Social Inclusion and Immunisation

Abstract

The current COVID-19 epidemic is both a health and societal issue; therefore, groups historically excluded and marginalised in terms of healthcare will suffer if COVID-19 vaccines, tests, and treatments are to be delivered equitably. This rapid review is exploring the social and cultural challenges related to the roll-out, distribution, and access of COVID-19 vaccines, tests, and treatments. It highlights how these challenges impact certain marginalised groups. Case studies are taken from sub-Saharan Africa (the Democratic Republic of Congo, South Africa), with some focus on South East Asia (Indonesia, India) as they have different at-risk groups. Lessons on this issue can be learned from previous pandemics and vaccine roll-out in low- and mid-income countries (LMICs). Key points to highlight include successful COVID-19 vaccine roll-out will only be achieved by ensuring effective community engagement, building local vaccine acceptability and confidence, and overcoming cultural, socio-economic, and political barriers that lead to mistrust and hinder uptake of vaccines. However, the literature notes that a lot of lessons learned about roll-out involve communication - including that the government should under-promise what it can do and then over-deliver. Any campaign must aim to create trust, and involve local communities in planning processes.

Initiatives for the Governance of the Covid-19 Vaccine Rollout, with Special Reference to Social Inclusion

“…A Lancet editorial looks at access to Covid-19 vaccines beyond COVAX (The Lancet 2021). A comment in Lancet Global Health discusses challenges to rolling out the Covid-19 vaccine in African countries (Nachega et al 2021).• There is a K4D helpdesk report on social inclusion and immunisation(Tull 2021).Chatham House held an event in partnership with the European Peace Institute looking at conflictsensitive approaches to Covid-19, with a focus on vaccines.26 Chatham House have also released a podcast on vaccine nationalism and what can be done to encourage more equitable distribution.27 They have also published a number of expert comments.28 The Center for Global Development have published a number of blogs about global equity.29 There is also a recorded event called 'Equity and Scale in Global Immunization: New Evidence from Nigeria on Cash Transfers for Vaccination'.Within the scope of a rapid review, it was difficult to identify specific interventions organised by CSOs on governance or inclusion issues regarding vaccine rollout.…”