By Jamie Minchin, Senior Associate, Vaccine Acceptance and Demand and Meaghan Charlton, Senior Manager, Vaccine Acceptance

Globally, the COVID-19 pandemic and newly developed vaccines present additional challenges to immunization efforts and the building of public trust in vaccination. With its population of approximately 1.4 million and over 10 million coronavirus cases, India has the second highest infectious rate in the world, alongside a complicated history when it comes to immunization campaigns and community coverage. To best address vaccine-related challenges, it is essential to understand the social factors underlying them, including the role that vaccine misinformation has played in the coronavirus pandemic in specific geographic contexts in India.

2020 Sabin Grant Awardee - Dr. Rajeev SethSabin’s Vaccine Acceptance and Demand initiative is proud to support a collaboration between Bal Umang Drishya Sanstha (BUDS), a non-profit organization focused on child health and welfare for marginalized children in New Delhi, India, and the Johns Hopkins University’s Maternal and Child Health Center (JHU). The funding is provided through our Social and Behavioral Interventions for Vaccination Acceptance Small Grants Program.

The collaborating groups will conduct a virtual research project exploring barriers to vaccine acceptance and a virtual community health worker-led intervention in the rural Indian region of Mewat, which reports a low vaccination rate of 13.1% of children under the age of two. Baldeep Dhaliwal and Dr. Anita Shet from JHU join the project to provide technical support and expertise in maternal and child health, while Dr. Rajeev Seth of BUDS will lead community engagement efforts and the research and intervention trainings in the Mewat region.

"BUDS and JHU are committed to working in tandem with community health workers and local community leaders to develop and implement sustainable solutions to improving vaccine uptake, addressing misinformation in the community and paving the way for a COVID-19 vaccine,” relayed Dr. Seth, senior consultant pediatrician at BUDS. “This project will highlight the importance and long-term benefits of involving participants in the design, implementation, and analysis of a study.”

The project is driven by baseline research previously conducted by the BUDS and JHU researchers. Their work explored the efficacy of mobile phone incentives for improving childhood immunization uptake and the role of community health workers (CHWs) in vaccine acceptance. The researchers found that while CHWs play an influential role in vaccine acceptance, they neither perceived their ownership over vaccination efforts nor felt well-trained to address community concerns. As such, the team identified the training of CHWs as a necessary component in better engaging the community and increasing vaccine acceptance.

2020 Sabin Grant Awardee - Baldeep DhaliwalBuilding upon their baseline findings, the study funded by Sabin will research specific barriers to vaccination, including misinformation, vaccine myths and community rumors through surveys and virtual workshops with Mewat region community members. The team will then design and conduct a CHW workshop drawing upon their research findings. Compared with past interventions working to increase community ownership, the BUDS/JHU research team will directly engage CHWs as sources of local knowledge and actors capable of bridging the community and health system. The intervention will aim to provide CHWs with additional training on vaccinations to enhance their ownership over vaccination and develop a mechanism for long-term community coverage.

With the Sabin grant, the research team will establish an understanding of the role of community-level misinformation dynamics and ASHAs on vaccine acceptance. The study has important implications for how future vaccination interventions are conducted and which actors are engaged in local interventions.