COVID-19 vaccines are critical to combating the pandemic, but vaccine hesitancy among many high-priority populations has hindered efforts to achieve optimal vaccine coverage against COVID-19. EMPHNET has been collaborating with the Ministries of Health in the Eastern Mediterranean region to address the issue of vaccine hesitancy. As part of this effort, EMPHNET supported an assessment to determine the factors affecting demand for COVID-19 and routine immunization.

The assessment detailed the social and behavioral factors that affect the acceptability and under-vaccination of COVID-19 and other Expanded Program on Immunization (EPI) vaccines among high-priority populations in the EMR region. It also assessed the regional, country, and sub-national planning efforts for introducing COVID-19 vaccines to high-priority populations by gathering, reviewing, and comparing data from various sources.

In Pakistan, ideation workshops were conducted in four provinces and a national workshop in the Federal capital to share assessment results and discuss priority areas that require attention to increase vaccine demand. Based on these discussions and assessment findings, an intervention was suggested to test a pilot program in a chosen district of a low-performing province regarding COVID-19 vaccination coverage.

This intervention in Pakistan intends to enhance access to COVID-19 vaccines for pregnant and breastfeeding women by educating Female Health Workers (FHWs) on vaccine safety and benefits. FHWs will also improve referrals to nearby vaccination centers and engage with the target audience through advocacy sessions, home visits, and meetings with pregnant and lactating women. The intervention focuses on women aged 18-24, children in the EPI target age group, and Pregnant and Lactating Women (PLW), with the objective of increasing vaccine demand, reducing reluctance, and enhancing uptake among these groups.

As a part of this intervention, EMPHNET arranged training sessions for FHWs and Lady Health supervisors with the aim of improving their advocacy and risk communication skills. The training was designed to equip them with the necessary skills to counter vaccine hesitancy, build vaccine confidence, and increase demand for COVID-19 vaccines and routine immunization among target groups.

The training sessions also focused on increasing the knowledge of FHWs about the safety, efficacy, and importance of COVID-19 vaccines, including both primary and booster doses. Following the training, FHWs have been conducting advocacy sessions with community leaders and influencers, such as religious leaders, husbands, mothers-in-law, and PLWs. These sessions have been designed to address any misinformation regarding vaccines and to help increase vaccine trust in the community. FHWs have been conducting home visits and referring unvaccinated women, PLWs, and children to health facilities to receive their vaccines.

 This intervention is expected to increase vaccination coverage and ensure that those who are hesitant about getting vaccinated receive the information and resources they need to make an informed decision.