Expert voice: recommendations for overcoming obstacles to vaccination in children

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Immunization, one of the most cost-effective preventive health interventions, has become a priority and is a driving force in reducing child mortality, including controlling vaccine-preventable diseases. Ensuring high immunization coverage and its acceptance by beneficiaries is crucial for a healthy society. Dr Fazal Nabi and Dr Deepti Thakur, Jaslok Hospital, explain and share some recommendations for overcoming the immunization barrier in children.

Immunization is a multisectoral activity, and substantial variability in coverage exists across the world, influenced by varying demographic, socio-economic and political structures. In addition, factors such as education, occupation, household income, gender, living conditions, housing, awareness, religion, etc. seem to play an important role even in the presence of immunization programs and other health services. It is a well-known fact that when immunization coverage is low, vaccine-preventable diseases contribute to worse health outcomes, especially in slums.

What are the barriers?

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There can be many obstacles depending on many factors. People come from diverse cultures with diverse ideologies regarding immunization, limited immunization awareness, the priority is to earn a living and therefore immunization may take a back seat in economically backward sects. Less community participation, so vaccination is still not the property of the people living in these settings. Responsibility is limited only to vaccinating those who come for a visit. No active monitoring and limited accountability or lack of on-the-job training and supportive supervision, limited resources including skilled and dedicated workforce, poor infrastructure for vaccine storage and other logistics ( for example, inactivated polio). These are just some of the many barriers to immunization.

Break down barriers

Role of health workers

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As healthcare workers, they must meet parents who are reluctant to have their children vaccinated, first acknowledge their concerns, then provide education to correct misconceptions and offer accurate information about the benefits and risks of vaccines. . Explain that serious vaccine reactions are rare and that vaccines are only approved for use if the evidence shows that their benefits significantly outweigh their risks. Provide parents with accurate information about vaccine-preventable diseases and advocate that all children receive the right vaccines at the right time. Provide them with accurate information and accurately answer parents’ questions about vaccines and their safety. They should be familiar with the current status and global and local prevalence of vaccine-preventable diseases, current vaccination recommendations, and the risks and benefits of vaccines. For more information on the alleged link between vaccines and autism, mitochondrial disease, or other health issues, they should direct parents to specific internet resources or experts better equipped to answer questions.

Role of social workers

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The role of social workers is really essential in raising awareness. They can create awareness similar to the polio program and involve communities in immunization planning and implementation.

They should help announce vaccination campaigns from places of worship, especially during festivals, and use public notice boards to inform about vaccination. They can also involve teachers to broaden their reach and send a reminder message (e.g. WhatsApp, SMS) a day before the scheduled date. They may come up with actions such as recognition or rewards for villages or communities with active participation and considerable immunization coverage to ensure that more people show up.

Role of health workers at grass road level

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Build trust between healthcare providers and beneficiaries and get to know their territory and their population. They should also start by listing the beneficiaries, updating the immunization micro-plan each year, listing the dropouts and organizing an awareness session for those not affected or never reached.

Organize regular catch-up rounds once every three months for dropout children. For those in the early stages of pregnancy, begin counseling on the benefits of vaccination and ensure a timely vaccine supply. Provide on-the-job training and supportive supervision and finally develop a positive attitude and behavior by motivating health service providers.

Policies that can help break down barriers

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Listen to your community and service providers, provide optimal resources, and improve disease surveillance. Policies can also help run awareness programs for staff at regular intervals and organize immunization sessions at times that are convenient for families.

They should address patient concerns and run a regular catch-up program, especially on Sundays, holidays, or evenings, so that everyone or most people are available to assist. Also incentivize both beneficiaries and service providers. By starting and carrying out appropriate immunization campaigns, we can achieve our goal of moving closer to a childhood free of preventable diseases for every child.

Also read: 5 important life skills every parent should teach their kids from the start

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