BOOST-UP

WHY?

Comprehensive immunization programs can significantly reduce the burden of disease attributable to vaccine preventable diseases across the lifespan. The continent of Africa, which is home to 1.3 billion people, has the lowest vaccination coverage rates globally. Although there have been major strides in vaccine coverage in sub-Saharan Africa, as evidenced by the reduction in measles-related deaths over the past twenty years barriers to achieving optimal coverage persist; namely, challenges related to care seeking patterns and vaccine hesitancy. To overcome barriers to vaccine uptake, it is critical to understand contextual and cultural factors that contribute to poor uptake and hesitancy from the perspectives of multilevel stakeholders. Healthcare providers can offer valuable insights into individual and structural factors driving vaccine hesitancy and low vaccination rates. They can also identify anticipated barriers around the introduction of novel vaccines and monoclonals which can inform delivery strategies and programmatic messaging.

Uganda serves as an ideal case study for other LMICs because it creates an opportunity to consider immunization programming in real world context under conditions that are characteristic of many LMICs, including: limited health infrastructure, suboptimal antenatal care engagement, low levels of health literacy, and a high prevalence of co-morbidities (such as HIV) which may have implications for both attitudes towards vaccination/monoclonals as well as maternal vaccine efficacy. We anticipate that the results from this study will not only benefit immunization efforts in Uganda but provide valuable preliminary data for identification of programmatic roll out approaches that can maximize the reach of maternal and pediatric vaccination/monoclonal delivery campaigns in similar contexts.