Understanding behaviours as a first step to addressing declining vaccination uptake in Europe

WHO/J. Hauspurg

Routine immunization coverage has declined in the WHO European Region as a whole over the past 5 years, creating increased risk of new outbreaks of vaccine-preventable diseases. National immunization programmes across the Region are eager to reverse this trend. However, to develop successful interventions they must first understand the underlying determinants of their populations’ vaccination behaviours – what drives people to vaccinate, and what may pose a barrier.

To help countries identify and address the causes of low vaccine uptake, WHO/Europe and the University of Erfurt, Germany, teamed up to offer a Behavioural Insights Summer School (BISS). The first-ever BISS took place at the University of Erfurt on 18–22 September 2017.

Through a varied programme that included academic-level plenary presentations and group exercises, the BISS demonstrated how immunization programmes can listen to communities and obtain behavioural insights in order to tailor their services and plan interventions to increase vaccine uptake.

The week-long course gathered representatives of Argentina, Bosnia and Herzegovina, Germany, Finland, France, the Republic of Moldova, Serbia and Sweden, and PhD students in the fields of psychology, communication science and behavioural economics. Together they worked to build the capacities of countries and academia to analyse and understand the barriers and drivers to vaccination among key target groups, as well as how to respond to them.

The BISS placed special emphasis on applying qualitative research methods and monitoring and evaluating interventions. Participants’ learning process was evaluated based on 5 learning objectives. Follow-up assessments to determine whether their new knowledge has been retained and used in practice will continue for the coming year.

TIP approach

The BISS also served as an introduction to WHO’s tailoring immunization programmes (TIP) approach. A group assignment on a fictitious case led participants through each step of the TIP process. To further the global use and adaptation of the TIP approach, the BISS included participants from Argentina, the United Nations Children’s Fund, the United States Centers for Disease Control and Prevention, the WHO Country Office in Burkina Faso and WHO headquarters.

Innovative training

The BISS is the first of its kind in the immunization field. It not only facilitates the sharing of experiences and ideas across cultural contexts and disciplines, but also enables practice–theory exchange and peer-to-peer learning among professionals and academics from different technical fields.

One participant noted that the course was “excellent and well-organized ... There was something useful for all participants, regardless of their background and experience.”

Based on the initial feedback from participants, the BISS will run annually to build capacity and inspire and initiate discussions on behavioural insights and behaviour-change projects among Member States, academia and professionals in the field. Discussions concerning opportunities to adapt the concept for use in other regions are also ongoing.