Impact of 5As Strategy on Vaccination Coverage against influenza in Mexico. Season

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1 Impact of 5As Strategy on Vaccination Coverage against influenza in Mexico. Season Dr. Romeo S. Rodríguez Epidemiological Surveillance Coordinator, IMSS Annecy. September 29,

2 Addressing vaccine hesitancy within a country requires an understanding of the magnitude and setting of the problem, diagnosis of the root causes, tailored evidence-based strategies to address the causes, monitoring and evaluation to determine the impact of the intervention and whether vaccine acceptance has improved, and ongoing monitoring for possible recurrence of the problem Recommendations on vaccine hesitancy from WHO SAGE, Oct

3 Vaccination coverage 5As Initiative: a systematic approach to maintain and increase vaccination coverage TARGET 1 ACCESS I CAN 2 AFFORDABILITY I CAN AFFORD TO 3 AWARENESS I KNOW 4 ACCEPTANCE I WILL 5 ACTIVATION I JUST DO IT Ability as individuals to be reached by or reach recommended vaccines Ability of an individual to pay for vaccination in terms of financial or opportunity costs Knowledge of individuals, communities & societies of the need for & availability of recommended vaccines The intention to get vaccinated where there is access to & awareness of, an affordable vaccine Actions that nudge people to take the final step to vaccinations Time 3

4 5As Process development & implementation of a national coverage plan PHASE 1: SCOPE & WORKING GROUP ENGAGEMENT 1 MONTH 3 MONTHS DEFINE SCOPE BUILD CORE TEAM PHASE 2: ANALYSIS SITUATION ANALYSIS DIFFERENTIAL DIAGNOSIS 5 As IN DEPTH ANALYSIS PHASE 3: STRATEGIC PLANNING 4

5 5As Process development & implementation of a national coverage plan PHASE 3: STRATEGIC PLANNING 1 MONTH 4, 5. YEARS DEFINE BARRIERS & DRIVERS NATIONAL COVERAGE PLAN PHASE 4: IMPLEMENTATION PILOT SCALE UP MONITOR & EVALUATE 5

6 What is the value of the proposed scheme 5As? 1.Scheme for disaggregating problems and developing targeted solutions * 2. Decisions based on evidence, not perception * 3. National approach plan ** 4. Monitoring and Continuous evaluation 5. Collective impact 6. Alliances with domestic institutions and associations 7. Schedule adapted to each country Maintaining and increasing vaccination coverage * It was possible to scientifically identify some of the most important reasons that influence the final decision to get vaccinated. ** This national approach was elaborated based on the weight that each component in the 5As had in a given country. 6

7 5As Development Strategy in Mexico Strategy Intervention Activities Inter-institutional Working Group 1ª Diagnosis of Influenza vaccination coverage Defining intervention 5As Strategy Development AWARNESS Community Participation 2ª Adult attitudes toward vaccination in general Strategy Development ACTIVATION 7

8 5As Development Strategy in Mexico Road to Awareness 8

9 Working group that developed the strategy 5As in Mexico Public Policy I.N. Geriatría Health Sector Seguro Popular Social Leaders Workgroup 5As Civil Society Media 9

10 Main activities carried out in Mexico related to the 5As program 1 ª intervention (Awareness) 5As group integration to analyze influenza s vaccination coverage. Development of the Vaccination Ambassadors strategy to add institutions, private sector and civil society. Launching of the Campaign with a socially recognized leader (Head coach of the national football soccer team). 10

11 Main activities carried out in Mexico related to the 5As program 1 ª intervention (Awareness) Involvement of Civil Society. Starting off with Teletón, with participation in 27 of 32 States in Mexico, (84%). Development of a Communication Strategy in social networking channels. Study of Attitudes towards Vaccination in Adults. 11

12 5As impact during the first year in Mexico Some numbers 3,148,587 new visitors to the YouTube channel 50,000,000 millions of people mediatically impacted by the campaign 33 million doses in the public sector (Additional 23% vs 2013/14) A 70% coverage increase by the end of the year (Dec vs Dec. 2013) 12

13 Results of vaccination against influenza in Mexico employing the 5As strategy (just Awareness) Period coverage increase Sept Dic (basal) Initial +/- 50% + 20% Sept Dic Final + 70% Coverage by the end of the season from Oct. to March 2015 Three months later > 90% + 20% Awareness Initial Activation 13

14 5As development strategy in Mexico Road to Activation 14

15 Study on adult attitudes to vaccination influenza vaccine Study on adult attitudes to vaccination USA., United Kingdom, France, Mexico Sample: 850 adults aged 18 and over by country Annual evaluation of the indicator "Index on adult attitudes to vaccination" 15

16 Progress of study on adult attitudes towards Vaccination against influenza in Mexico N= 850 (Pilot study) Variable % obtained Confidence in the vaccine 80 % Acceptance of the vaccine 82 % In favor 80 % Support for vaccination In doubt 18 % Against 2 % 16

17 Progress of study on adult attitudes towards Vaccination against influenza in Mexico N= 850 (Pilot study) TO BE IMPROVED 5 Accessibility to vaccine Variable Openness to receive vaccine % obtenido Vaccinated 70 % Unvaccinated 59 % Vaccinated 45 % Unvaccinated 46 % ACTIVATION I JUST DO IT Actions that nudge people to take the final step to vaccinations 17

18 Study on adult attitudes towards Vaccination Activities to do II. Redirect the communication to the vulnerability of people when not vaccinated in order to improve the "ACTIVATION". I. Keep those activities of the previous season: a. Network communication campaign b. Participation of an ambassador for influenza vaccination c. Communication to health workers (different target) in favor of vaccination of 5As "AWARENESS VACCINATED! 18

19 THANK YOU! 19