Key Strategies for Overcoming Vaccine Hesitancy among Healthcare Workers [Report]

Vaccination is a cornerstone of public health, saving millions of lives annually. Yet, despite their critical role in administering vaccines and promoting public health, healthcare workers (HCWs) are not immune to vaccine hesitancy.

This article explores key strategies to increase vaccination uptake among healthcare providers worldwide, based on a comprehensive report by the World Federation of Public Health Associations (WFPHA).

The Importance of Vaccinating Healthcare Workers

Healthcare workers are essential in shaping public perception and trust in vaccines. Their vaccination status significantly influences whether they recommend immunization to their patients.

Despite this, global trends show an alarming decline in vaccine uptake among HCWs, driven by concerns about vaccine safety, efficacy, and personal susceptibility to disease.

This hesitancy seriously affects the healthcare providers and the vulnerable populations they serve.

Case Studies: Successful Vaccination Campaigns in Healthcare

The WFPHA report draws real-world examples from six WHO regions to highlight successful vaccination campaigns for HCWs. These case studies reveal how tailored strategies can overcome barriers to vaccination:

• Zambia: A hepatitis B vaccination campaign targeting healthcare workers and nursing students, featuring free vaccines, transportation reimbursements, and peer influence.
• Canada: An MMR vaccination initiative for healthcare professionals, utilizing mobile apps for tracking and reminder systems to boost vaccination rates.
• Qatar: An influenza vaccination campaign with strong leadership involvement, peer education, and mandatory declination forms for healthcare workers in high-risk areas.

Key Drivers of Successful Vaccination Campaigns

Several factors are crucial in improving vaccination rates among HCWs:

• Leadership Engagement: Leadership support is vital in promoting a culture of vaccination. Visible participation by senior management encourages vaccination compliance and builds trust within healthcare institutions.
• Peer Influence: HCWs are more likely to get vaccinated when encouraged by their peers, particularly when they witness vaccines’ impact on protecting staff and patients.
• Convenient Access: On-site vaccination clinics, extended hours, and mobile units make it easier for HCWs to get vaccinated, reducing logistical barriers.

Addressing Gaps in Data and Research

A critical finding in the report is the need for comprehensive data on healthcare worker vaccinations, particularly in low-income countries (LICs).

Designing effective vaccination strategies or allocating resources appropriately is difficult without accurate data.

Moreover, HCWs often need to be more represented in policy-making processes, leading to strategies that fail to address their unique challenges and needs.

Recommendations for Improving Healthcare Worker Vaccination

The WFPHA offers a range of recommendations to increase vaccination rates among healthcare workers, categorized into three levels of implementation:

• Entry-Level Strategies: These include cost-effective interventions such as educational materials tailored to specific concerns, peer-to-peer vaccination programs, and small incentives to motivate HCWs to get vaccinated.
• Mid-Level Strategies: These are more resource-intensive measures, such as on-site vaccination clinics, mobile units, and active declination processes in which HCWs who refuse vaccination must provide reasons for their decision.
• Advanced Strategies: Systemic changes include mandatory vaccination policies for HCWs in high-risk areas and data registries to track vaccination status. Advocacy for amending occupational safety laws to include vaccination is also a key recommendation.

Strengthening Occupational Safety Laws

In many LICs, occupational safety laws do not adequately protect healthcare workers through vaccination. The report stresses the need for governments to update these laws to ensure HCWs are protected against preventable diseases, ensuring both safety and sustainability for global health systems.

Conclusion: A Global Approach to Protecting Healthcare Workers

The WFPHA report highlights the importance of collaboration between healthcare providers, policymakers, and public health organizations in creating effective vaccination programs. By addressing individual hesitations and systemic barriers, these strategies aim to protect healthcare workers and their communities, ultimately enhancing global health security.

Read the full report here.

Women, Children, and Youth Health Working Group Co-Chairs Interview: Fiona Robards and Deborah Walker

The Working Group of Women, Children, and Youth Health is integral to the World Federation of Public Health Associations (WFPHA). The group is dedicated to advancing public health efforts that support the well-being of women, children, and young people globally. They focus on advocacy, research, and policy development, emphasizing vulnerable populations. 

We had the pleasure of speaking with the Working Group’s co-chairs, Dr. Fiona Robards and Deborah Walker, to learn more about their motivations, current activities, and vision for the future.

Please introduce yourselves.

Fiona Robards: I’m Dr. Fiona Robards, co-chair of the World Federation of Public Health Associations Women, Children, and Youth Health Working Group, and I’m an academic at the University of Sydney in Australia.

Deborah Walker: I’m Deborah Klein Walker, co-chair of the World Federation Women, Children, and Youth Health Working Group. I’m an adjunct professor at Tufts University and the Boston School of Public Health in Boston. I’m also the designated liaison between the American Public Health Association and the World Federation.

What motivated you to pursue a career in the public health sector?

Fiona Robards: I’ve always been interested in the big picture. I started as a psychologist, managed health services for homeless young people, and then moved into policy and academia. I’m interested in preventing health issues and achieving health equity, especially for women, children, and youth. We know that women, children, and young people continue to die at high rates from preventable causes, and child well-being and survival are directly related to the health of mothers. Young people are another neglected population, most living in lower- and middle-income countries.

Deborah Walker: It’s interesting because my reasons for joining public health are similar to Fiona’s. I was trained as a psychologist and discovered public health, which I define as the practice of social justice, improving the health of populations every day. Our working group advocates for interventions to improve the health of women, children, and young people. Universal health care, equity, and health as basic human rights are critical issues for these groups. I have worked in the public health field with a focus on maternal and child health for over 40 years, in academia, public health practice at local, state, and federal levels in the United States, and as a researcher and vice president at a global consulting firm.

Tell me how long you’ve been associated with the World Federation of Public Health Associations.

Fiona Robards: I joined the Women, Children, and Youth Working Group in 2022 and became its co-chair last year, in 2023.

Deborah Walker: I’ve been associated with the World Federation of Public Health since I was the President of the American Public Health Association. I joined actively in 2010. I was a member of the Governing Council at one point, the Advisory Committee, and the Policy Committee since I joined in 2010. I became the chair of the Women, Children, and Youth Working Group in July 2020.

Could you elaborate on your working group’s current activities and share your vision and plans for the future?

Fiona Robards: Our working group has four goals: to advocate for equity in global policies to improve the health of women, children, and youth; to advance public health practice, education, training, and research related to these groups; to expand and strengthen partnerships; and to promote and support the advancement of women, children, and youth health in strong member associations. We’re currently focusing on policy development. We recently developed a new policy on children and young people’s health and rights, and we’re working on a range of new policies, including one on youth mental health, a call to action on climate action for maternal, newborn, and child health populations, breastfeeding, preconception and fertility, and youth health.

Deborah Walker: We, for example, have difficulty finding a time for our meetings that will incorporate all the time zones of the world, especially since Fiona and I are in two opposite extremes of the globe, Australia and the United States. We’ve settled on a time that seems to work for us and all the other time zones. Another challenge is finding resources so we can meet in person. We are especially looking for funds to send a core group of us to the next World Congress in South Africa.

How do the working group’s activities align with and support implementing the WFPHA strategic plan?

Deborah Walker: The mission of the World Federation of Public Health Associations is to protect people and the planet, prevent diseases, and promote peace, health, and well-being. The Women, Children, and Youth Working Group focuses on addressing health inequity for these populations, emphasizing the most vulnerable groups and providing a forum for developing resolutions for actions for the World Federation and its member public health associations. The World Federation’s goals that we align with and support include advocating for peace, sustainable health equity, and global policies; contributing to systems change; strengthening and democratizing global health governance; advancing public health knowledge, education, practice, and research; growing new and maintaining existing partnerships; supporting and enhancing member organizations; and building an effective, efficient, responsive, and sustainable World Federation of Public Health Associations.

Please tell me in what ways being part of the WFPHA and its network has enhanced the activities of your working group.

Fiona Robards: We collaborate with two working groups, the Tobacco Working Group and the Oral Health Working Group, on research projects. One project explores young people’s views of the tobacco endgame, and another explores international and national frameworks, guidelines, recommendations, and strategies for maternal tobacco prevention and cessation. We’re also developing a youth mental health policy and will seek feedback from the Mental Health Working Group.

How does being part of the WFPHA strengthen your group’s advocacy for the health issues of women, children, and youth?

Deborah Walker: The World Federation of Public Health Associations provides a global platform for advocacy to promote the health of women, children, and youth. We have used this platform to reach out to public and regional public health associations to build our membership. Recently, 32 new members joined from a wide range of countries on all continents. The new members have expressed interest in working on our various policies under development, which is fabulous to see.

What strategies does the group use to form effective partnerships for advancing health outcomes for women, children, and youth?

Fiona Robards: If we’re to end preventable maternal, child, and youth deaths and improve the quality of life for all the world’s people, then, of course, the voices from these population groups must be heard and engaged. We learn from our colleagues around the globe about culturally appropriate and effective interventions.

What benefits has your group gained from WFPHA’s global partnerships and collaborative opportunities?

Deborah Walker: The World Federation of Public Health Associations’ collaborative opportunities have enabled us to develop research partnerships and policies and grow our membership. Frankly, we are beginning to see the impact of the World Federation’s partnerships on our work.

Do you have any accomplishments right now that you’re proud of?

Deborah Walker: We were fortunate to have an intern from the World Federation who developed a study on all maternal and child health policies from the different member associations. Fiona took the lead on the article to be published in the Journal of Public Health Policy. We found very few policies on women, children, and youth in those public health associations. That is why we are focused on developing policies for the World Federation that member public health associations can adopt. When this population is almost half of the world, and if women and children do well, we all do.

Conclusion

The WFPHA Working Group on Women, Children, and Youth Health is dedicated to improving global health outcomes for these vulnerable populations through advocacy, policy development, and partnerships. Under the leadership of co-chairs Fiona Robards and Deborah Walker, the group continues to drive forward initiatives that emphasize equity, health rights, and culturally relevant interventions. Their work is essential in shaping a healthier future for women, children, and youth worldwide, ensuring their voices are heard and needs addressed globally.

Working Group members:

Adebayo Amao, Professor and Consultant Community Physician Adesola Olumide, University of Ibadan Nigeria

Alix Woldring, Centre for Population Health, NSW Ministry of Health, PHA of Australia
Dr. Amie Steel, University of Technology Sydney, PHA of Australia

Anastesia Araba Tawiah, WFPHA Intern, PHA of Australia

Ayokunle Kajero, Society for Adolescents and Young People’s Health in Nigeria (SAYPHIN), Nigeria

Dr. Claire Copperstone, Malta Association of Public Health Medicine, Faculty of Health Sciences, University of Malta

Danielle Schoenaker, UK

Deborah Klein Walker, EdD,  Boston University, American PHA, USA

Professor Debra Jackson, London School of Hygiene & Tropical Medicine, UK
Evelyn Cherow, MA, MPA, American PHA, USA

Professor Fatema Ashraf, Public Health Foundation of Bangladesh

Dr. Fiona Robards, University of Sydney, PHA of Australia

Dr. Funmilayo Morebise, Society for Adolescent and Youth Health in Nigeria (SAYPHIN, Nigeria

Haley Myers, MPH, American PHA, USA

Dr. Hyewon Lee, Korea

Jasmine Lykissas, Communications at the PHA of Australia

Justine Salisbury, Centre for Population Health, NSW Ministry of Health, PHA of Australia

Professor Mitike Molla Sisay, Ethiopian PHA, Ethiopia

Nabankema Victoria, MPH, Uganda National Association of Community Occupational Health, Uganda

Narila Mutia, Assistant Professor, Indonesia Public Health Association/ IAKMI, Indonesia

Olaniyan Halimat, Society for Adolescent and Youth Health in Nigeria (SAYPHIN), Nigeria

Dr. Oliver-Williams, Clare, Global Violence Prevention SIG Co-Chair, UK

Dr. Olujide Arije, Institute of Public Health, Obafemi Awolowo University, Nigeria

Onyinye Gloria, Society for Adolescent and Youth Health in Nigeria (SAYPHIN), Nigeria

Owolabi Tomiwa, PhD candidate, Institute of Child Health, University College Hospital, Ibadan, Nigeria

Rachel Barbabela, MPH, Child and Adolescent Psychiatrist, Portugal

Dr. Tope.O. Durojaiye, Society for Public Health Professionals in Nigeria (SPHPN), Society for Adolescent and Young People’s Health in Nigeria (SAYPHIN), Nigeria

Vina Hulamm, USA

Yemisrach Shiferaw, Ethiopian PHA, Ethiopia

Advancing Children and Young People’s Health and Rights

The Urgent Need for Advocacy in Children’s Health and Rights  

Governments primarily safeguard children’s rights, well-being, and safety. This includes supporting families and communities to address the social determinants of health—factors like poverty, education, and access to healthcare that significantly impact a child’s life trajectory. Despite this, a startling study by Robards, Myers, and Klein Walker (2024) revealed that only eight out of 130 Public Health Associations (PHAs) globally and one Regional PHA have policies specifically addressing women, children, and youth. This gap highlights the urgent need for advocacy and policy development to ensure equitable access to healthcare and integrated support systems.  

Article 24 of the United Nations Convention on the Rights of the Child underscores every child’s right to the highest attainable standard of health. However, the World Health Organization reports that injuries, interpersonal violence, self-harm, and maternal conditions remain the leading causes of death among youth. These statistics underscore the critical need for targeted interventions and policies to protect and promote children’s and young people’s health.  

The WFPHA’s Policy Framework: A Roadmap for Change  

The WFPHA’s Children and Young People’s Health and Rights Policy was developed by a dedicated working group comprising over 50 representatives from Public Health Associations worldwide. This policy emphasizes the importance of integrated care and comprehensive support from birth to 18 years, ensuring optimal health and well-being.

Key recommendations include:  

1. Equitable Access to Healthcare: Ensuring all children, regardless of background, have access to essential health services.
   
2. Rights-Based Approaches: Engaging marginalized groups and recognizing children as active participants in decisions affecting their lives.
   
3. Preventive Health Measures: Strengthening primary healthcare and promoting vaccination and early intervention strategies.
4. Mental Health and Trauma Support: Investing in mental health services and trauma-informed care for young people.
   
   
5. Cultural Respect for Indigenous Children: Addressing inequities by prioritizing self-determination and cultural respect.  

The Role of Public Health Associations in Driving Change  

Public Health Associations (PHAs) play a pivotal role in advancing the health of women, children, and youth. However, the research by Robards et al. (2024) found that only 10 out of 130 PHAs globally have dedicated workgroups focusing on these groups. This lack of focus undermines efforts to achieve the Sustainable Development Goals (SDGs), particularly those related to health equity and gender equality.  

The WFPHA’s policy serves as a valuable tool for advocacy, urging governments and PHAs to prioritize children’s health and rights. By adopting and implementing this policy, countries can reduce inequalities and create a healthier, more equitable future for all.  

Key Recommendations for Governments and PHAs

1. Develop and Implement Policies: PHAs should create policy statements that advance the health and rights of women, children, and youth. 
2. Invest in Early Intervention: Governments must allocate resources to early intervention and prevention strategies, particularly for mental health and trauma. 
3. Promote Community Education: Educate communities about preventive health measures like vaccination and healthy lifestyles. 
4. Strengthen Integrated Care: Ensure child protection, family support, and welfare services are adequately resourced and integrated. 
5. Advocate for Equity: Address systemic inequities faced by marginalized groups, including Indigenous children and young people.  

A Collective Responsibility

The health and rights of children and young people are not just a moral imperative but a foundation for sustainable development. The WFPHA’s Children and Young People’s Health and Rights Policy provides a comprehensive framework for action, but its success depends on collective efforts. Governments, PHAs, and communities must work together to ensure every child has the opportunity to thrive. 

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