. .


Vaccination is a cost-effective strategy for reducing childhood mortality and morbidity, but more than 24 million children still do not have access to basic immunization services worldwide. Vaccination access and uptake in 'Hard to reach' groups also remains an issue.

Strategies to increase vaccination uptake involve:

  • Supply-side interventions: these include improving the availability of effective vaccines, technologies to support their application and health personnel to deliver services
  • Demand-side or consumer level components: these include communication to various stakeholders about vaccination

In research and policy, more attention has been placed on supply side interventions while neglecting demand side or consumer level components. However, demand-side strategies, such as interventions to improve communication between parents and health care providers, have the potential to address barriers to vaccination associated with parental knowledge and understanding, attitudes, beliefs and behaviour. Such strategies may improve childhood vaccination uptake in low- and middle-income countries (LMICs) as well as the cost effectiveness of immunization programmes.

What is a communication intervention?
In the COMMVAC project we define a communication intervention as a purposeful, structured, repeatable and adaptable strategy to inform and influence individual and community decisions in relation to personal and public health participation, disease prevention and promotion, policy making, service improvement and research.

Communication interventions may operate at individual, community or societal levels, and target people in their role as parents or community members. The COMMVAC taxonomy of interventions to improve communication about childhood vaccination identifies seven key purposes of communication targeted at three different groups. The target groups are:

  • Parents, soon to be parents and caregivers
  • Communities, community members or volunteers
  • Health professionals

The seven main communication purposes are:

  • To inform or educate
  • To remind or recall
  • To teach skills
  • To provide support
  • To facilitate decision making
  • To enable communication
  • To enhance community ownership

What evidence exists to inform the development of communication strategies to increase vaccination uptake?
There are few high quality systematic reviews of interventions to improve vaccination uptake. However, there is a substantial body of evidence from randomized controlled trials (RCTs) assessing relevant communication interventions. To date, the findings of many of these RCTs have not been synthesized in reviews. This is also the case for qualitative information concerning communication for vaccination, such as parents’ preferences regarding how they wish to be communicated with and how people perceive the vaccination information that they receive.

As part of the first phase of the COMMVAC project, we undertook two systematic reviews of high priority questions regarding the effectiveness of vaccination communication interventions:

In the second phase of the COMMVAC project, we will review information on the implementation of vaccination communication interventions and also on parents’ preferences regarding how they wish to be communicated with and how people perceive the vaccination information that they receive.

Norwegian Institute of Public Health La Trobe University Ministry of Health Mozambique Catholic University Chile University of Calabar IUHPE Swiss TPH