| Routine childhood immunization |
Lack of or outdated demand strategy at national and sub-national levels One-off social mobilization (SM) activities and poor planning Outdated or no micro-plans for SM, leading to suboptimal outreach, especially in hard-to-reach areas or for transient populations Outdated or no monitoring and evaluation framework Inadequate or no specific budget for routine demand promotion and SM |
Develop/update demand strategy that articulates the role of SM40 At a minimum, implement Reaching Every District guidelines for SM, microplanning and recurring engagements with the community stakeholders.41 Develop/update national and district-level monitoring and evaluation plans for SM. Determine and allocate an appropriate budget for social mobilization based on a clear action plan linked to an overall demand strategy. |
| Supplementary immunization activities |
Communities may end up having “campaign fatigue” and see limited personal or public benefit in repeated campaigns42 People may not understand the differences between doses received during campaigns and routine immunization SIAs vaccinate many people at once, increasing the likelihood of serious adverse events occurrence following immunization (AEFIs), especially in clusters, causing vaccine safety concerns in the community43 |
Sustain mobilization of a wide coalition of stakeholders to prioritize high coverage among target population during the campaign and help achieve targets as well as preventing outbreaks44 SIA messages during social mobilization should articulate to caregivers the need to continue with the regularly scheduled doses in the routine schedule Ensure vaccine safety is addressed in social mobilization events, and that caregivers know how to report AEFIs |
| Humanitarian emergencies and outbreak settings |
Unknown or incomplete immunization history of the affected population Population may not have been socialized to vaccination benefits Context can deprioritize immunization over more pressing health, security, and livelihood concerns |
Use existing community leadership structures to build confidence and trust in vaccines among45 Use social mobilization and immunization activities adapted for difficult contexts (e.g. health days for multiple health services or entering the community on days of tranquility)46 Conduct social mobilization and immunization at gathering points (e.g. places of worship, food distribution centers, and recreational events) |
| Introducing, piloting, or testing of new vaccines |
Low perceived risk of the disease prevented by the vaccine or prevention benefits not resonating47, 48 Safety concerns of a new vaccine, especially unlicensed vaccines The new vaccine may be partially effective The new vaccine may only be available for sub-populations and/or targets an age group not currently served by the immunization program49 Challenges with inter-ministerial collaborations when introducing a new vaccine, requiring involvement of multiple government ministries. |
Develop, test, and refine SM messages to articulate the benefits of the new vaccine and health risks if left unvaccinated Use qualitative approaches to get a deeper understanding of the safety or efficacy concerns and identify appropriate messages and trusted messengers to communicate the safety profile of the vaccine, using plain language31, 50 Prevent misinformation by clarifying who is eligible and who is not and why to address misinformation50 Consider policy updates required to successfully target social mobilization at new locations (e.g. schools) and with new populations (e.g. adolescents). |
