Optimising vaccination for disease outbreaks : parallels and a proposed framework from Nigeria’s less-established vaccination programmes

Le résumé fourni par la source

Introduction High vaccination coverage can mitigate vaccine-preventable diseases. However, less established vaccine programmes often struggle to achieve high coverage in low- and middle income-countries. This thesis aimed to, in Nigeria, i) understand factors influencing the implementation and uptake of less-established adult and childhood vaccination programmes and ii) develop a framework to optimise future outbreak vaccination. Methods A systematic review and meta-ethnography were conducted to synthesise factors influencing adult COVID-19 vaccination in Nigeria. A qualitative study using focus groups and interviews was conducted in three states to i) explore factors influencing measles vaccination for children, and COVID-19 vaccination for adults, and ii) obtain stakeholder recommendations to optimise vaccination programmes in outbreaks. Findings were integrated through a meta-summary, and a framework was developed to optimise vaccination programme implementation and uptake for disease outbreaks in Nigeria. Key Findings Factors influencing the implementation of adult and childhood vaccination programmes are health system and policy-level in nature. A complex interplay of individual motivations, community and interpersonal drivers, health systems and policy-level enablers and constraints influenced vaccination uptake. Cross-cutting factors, such as health systems' readiness for vaccines, influence both adult and childhood programmes. Distinct factors, such as adaptive vaccination delivery, enabled the implementation of COVID-19 vaccines. Policy operationalisation challenges and design considerations for new vaccination touchpoints constrained childhood vaccinations. Cross-cutting uptake factors included the opportunity costs of vaccination. Distinct COVID-19 vaccine uptake factors included individual vaccination preferences. The proposed ‘Optimal Vaccination for Outbreaks’ Framework introduces ‘optimisation pathways’, including accessible services and incentives to improve vaccination implementation and uptake. Conclusion This thesis highlights opportunities to improve the roll-out and uptake of vaccinations for adults and children in future outbreaks by utilising optimisation pathways that consider cross-cutting and distinct factors influencing routine and outbreak vaccination in both groups.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.