2_SAGE_Appendicies_Background_final

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Appendix for Section 5Appendix A5.1: Pilot Test of Vaccine Confidence Indicators 2012<strong>Background</strong>23Pilot Test of Vaccine Confidence Indicators 2012GAVP Strategic Objective 2Vaccine hesitancy is not a new phenomenon, although more attention has been paid to it inrecent years. Vaccine hesitancy is an emerging term in the discourse on determinants ofvaccine acceptance where uptake of a vaccine or immunization program in a community islower than would be expected in the context of information given and services available.Vaccine hesitancy recognizes that issues of complacency, convenience and/ or confidence invaccine(s) or immunization programs may all contribute to the delay or refusal of one, someor almost all vaccines. These factors which influence vaccine acceptance vary by setting andresponses need to be locally assessed.In 2012, the WHO Strategic Advisory Group of Experts on Immunization (<strong>SAGE</strong>)established a Working Group to address the issue of vaccine hesitancy which defined vaccinehesitancy and its scope and identified drivers of vaccine hesitancy.In light of the Decade of Vaccines Global Vaccine Action Plan, the working group was askedto develop and pilot test one or several indicator(s) of vaccine confidence that could be usedto monitor the issue on a global and on a national level. The group was asked to pilot testthese two indicators over a broad range of regions in countries with representing all levels ofincome to assess response, comparability and feasibility.MethodsSampling frameThe WHO PAHO and the EUR region volunteered to pilot test the questions related to theindicators in their 2012 UNICEF/WHO Joint Reporting Form (JRF). The JRF was sent to thecountries in December 2012 and January 2013. The countries were asked to return thecompleted forms by 15. April 2013. In addition self-administered questionnaires werepersonally distributed at the Intercountry Support Team South & East and Central Africaimmunization managers' meeting in Q1 2013 to selected EPI managers. The selfadministeredquestionnaire allowed immunization managers to comment on the twoindicators.Indicators and definitionThe questions related to the indicators to assess vaccine confidence were translated in 4WHO languages, French, Russian, Spanish and English. The questions were accompanied bythe definition of vaccine confidence.
DefinitionVaccination confidence is one of a number of factors that affect individual and populationlevelwillingness to accept a vaccine. It means having confidence in the safety and efficacy ofa vaccine, having confidence in the reliability and competence of the health services andhealth professionals who deliver and administer the vaccine, and having trust in themotivations of the policy-makers who decide which vaccines are needed and when.If vaccine coverage is understood as being determined by a combination of supply anddemand factors, confidence is primarily a demand factor, although it can be influenced bysupply factors such as ease or difficulty in accessing services, competence of the vaccinatorand reliability of the vaccine supply. It can also be influenced by factors outside the healthsystem.Indicator 1: % of countries that have assessed (or measured) the level of confidence invaccination at subnational level.Question 1:Has there been some assessment (or measurement) of the level of confidence in vaccinationat subnational level in the past?Question 2:If yes, please specify the type and the year the assessment has been done.Indicator 2: % of un- and under-vaccinated in whom lack of confidence was a factorthat influenced their decision.Question 1:What is the % of un- and under-vaccinated in whom lack of confidence was a factor thatinfluenced their decision (this applies to all vaccines)?Question 2:Was this % measured or estimated?Question 3:Any comments or specific issue?ClassificationWe classified the countries by level of income using the World Bank’s main criterion forclassifying economies, the gross national income (GNI) per capita.Data collection and analysisData were collected by the respective regional offices, submitted to WHO HQ and analyzedusing Microsoft Excel and Stata 11.0.Inclusion and Exclusion criteria24
Page 1: APPENDICES TO THEREPORT OF THE SAGE
Page 4 and 5: vaccine hesitancy in low income cou
Page 6 and 7: INDIVIDUAL andGROUPINFLUENCESInflue
Page 8 and 9: Another model reviewed by the Worki
Page 10 and 11: Appendix for Section 4Appendix A4.1
Page 13 and 14: epresented mostly low and middle in
Page 15 and 16: was more hesitant than the younger
Page 17 and 18: a variable or to a lack of understa
Page 19 and 20: References[1] World Health Organiza
Page 21 and 22: Country FVaccine hesitancy is not a
Page 23: Figure 1. IMs’ opinions regarding
Page 27 and 28: Of all participating countries, 19%
Page 29 and 30: Countries from all 3 regions provid
Page 31 and 32: Table 5: Income level of countries
Page 33 and 34: variety of determinants of vaccine
Page 35 and 36: Uruguay no no responseVenezuela no
Page 37 and 38: RussianFederationyesQuestioning dur
Page 39 and 40: Question 2:Was this % measured or e
Page 41 and 42: Of those countries which submitted
Page 43 and 44: Indicator 2:Indicator 2 was modifie
Page 45 and 46: Table 4. Top three reasons for vacc
Page 47 and 48: The overall response rate to both i
Page 49 and 50: Czech Republic No 1. The fear of si
Page 51 and 52: Kyrgyzstan Yes В 2013 году в
Page 53 and 54: Table A5.3 .1: Survey questions to
Page 55 and 56: Table A5.3.1: Survey questions to a
Page 57 and 58: Table A5.3.2: Survey questions to a
Page 59 and 60: Appendix A5.4 WHO EUR Tailoring Imm
Page 61 and 62: Objective 2 - Characteristics of ev
Page 63 and 64: Most interventions targeted parents
Page 65 and 66: Table 2. PICO questions proposed by
Page 67 and 68: Dialogue-based interventionsEleven
Page 69 and 70: The impact of information-based tra
Page 71 and 72: Conclusions and implicationsLiterat
Page 73 and 74: Appendix A6A.2 Strategies to addres
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change in attitudes).- Most studies
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Strategies to address vaccine hesit
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Table 1.Summary of published litera
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Title/ First author/year of publica
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References1. Williams, S.E., What a
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Appendix A6C.1 Vaccine Hesitancy La
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ii. Google (Hong Kong)• Used the
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Categories Key Actors Areas ofWork/
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Categories Key Actors Areas ofActio
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This landscape analysis, along with
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References for Vaccine Hesitancy La
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67 Robert Wood Johnson Foundation.
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