‘Learn from the lessons and don’t forget them’: identifying transferable lessons for COVID-19 from meningitis A, yellow fever and Ebola virus disease vaccination campaigns

Abstract

IntroductionCOVID-19 vaccines are now being distributed to low- and middle-income countries (LMICs), with global urgency surrounding national vaccination plans. LMICs have significant experience implementing vaccination campaigns to respond to epidemic threats but are often hindered by chronic health system challenges. We sought to identify transferable lessons for COVID-19 vaccination from the rollout of three vaccines that targeted adult groups in Africa and South America: MenAfriVac (meningitis A); 17D (yellow fever) and rVSV-ZEBOV (Ebola virus disease).MethodsWe conducted a rapid literature review and 24 semi-structured interviews with technical experts who had direct implementation experience with the selected vaccines in Africa and South America. We identified barriers, enablers, and key lessons from the literature and from participants’ experiences. Interview data were analysed thematically according to seven implementation domains.ResultsParticipants highlighted multiple components of vaccination campaigns that are instrumental for achieving high coverage. Community engagement is an essential and effective tool, requiring dedicated time, funding and workforce. Involving local health workers is a key enabler, as is collaborating with community leaders to map social groups and tailor vaccination strategies to their needs. Vaccination team recruitment and training strategies need to be enhanced to support vaccination campaigns. Although recognised as challenging, integrating vaccination campaigns with other routine health services can be highly beneficial if well planned and coordinated across health programmes and with communities.ConclusionAs supplies of COVID-19 vaccines become available to LMICs, countries need to prepare to efficiently roll out the vaccine, encourage uptake among eligible groups and respond to potential community concerns. Lessons from the implementation of these three vaccines that targeted adults in LMICs can be used to inform best practice for COVID-19 and other epidemic vaccination campaigns.

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“…However, its implementation has not always been effective, 19 even though lessons learnt from previous vaccination programmes show that community engagement is an effective and essential tool. 20 In South Asia, for example, community engagement efforts in Ebola and Polio vaccines were used consistently and successfully. 21 A recent review on community engagement for the prevention and control of infectious diseases 19 noted how community engagement has been used to support vaccine uptake.…”

“…Community engagement has been part of global recommendations and guidelines on the response to the COVID-19 pandemic. However, its implementation has not always been effective,19 even though lessons learnt from previous vaccination programmes show that community engagement is an effective and essential tool 20. In South Asia, for example, community engagement efforts in Ebola and Polio vaccines were used consistently and successfully 21.…”

Role conflict, job crafting, stress and resilience among nurses during COVID‐19

“…The opioid epidemic (Fortunato & Gigliotti, 2019 ), and viral outbreaks throughout the world (Ebola, SARS, etc. ), exemplify healthcare crises with no easily defined cause or agent of responsibility (Collins et al, 2021 ). Unique in terms of its global spread, contagiousness, and high mortality rate, in combination with inundated healthcare systems, COVID‐19 is a historic example of a prolonged crisis with shifting sources of blame and responsibility.…”