As countries begin rolling out COVID-19 vaccination, public health experts know that the last inch — getting the vaccine from vial to arm — can be the hardest. Public uncertainty in the current pandemic has been exacerbated by an “infodemic,” a confusing epidemic of information and misinformation. The Vaccination Demand Observatory (The Observatory) is developing tools, training, technical support and research to equip in-country teams to mitigate the impact of misinformation and mistrust on all vaccines. This programme is organized in three pillars: social listening analytics and insight generation, a training and education program to tackle challenges related to all vaccines, and a communications lab.
The Vaccine Acceptance Interventions Lab (VAIL) will draw upon behavioural and social research and insights from social listening to develop engaging, relevant content to fill information gaps. VAIL also will develop “inoculation” messages to vaccinate people against vaccine misinformation. The content and programs will be rapid field tested for tone, format and behavior change impact before being implemented.
“In these times of heightened anxiety and uncertainty, people have many perfectly reasonable questions and concerns about vaccines. But their search for answers may be confounded by huge information gaps and a miasma of mis- and disinformation,” says Dr. Angus Thomson, PhD, Senior Social Scientist for UNICEF. “We can’t address people’s concerns if we don’t first understand them. Then we must speak with – not at – people, where they are, about what matters to them. The Observatory will help empower countries to do this.”
Working much like a disease surveillance system, an Observatory-supported country programme will contextualize vaccine conversations, characterizing questions, concerns, and misinformation, to provide regular updates to local health agencies and partner organizations. Unlike previous efforts, this programme is built around a “Field Infodemic Manager” rather than a dashboard. This manager will coordinate the listening, analytics, and identification and assessment of vaccine rumours and information gaps to provide real-time actionable insights and recommendations to the teams which are engaging with communities.
“Because local communication is key to the success of any vaccination program, we are focused on building local-level programs that are as powerful and sophisticated as any global system. Each country on earth has its own cultural nuances. The Observatory system will entail both quantitative and qualitative methods for tracking and characterizing local vaccine narratives. Subsequent public health programs can then be customized to each country’s context, and evaluated by potential traction and impact,” says Dr Joe Smyser, PhD, MSPH, Chief Executive Officer of PGP.
UNICEF helps reach almost half of the world’s children with life-saving vaccines and those kids’ access to education, health and protection services has been severely disrupted by the pandemic. UNICEF’s local-level footprint, through active community engagement, risk communication, social mobilization and partnership in countries around the world will be informed in real-time by this social listening programme. UNICEF works through the Vaccination Demand Hub to coordinate its support to countries with other multilaterals, global partnerships, donors, non-governmental and civil society organizations.
As a first step, the Observatory released the Vaccine Misinformation Management Field Guide in December 2020. This practical guide, available in 6 languages, aims to help organizations to address the global infodemic through the development of strategic and well-coordinated national action plans to rapidly counter vaccine misinformation and build demand for vaccination.
The Observatory’s first on-the-ground project is ongoing in multiple West African countries supporting UNICEF polio teams in the launch of a new oral polio vaccine.
“Existing global-level vaccine social listening efforts lack the granularity for community-level insights, and focus on digital channels,” says Dr Thomson. “Data equity is essential if countries are to reach every person with vaccines. The Observatory focuses on aggregating both online and offline listening sources, to ensure we also hear the voices of the digitally disenfranchised.”
As a first step to enhancing capabilities in countries, the Observatory has stood up regional listening dashboards that are being interpreted by Infodemic Managers. But it is now seeking support to rapidly take these tools, training and technical assistance to countries as they manage COVID-19 and polio vaccine introductions, and work to sustain trust in routine immunization programs.
“We should expect the same rigor from vaccine acceptance science as we do from vaccine development science,” says Professor Saad B. Omer, MBBS MPH PhD, Director of Yale Institute for Global Health. “The Observatory brings together evidence-informed approaches to inoculate against misinformation and increase vaccine acceptance and demand.”
“We applaud the mobilization of funders to support the COVAX facility providing COVID-19 vaccines to over 100 countries. However, lack of investment in misinformation management and demand generation means we risk precious doses sitting unwanted and unused,” says Dr Smyser. “Current investment in this crucial work remains only a tiny fraction of a percent of the investment in producing and distributing vaccine doses.”