Immunization directly impacts health SDG 3 and contributes to 14 out of the 17 SDGs. Although immunization is essential for reducing mortality, particularly among children under five, and substantial progress has been made in recent decades, SDG3 immunization-related indicators continue to lag behind in sub-Saharan Africa. There are a number of reasons for this – and the current GAVI Replenishment troubles won’t help. Yet, clearly fake news and conspiracy theories also play an important (and increasing?) role, especially after the Covid pandemic. Many countries find it challenging to achieve optimal immunization coverage nowadays. Despite proven effectiveness, plenty of people remain hesitant about vaccination. Vaccine hesitancy is not just a challenge in developed countries like the United States or Europe. It also affects West Africa with a significant public health impact as Mutombo argued in a 2022 Lancet Global Health Comment.
Recently, our research institution Laboratoire d’Etude et de Recherche-Action en Santé (LERAS) based in Benin has obtained a grant from the West African Health Organization (WAHO) to study the factors that drive vaccine hesitancy in 4 countries in West Africa (Nigeria, Ghana, Benin, and Côte d’Ivoire). The RICOVHes (Hésitation à la Vaccination systématique et au vaccin COVID-19 et des facteurs liés aux systèmes de santé qui influencent les efforts de vaccination en Afrique de l’Ouest) project aims to better understand why some populations are reluctant to get vaccinated and to develop tailored strategies to improve vaccine coverage.
In this blog, we shed some light on the research ahead, also with the aim to raise the issue on the health policy research agenda.
Establishing a collaboration and partnership between LERAS and WAHO
But first a few more words on LERAS.
LERAS is a non-governmental organization of which the objective is to guide evidence-based public health policy. As part of the programs developed by LERAS in various areas of intervention, LERAS is interested in a continuum of activities covering the definition, implementation and evaluation of population health interventions. We make an effort to collaborate with international health institutions, advocating together to increase people’s and policymakers’ awareness. Against this backdrop, we are very proud to collaborate with WAHO on a specific project that focusses on vaccine hesitancy in West Africa. We hope that other institutions will come on board and support us in mobilizing resources for health policy evaluation in West Africa.
RICOVHES
Our study uses a mixed-methods research design, combining quantitative and qualitative approaches across the four countries involved. We will collect data from the country level immunization program and analyze the key factors that influence vaccine acceptance or refusal for everyone (adult vaccination, adults’ acceptance or refusal for their children’s vaccination). Covid-19 is not ‘epidemic’ currently, however its continued impact on vaccine hesitancy remains high, and so we plan to assess its impact on vaccine hesitancy in the four countries in West Africa. Given the investigation of a human case of Lassa fever in Ivory Coast some years ago, additionally, we would also like to investigate the behaviors and practices related to the next Lassa fever vaccine that will be proposed in West Africa.
The findings from RICOVHes will help refine new strategies for implementing immunization programs. Our objective is not only to increase vaccine coverage but also to equip healthcare professionals with the necessary tools to address public concerns and misinformation. Through these initiatives, we hope to offer effective evidence-based solutions that governments can implement to enhance their immunization programs and strengthen public trust in vaccines in West Africa.
A new era for immunization in West Africa
Vaccine hesitancy is not just a public health issue, there are also vital links with governance, social stability, and economic development. By leveraging the insights from RICOVHes, policymakers will be able to refine their vaccination policies, enhance communication, and ensure optimal vaccine coverage. By integrating these recommendations into national health policies, West African countries can build a resilient, inclusive and effective healthcare system, better prepared to handle future pandemics and health crises.
RICOVHes embodies a new era for immunization in West Africa: by combining scientific research, community engagement, and innovation, RICOVHes aims to break down the barriers of vaccine hesitancy. More than just a research project, it represents a transformative opportunity to raise public health awareness in West Africa.
We hope that our work will break down barriers to vaccine hesitancy and contribute to a future where every child, every adult, and every community can fully benefit from life-saving immunization programs.
Our thanks go to Arsène KPANGON (RICOVHes), Euripide AVOKPAHO (RICOVHes), Rodrigue KOHOUN, Aliyu MOUSTAPHA, Doris OTTIE-BOAKIE, Richard YAPI (all members of the steering committee of ECOWAS), Pr Issiaka SOMBIE (WAHO) for their commitment to this blog.