Training community leaders in Fiji to promote and educate others about the benefits of vaccines builds trust and could be key to eradicating preventable diseases, according to a new study.
The research, led by Murdoch Children's Research Institute (MCRI) and driven by the Fiji Government, found the initiative, which leveraged cricket and rugby codes alongside healthcare workers, helped to boost COVID-19 vaccination rates and address the decrease in vaccine confidence post-pandemic.
The Vaccine Champions Program empowers local leaders and healthcare workers via comprehensive vaccine education and communication skills training to deliver information sessions to their communities.
Image: MCRI Professor Margie Danchin, Belle Overmars and Dr Jessica Kaufman during the co-design workshop in Fiji.
In Fiji, the program brought together faith and village leaders, the Red Cross, and coaching staff from Fiji Rugby and the Fiji Cricket women's team.
The program was supported by the Australian Government and co-designed by MCRI researchers in partnership with Fiji's Ministry of Health, UNICEF, The University of Sydney and UNSW Sydney.
The training involved 35 champions conducting 54 sessions over six months, reaching more than 1700 people. It focused on COVID-19 boosters for adults, COVID-19 vaccines for five to 18 year olds and routine childhood vaccines.
Published in BMJ Global Health, the study reported the community leaders and healthcare workers found the training overwhelmingly positive, with attendees' intention to receive a COVID-19 booster increasing from 41 per cent to 83 per cent.
MCRI Dr Jessica Kaufman said improving trust and confidence in vaccines was a global priority as countries have grappled with delivering COVID-19 vaccines, maintaining routine childhood vaccination rates and introducing new vaccines.
Image: Team members Belle Overmars, Professor Margie Danchin, Dr Jessica Kaufman, Kylie Jenkins and Louisa Vodonaivalu with Fiji's Ministry of Health team Dr Rachel Devi and Sr Litiana Volavola.
"During the COVID-19 pandemic, the value of community engagement strategies was increasingly recognised as governments realised that promoting vaccines through broad media campaigns alone was not sufficient to overcome diverse access and acceptance barriers to uptake," she said.
In Fiji, the initial uptake of primary doses of COVID-19 vaccine among adults was relatively high. But by early 2022, the uptake of booster doses had slowed considerably and coverage in adolescents and children was low.
To counter the vaccine hesitancy, Fiji's Ministry of Health supported the champions program to help improve uptake of third doses for adults and primary doses for children and adolescents.
Dr Kaufman said several vaccine champions witnessed the direct benefits of their community sessions.
Image: The Vaccine Champions Program in Fiji included 54 sessions over six months, reaching more than 1700 people.
"Some attendees decided to get COVID-19 boosters or vaccines for their children when they were previously unsure, and others became more open to learning about the importance of vaccines," Dr Kaufman said.
"They also talked about how they had shared the information they learned in the session with other people in their community."
The study reported while there were a range of factors influencing vaccine uptake, COVID-19 booster rates increased in Fiji during the program roll-out from 44 per cent to 54 per cent.
MCRI Professor Margie Danchin said the findings highlighted that training local leaders and healthcare workers to be vaccine advocates was extremely effective because they were trusted and respected in their communities.
"Living in the community, vaccine champions are able to speak the local language, highlight local motivating factors and influence social norms to encourage vaccination," she said.
"Unlike programs that simply partner with community leaders to promote vaccination, this intervention includes intensive training and education to provide key facts about vaccine safety and effectiveness, address misinformation and help advocates to answer questions about vaccines from their communities.
"This program can reduce the burden on health workforces an issue facing many countries in the Asia Pacific region. Community advocacy is grounded in building and sustaining trust in vaccines and is crucial for current global efforts to combat measles outbreaks and eliminate vaccine-preventable diseases such as cervical cancer."
Professor Danchin said the program had been adapted and implemented in other countries in the Asia Pacific region including Indonesia, Vietnam and Tonga.
Researchers from the University of Melbourne, Fiji Ministry of Health, The University of Sydney, UNSW Sydney, UNICEF Pacific, UNICEF East Asia and Pacific and The Royal Children's Hospital also contributed to the study.
Publication
Jessica Kaufman, Isabella Overmars, James Fong, Jemesa Tudravu, Rachel Devi, Litiana Volavola, Luisa Vodonaivalu, Kylie Jenkins, Julie Leask, Holly Seale, Yasmin Mohamed, Kshitij Joshi, Halitesh Datt, Sonya Sagan, Michelle Dynes, Monsurul Hoq and Margie Danchin. 'Training health workers and community influencers to be Vaccine Champions: a mixed methods RE-AIM evaluation.' BMJ Global Health. DOI: 10.1136/bmjgh-2024-015433
*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.
About Murdoch Children's Research Institute
Murdoch Children's Research Institute is the largest child health research institute in Australia committed to making discoveries and developing treatments to improve child and adolescent health in Australia and around the world. They are pioneering new treatments, trialling better vaccines and improving ways of diagnosing and helping sick babies, children and adolescents. It is one of the only research institutes in Australia to offer genetic testing to find answers for families of children with previously undiagnosed conditions.
Funding
This publication has been funded by the Australian Government through the Department of Foreign Affairs and Trade. The views expressed in this publication are the author's alone and are not necessarily the views of the Australian Government.
