13,919 The Drum Beat 775, June 19 2019, Post-Crisis Communication: The Case of Polio and Vaccines In this issue:  

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The Drum Beat 775
June 19, 2019
Post-Crisis Communication: The Case of Polio and Vaccines

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In this issue:

* WHY WE SHOULD WORRY: IMPACTS OF A CONFIDENCE CRISIS
* LEARNING FROM PAST INCIDENTS: POLIO
* ACTING IN THE AFTERMATH: LEGAL/PUNITIVE MEASURES
* LONGER-TERM RESPONSE STRATEGIES
* PLEASE WEIGH IN: CI SURVEY

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Beginning on April 22 2019, an unfolding communication crisis in polio-endemic Pakistan threatened to impede progress on the quest for global polio eradication. The situation started when false and fabricated videos went viral on social media claiming that the polio drop made children sick. The public response that followed has led to an unprecedented increase of vaccination refusal. Looking outside of Pakistan and that particular crisis for experiences and lessons learned, this Drum Beat focuses on recovering from large-scale events involving misinformation, rumours, refusal, and adverse events following immunisation (AEFIs).
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WHY WE SHOULD WORRY: IMPACTS OF A CONFIDENCE CRISIS
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LEARNING FROM PAST INCIDENTS: POLIO
  • 4.“This Is a Pakhtun Disease”: Pakhtun Health Journalists’ Perceptions of the Barriers and Facilitators to Polio Vaccine Acceptance Among the High-Risk Pakhtun Community in Pakistan
    by Sayyed Fawad Ali Shah, Tamar Ginossar, and David Weiss
    In Pakistan, there are still pockets of communities, mostly ethnic Pakhtun living in the Khyber Pakhtunkhwa (KP) province, that resist oral polio vaccine (OPV). In March 2018, for example, both national and local media outlets reported an unsubstantiated news story that 3 children had died after receiving OPV – leading the number of polio vaccine refusal cases to double in April 2018. Considering that local journalists may be important sources of health information, this study examined Pakhtun health journalists’ beliefs regarding OPV and their views on the barriers and facilitators that influence OPV acceptance or hesitancy in their communities. The findings point to ways to improve OPV advocacy and prevent communication crises, including through media coverage. [May 2019]
  • 5.2018 Nigeria Polio Eradication Emergency Plan
    Nigeria’s National Primary Health Care Development Agency explains that there was a surge in resistance to vaccination in the fourth quarter of 2017 following rumours that linked a monkey pox outbreak to vaccination. Several high-risk states were affected negatively. A study was conducted to assess the impact of the rumours, after which some strategies were proposed – e.g., disseminate a single set of messages through the same channels as those used by the rumour-mongers, and do not raise the rumour-mongers’ profile by identifying and denouncing them. [Jan 2018]
  • 6.100 Days of the Polio Outbreak Response: Special Report on Papua New Guinea
    To mark the 100 days since the Government of Papua New Guinea launched the Emergency Response to the Polio Outbreak, the National Department of Health released this report on the key accomplishments and highlights from the response operations. Rumours and misconceptions were managed either through an influential person/group, dialogue with church groups, and/or getting media support. Looking ahead, the risk communication and social mobilisation approaches will transition into strategic communication strategies designed to sustain people’s and media interest on polio, promote long-term behaviour changes, and increase uptake of routine immunisation. [Sep 2018]
  • 7.Polio Outbreak Ukraine Report 2015-2016: Unique Challenges, Comprehensive Response
    From the United Nations Children’s Fund (UNICEF) Ukraine Country Office, this report provides documentation and analysis of the communication response to the summer 2015 outbreak of circulating vaccine-derived poliovirus (cVDPV) in Western Ukraine. Beginning with a measles outbreak in 2008 in which the death of a teenager was wrongly linked to receiving a vaccine, routine immunisation coverage rates, including polio, plummeted. UNICEF, the World Health Organization (WHO), and the Ukraine Ministry of Health (MOH) were battling public mistrust of vaccines, misconceptions among health care providers, vaccine shortages, and a restrictive legislative and regulatory environment. As the 2015 campaign moved forward, systematic response to mistrust included collaborative efforts launched directly with media producers to ensure the media mix was diversified and made more aggressive. A wider array of trusted local, national, and international health care experts delivered this more agg! ressive messaging.
  • See also:
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ACTING IN THE AFTERMATH: LEGAL/PUNITIVE MEASURES
  • 8.Mandatory Infant & Childhood Immunization: Rationales, Issues and Knowledge Gaps
    by Noni E. MacDonald, Shawn Harmon, Eve Dubé, Audrey Steenbeek, Natasha Crowcroft, Douglas J. Opel, David Faour, Julie Leask, and Robb Butler
    This article presents an overview of mandatory immunisation, providing examples in one low- and two high-income countries to illustrate variations, summarise limited outcome data related to mandatory immunisation, and suggest key elements to consider when contemplating mandatory infant and/or child immunisation. Among other issues, the authors examine evidence of unintended consequences. For example, in Serbia, the government responded to the decline in measles, mumps, and rubella (MMR) immunisation and the 2014/2015 outbreak of measles with substantial tightening of mandatory immunisation and harsher penalties. As they had not addressed the problem with the families and the general public, the response to the tightened law heightened anti-vaccine sentiments and enhanced attention to negative vaccination messages in the media. Now, the vaccine uptake problem is compounded by low confidence in the programme, which may have been further undermined by the new harsher penalties.! [Aug 2018]
  • 9.Outbreak of Vaccine-Preventable Diseases in Muslim Majority Countries
    by Ali Ahmed, Kah S. Lee, Allah Bukhsh, Yaser M. Al-Worafi, Md. Moklesur R. Sarker, Long C. Ming, and Tahir M. Khan
    The increase in Muslim parents’ refusal and hesitancy to accept childhood vaccination has been identified as one of the contributing factors to the increase of vaccine-preventable disease (VPD) cases in countries such as Afghanistan, Malaysia, and Pakistan. The authors are concerned about what they call inaccurate and irresponsible information being spread by the anti-vaccination movement, such as claims that have gone viral on social media that the vaccine is a plot to weaken Muslims. Authorities in some countries have resorted to imposing strict punishments on parents who refuse to allow their children to be vaccinated. However, the authors stress that “mandatory vaccination and punishment are ineffective in encouraging parents to vaccinate their children without extensive public education.” [Oct 2017]
  • See also:
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LONGER-TERM RESPONSE STRATEGIES
  • 10.Exploring Pathways for Building Trust in Vaccination and Strengthening Health System Resilience
    by Sachiko Ozawa, Ligia Paina, and Mary Qiu
    This paper reflects on how disruptions to immunisation systems can affect trust in vaccination and can compromise vaccine utilisation. It then explores key pathways for overcoming system vulnerabilities in order to restore trust, strengthen the resilience of health systems and communities, and promote vaccine utilisation. Having identified multiple routes through which trust in vaccination can be gained or lost and highlighting key vulnerabilities within health systems and communication channels, the authors identify key areas to build resilience. [Nov 2016]
  • 11.The Importance of the Patient Voice in Vaccination and Vaccine Safety – Are We Listening?
    by D. Holt, F. Bouder, C. Elemuwa, G. Gaedicke, A. Khamesipour, B. Kisler, S. Kochhar, R. Kutalek, W. Maurer, P. Obermeier, L. Seeber, B. Trusko, S. Gould, and B. Rath
    This paper reflects on the paradigm shift towards increasing attention to the patient voice in vaccination and vaccine safety and looks at how listening to the patient voice is key in any risk communication strategy. This shift reflects the reality that (most) patients are not experts in the field of vaccines or risk assessments. As a result, communication needs to be clear and concise, without complicated jargon and allowing questions and seeking feedback regularly. Two case studies illustrate lessons that can be learned from challenging situations: OPV refusals in Nigeria, and the measles vaccination campaign following Ebola outbreaks in Liberia. [Dec 2016]
  • 12.New Framework Model for Communication
    This communication planning model addresses the main research questions presented by the TELL ME (Transparent communication in Epidemics: Learning Lessons from experience, delivering effective Messages, providing Evidence) project. In contrast to top-down models that convey the notion that information flow is unilateral, this model “sees the public not as another stakeholder but rather as a partner, not to be patronized but engaged….A successful public health campaign must take into an account that in the current reality, the ‘health blogger’ or the ‘concerned mother’ are sometimes as important as the healthcare official….The contribution of this model is that it can be adapted to many specific risk situations through simulations in which the ideas can be developed into concrete plans.”
  • 13.Communication is key to quashing suspicion around vaccination drives
    by Wilmot James
    “…The barrier that rumour-mongering presents to vaccine delivery logistics is so serious that the world’s premier pandemic preparedness assessment body, the …Joint External Evaluation, or JEE Alliance…ranks ‘dynamic listening and rumour-management’ as one of the most important risks governments must get under control. The JEE assessment document talks about health risk communication as ‘real-time exchange of information, advice and opinion between experts and officials or people who face a threat or hazard’ and providing citizens with the hard facts….Effective public messaging requires taking into account community-specific social, religious, cultural, political and economic needs. Effective engagement with communities means building resilience and holding exercises and simulations with citizens. Dynamic listening and effective rumour management are about the continual monitoring of all social media platforms during a crisis so there is an early understanding of! what affected communities need.” [Dec 2017]
  • See also:
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This issue of The Drum Beat was written by Kier Olsen DeVries.
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The Drum Beat is the email and web network of The Communication Initiative Partnership.

Full list of the CI Partners:
ANDIBBC Media ActionBernard van Leer FoundationBreakthroughCiturna TVFundación Imaginario,Fundación Nuevo Periodismo Iberoamericano (FNPI)HeartlinesJohns Hopkins Center for Communication ProgramsMaternal and Child Survival Program (MCSP)MISAOpen Society FoundationsOxfam NovibPAHOThe Panos InstitutePuntos de EncuentroSAfAIDSSesame WorkshopSoul CitySTEPS InternationalUNAIDSUNICEFUniversidad de los AndesWorld Health Organization (WHO)W.K. Kellogg Foundation

The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.

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The Editor of The Drum Beat is Kier Olsen DeVries.
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