Lessons Learned and Relearned to Improve Routine Childhood Vaccination: Six Insights from the COVID-19 Pandemic – JSI

The USAID MOMENTUM Routine Immunization Transformation and Equity project (the project) was designed to mitigate entrenched obstacles to high equitable coverage of routine immunization (RI). After COVID-19 vaccines were introduced in response to the pandemic, the project worked in 18 countries to support national and subnational governments in their extraordinary efforts to vaccinate large and diverse groups of high-priority populations in record time. The project directly supported the administration of over 21 million doses of COVID-19 vaccines and made significant contributions to a range of technical areas.

The urgency to vaccinate, coupled with huge global investments, drove innovations and adaptations to old approaches and elevated immunization practices that had received insufficient attention. For the 50th anniversary of the World Health Organizations Expanded Program on Immunization, with attention refocused on RI, the project is applying six insights from COVID-19 vaccination to achieve the global goal of equitable access to life-saving vaccines for every child.

The rapid pace of vaccine development and roll-out gave rise to myths about the vaccine and its side effects. For those who sought vaccination services, geographic, logistic, and other barriers limited many peoples ability to get vaccinated. Despite obstacles, the project increased acceptance and uptake by listening to community voices when planning, promoting, and providing vaccination.

In India, it worked with local civil society organizations (CSOs) that used boats to bring COVID-19 vaccines to fisherfolk in the Brahmaputra Islands. Recognizing that older adults with limited digital literacy were unable to register for vaccination via mobile phones, local CSOs also offered on-site registration assistance. Under community leaders advice, the project created radio broadcasts and print materials in 12 languages to reach tribal and remote populations.

In Mozambique, caregivers cited poor treatment and communication at health facilities as major barriers to RI schedule completion. In response, the project designed interventionsincluding training health providers in interpersonal communication; facilitating coordination between health care providers and community counterparts; and introducing quality of care scorecardsthat improved health care provider and client interactions.

COVID-19 immunization required new strategies to reach people who were not previously the focus of vaccination services. To increase uptake, the project doubled its efforts to make vaccines accessible to priority populations in high-traffic locations and at expanded times. In Kenya, motorcycle drivers did not want to interrupt work to get vaccinated, so the project coordinated with local health authorities to offer COVID-19 vaccination at locations where drivers wait for customers, which enabled it to vaccinate both drivers and their riders. In the Democratic Republic of Congo (DRC), the project set up COVID-19 vaccination sites at markets so passersby could get vaccinated without going out of their way, and later established similar sites to provide childhood immunization at markets. The project is working in urban health centers in Lagos, Nigeria to institutionalize weekend immunization services to accommodate caregivers who cannot bring children to facilities during weekday morning sessions.

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Lessons Learned and Relearned to Improve Routine Childhood Vaccination: Six Insights from the COVID-19 Pandemic - JSI