Building Trust and Responding to Adverse Effects Following Immunisation in South Asia

This working paper addresses the communication efforts needed to prepare
for and address adverse effects following immunisation (AEFI). Serious AEFI can, according to the authors, erode public confidence
and contribute to a drop in immunisation rates. Communication strategies should, therefore, provide a comprehensive communication plan that does more than deal with individual cases
in an ad-hoc manner.



The authors make the following recommendations to managers who may face real or perceived cases of
AEFI:

• Respond swiftly with accurate information based on evidence;
• Know how to deal with broad vaccine safety issues, often coming from the
  media versus individual AEFI cases;
• In case of a rumour, assess the origins of the rumour and be prepared with a number of potential strategies to counter them;
• Foster long-term partnerships with professional organisations and credible national
  spokespersons inside and outside the Ministry of Health;
• Collaborate with the national immunisation committee dealing with vaccine safety
  issues;
• Work through different channels and spokespeople to promote accurate information and
  cooperation to ultimately enhance public trust in immunisation;
• Monitor the community's knowledge, attitudes and practices toward immunisation
  particularly after an adverse event has occurred;
• Document lessons learned in handling communication responses to AEFI.

The paper expands on this advice by recommending proactive communication plans,
and providing advice for communication with health workers, families, communities
and the media. Suggested communication techniques vary by group, and the authors
recommend different techniques for subgroups, such as radio, television or print
media.


Evaluation of any communication intervention is essential, according the
the authors, to determine how much has been accomplished and how future
interventions can do better. The authors suggest methods to monitor public
opinion, including methodologies, indicators and evaluation techniques.



This paper also provides examples of adverse events that occurred in Bangladesh,
Pakistan, India and Afghanistan. Each case study lists the responses that took
place, and the lessons that can be drawn. The authors recommend this type of
documentation and analysis whenever a  response occurs to an AEFI.