To protect against diseases such as measles, high vaccination rates are vital. By vaccinating at least 95% of children with two doses of measles vaccine, outbreaks can be prevented.
However, even when the average vaccination rates in a city or region are high, vaccine uptake may not be at the same level in all communities. This could be due to cultural, practical or other reasons. The best way to understand why vaccination rates are low among members of a social or religious group is to ask them.
That’s where medical anthropologists come in.
They are experts at understanding the cultural, social and biological factors that influence health. They work with communities to get an understanding of their daily lives, and help to design services that meet people’s needs.
For example, Dr Ben Kasstan-Dabush, a medical anthropologist, worked with colleagues and members of the Charedi orthodox Jewish community in London to learn about their views on vaccination. The team then designed a video that answers common questions in a relatable way.
‘Vaccine delay can be common in the orthodox Jewish community, leaving children vulnerable to infection,’ Dr Kasstan-Dabush says. ‘Orthodox Jewish healthcare workers are often called upon to discuss vaccination with parents who may be reluctant to have recommended vaccines on schedule. They are trusted voices within the community. We developed a script to address the kinds of questions families have.’
Lifting practical barriers
This kind of approach has been taken before when designing community-specific immunisation programmes and campaigns – including among the Charedi community in London.
As part of a separate initiative ten years ago, researchers found that practical barriers, such as bringing large families across the city to attend appointments, were the main challenge for parents. When services were designed to be more accessible, convenient and appealing, parents were more likely to keep up with the recommended vaccine schedule.
However, ongoing funding is needed if this research is to be used to connect people with health services.
‘We’ve got documented evidence of what the challenges are and what the enablers are, but the ability to sustain that strategy is undermined by the funding cycle,’ says Dr Kasstan-Dabush – an Assistant Professor and Lecturer in Global Health Policy at University of Edinburgh and Assistant Professor of Global Health & Development at the LSTHM.
He also calls for standard vaccine confidence training for healthcare providers and those in administrative roles who have contact with the public. This can help to improve vaccine uptake among children, as well as at other stages of life.
Speaking on the Coalition for Life-Course Immunisation (CLCI) podcast, Dr Kasstan-Dabush points to the need for community engagement to support a wide range of recommended vaccines during pregnancy and for older people, as well as against HPV-related cancers.
‘At its most basic, life-course immunisation is allowing all people to benefit from recommended vaccinations at every point in their lives,’ he said.
Check out the video, which also explores the role of life-course immunisation in the context of global health goals.