countries

Abstract

Creating and sustaining demand for immunization services is a global priority to ensure that vaccineeligible populations are fully protected from vaccine-preventable diseases. Social mobilization remains a key health promotion strategy used by low-and middle-income countries (LMICs) to promote vaccination demand. In this commentary, we synthesize illustrative evidence on successful social mobilization efforts promoting the uptake of immunization services in select LMICs. The first example focuses on Sierra Leone's routine immunization program during the Universal Child Immunization initiative in the late 1980s. We then give an example of India's establishment of a social mobilization network in the early-to mid-2000s to support polio elimination in high-risk communities. Thirdly, we highlight the complexities of social mobilization in a humanitarian emergency during the 2017-2018 diphtheria outbreak among displaced Rohingyas in camps and settlements in Bangladesh. Lastly, we draw upon examples from the introduction of the human papillomavirus vaccine in several countries. We then critically examine recurring challenges faced when implementing social mobilization for immunization in LMICs and offer practical recommendations for improvement.

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

“…Social signaling of positive attitudes towards vaccines may help shift social norms toward even greater immunization acceptance and uptake in the community at large 68 – 70 . As with messaging, policymakers should consider designing and evaluating social mobilization strategies targeted toward more hesitant subgroups 71 .…”

Embracing challenging complexity: exploring handwashing behavior from a combined socioecological and intersectional perspective in Sierra Leone

“…Our analysis also highlights the role of influential, rather resourceful leaders who can be employed as opinion leaders or agents of change [ 63 ]. Identifying and employing influential individuals such as local leaders has shown to positively influence the behaviors of different social groups in public health emergencies [ 66 , 67 ] and non-emergency settings [ 68 , 69 ]. They could contribute to empower disadvantaged but relevant individuals for handwashing, e.g., increase community-based health communication activities (most recommended in villages) and thereby allow rural, young wives to increase their health literacy.…”

Lessons from humanitarian clusters to strengthen health system responses to mass displacement in low and middle-income countries: A scoping review

“…Social mobilisation is a key strategy to encourage vaccine uptake and address participation barriers, e.g. religious concerns, safety concerns, and perceived lack of sensitivity to gender norms including female vaccinators for girls ( Jalloh et al . , 2020 ).…”

“…Specific groups required targeted support, e.g. providing women vaccinators for girls and including women in agenda setting and project implementation ( Jalloh et al . , 2020 ).…”