As the world starts to vaccinate against COVID-19, social, economic, and geographic issues are magnified. These include access to the vaccines for vulnerable communities, misinformation, and gender inequality.

Without clear communication strategies and organised implementation, immunisation campaigns can become ineffective, allowing the opportunity for misinformation and dishonest narratives to enter the discourse and alter the outcome.

There have been recent examples of this with Polio vaccinations in Afghanistan, where religious hard-liners spread rumours of children falling sick from the vaccine, with devastating consequences for three local vaccinators. In Malawi, ‘Vaccine hesitancy’ is contributing to a reduced uptake in the Covid-19 vaccine due to ‘a lack of understanding’.

And in parts of Serbia, where despite the government having stock of five different Covid-19 vaccines, suspicion around the vaccine’s side effects led to more than 92 in 100 people refusing to be immunised.

Ultimately, vaccines don’t save people; it’s the vaccinations that do, so how do our communication efforts contribute to encouraging positive human behaviour?

 

Successful immunisation campaigns depend on clear communication

Underpinning any immunisation campaign must be a comprehensive narrative and visual communications strategy targeting all sections of society, which uses local context and social norms to motivate people to vaccinate; delivered in multiple languages, or with content that can be interpreted universally despite individual levels of literacy, such as animation.

7.7 million unimmunized children live in fragile or humanitarian settings, global vaccination coverage is at 85% but better immunization could prevent an additional 1.5 million deaths.

To successfully communicate the benefits of vaccination, it is essential to ‘speak the language’ of every community both literally and figuratively, using terms that are readily understood and demonstrating an appreciation for local social problems and respect for local customs and culture.

Some key considerations of a communications strategy might include the primary message you want to communicate, what media will be the most suitable for disseminating information, and what resources will be required to deliver this strategy effectively.

Communication tools should focus on a human-centred design and, where possible, can be innovative in their approach, for example, an immunisation board game for families.

 

Communications to encourage a positive change in human behaviour

For many, firmly held views do not change fast; it can take time for people to change their attitudes. The main goal of any immunisation campaign is to increase vaccine coverage. Therefore the aim of communications must be to bring about a positive behavioural change in those who oppose vaccination or don’t know differently.

Some parents don’t recognise the threat of diseases they don’t see or understand, in Colombia for example more than 48% of caregivers were unaware that their child was under-vaccinated (the Quechuan language (spoken in Bolivia, Ecuador, Colombia and Argentina) alone has 9 dialects making generic vaccination messages almost impossible).

Educational content alone won’t lead to this change; an immunisation comms strategy must be multi-faceted. Target audiences must be identified, and communication tactics and content designed in partnership with local communities and delivered accordingly.

Through working directly with affected or beneficiary communities to hear their problems, struggles and opinions we can assess what strategy will work best.

 

Photo: Kate Holt/ GAVI/ Arete. A group of women with their children learn about routine vaccinations at a health clinic in Moyamba, Sierra Leone.

Engage with different communities

Mobilising the community is essential to the success of any immunisation programme. In order to mobilise the community, it is important to interact with the various target audiences in person and, in partnership with local communities, prepare content, such as posters and videos, that can be easily disseminated to follow up and reinforce the message.

 

What are the different sectors of communities? Why do you need to define comms differently to each different section of society?

Most communities in the world will contain a number of different sectors, as an example. these may include religious and community leaders, teachers, health workers, parents, and children. A communications strategy should identify each of these sectors, and outline a plan on how to interact.

This interaction could take place in community meetings, religious places, shops and marketplaces. But also indirectly via local theatre, radio and television. The aim of the message will remain the same, but the delivery should vary depending on your audience. If using illustrative flashcards in a mosque, for example, the people in the depictions should be dressed appropriately.

Community mobilisation is an important step for promoting the long-term commitment to sustained behaviour change and leading to a feeling of local ownership of the immunisation campaign — ensuring higher participation and involvement of everyone in a shared goal.

 

Photo: Brian Ongoro/ UNICEF/ Arete — Villagers in South Sudan learn about the dangers of coronavirus from a UNICEF partner organisation.

Community conversation

Community meetings

A collective community discussion of a particular issue within the immunisation campaign, such as a poor turnout, can be a great and inclusive way to problem solve.

Community meetings can prove to be a suitable and effective platform for discussion, ensuring that everyone is given the opportunity to be heard. It is important that people feel at ease enough to share their opinions for a productive community conversation.

This can be achieved by clearly communicating the purpose of the conversation, organising a meeting place where there will be little interference, and chairing the meeting to facilitate a fair, open, and non-judgmental conversation.

In addition to general community meetings, organising meetings and creating content that is targeted at specific interest groups is also useful — this could be with community leaders, parents, other NGOs and partners, or special groups such as ethnic, minority, and religious groups.

 

communication immunisation campaigns
Photo: Kate Holt/ UNICEF/ Arete. A local family talk about the polio vaccination with a World Health Organisation representative.

Personal conversations

Immunisation advocates can be effective at encouraging a change in behaviour with certain community members through interpersonal communication.

One-on-one conversations and conversation with small groups can be a great way to persuade individuals about the value of a proposed behaviour change by explaining and responding to questions about the vaccination programme and providing practical information regarding how and when to vaccinate. This can also be an effective way to challenge and quash misinformation and rumour.

 

Advocacy

Advocacy activities at a stakeholder and organisational level are also key to garnering support for an immunisation programme. Lobbying, negotiations, meetings, and the sharing of educational content such as PDF presentations and videos of first-hand beneficiary storytelling, can be effective tools for influencing opinion leaders, policymakers, and politicians — ensuring support for the national deployment of a campaign.

 

A slide from a presentation Arete prepared for UNICEF stakeholders to report on a Polio immunisation campaign in Papua New Guinea.

Combatting misinformation and negative rumours

A robust and organised communication campaign with a clear message will be your strongest ally in combating misinformation. Creating content, such as animation and posters, that are universally understood and disseminated en-mass can directly address and dispel negative rumours.

 

communication immunisation campaigns
A poster designed by Arete for the UNICEF Polio Global Eradication Initiative.

But the most important aspect of combating misinformation is knowing what is being spread. Understanding what the rumour is, and where the misinformation originated, will be key to dismantling any argument underpinning it effectively.

This understanding should inform the creation of your content, the agenda of community meetings, and the training of volunteers, and staff, to create ongoing communication to combat potentially life-threatening misinformation.

Experience shows that strategic actions need to be based on information that identifies patterns and differences among users, non-users, and inconsistent users of immunisation services.

 

Clear communication

If all programs in the sector are provided with the necessary resources, assuming they are available, then they will be able to contribute significantly to immunisation by increasing and maintaining demand and advocating for continuous support for vaccine programs among partners and decision-makers.

Although not an exhaustive list of activities that can be undertaken. Many of these activities demonstrate why a well-designed and organised communication strategy is a vital component.

 

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