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Article
Publication date: 22 February 2022

Jaylan Azer and Matthew Alexander

COVID-19 vaccinations face a backdrop of widespread mistrust in their safety and effectiveness, specifically via social media platforms which constitute major barriers for…

Abstract

Purpose

COVID-19 vaccinations face a backdrop of widespread mistrust in their safety and effectiveness, specifically via social media platforms which constitute major barriers for the public health sector to manage COVID-19 (and future) pandemics. This study provides a more nuanced understanding of the public's engagement behavior toward COVID-19 vaccinations.

Design/methodology/approach

Using Netnography, this study explores the public's interactions with vaccine communications by the WHO via Facebook. From WHO posts about the COVID-19 vaccination 23,726 public comments on Facebook were extracted and analyzed.

Findings

Building on crisis communication, health and engagement literature, this paper identifies and conceptualizes seven patterns of engagement behavior toward the COVID-19 vaccination and develops the first framework of relationships between these patterns and the extant vaccine attitudes: vaccine acceptance, hesitancy and refusal.

Practical implications

This paper helps policymakers identify and adapt interventions that increase vaccine confidence and tailor public health services communications accordingly.

Originality/value

This research offers the first typology of patterns of engagement behavior toward COVID-19 vaccinations and develops a framework of relationships between these patterns and the existing understanding in health literature. Finally, the study provides data-driven communication recommendations to public health service organizations.

Article
Publication date: 4 September 2017

Wesley D. Kufel, Dennis M. Williams and David Jay Weber

Payment for healthcare services in the USA has shifted from fee for service to compensation based on value and quality. The indicators used for payments are a variety of…

Abstract

Purpose

Payment for healthcare services in the USA has shifted from fee for service to compensation based on value and quality. The indicators used for payments are a variety of clinical measures, including administration of vaccines to patients. The purpose of this paper is to describe the implementation of programs in health systems to improve vaccination rates and patient outcomes.

Design/methodology/approach

A search of the literature was conducted to find examples of vaccine programs in US health systems, and also to identify policies to improve immunization rates.

Findings

Successful programs for improving vaccination rates require advocacy and support of leadership, a systematic and multidisciplinary approach, and an evaluation of local resources and capacity. Numerous examples exist of medical, nursing, and pharmacy led programs that improve vaccination rates. The department in charge has relied on the support of other groups to ensure the success.

Social implications

Mandatory vaccination of healthcare personnel (HCP) in the health system has been a growing trend in the USA. Although there has been some resistance to mandatory vaccinations for HCP, the standards and requirements have resulted in improved rates in health systems, which ultimately improve efficiency and protects patients.

Originality/value

This review describes considerations for implementing a successful vaccination program in a health system and provides examples of specific strategies. An overview of mandatory vaccinations for HCP is also described.

Details

International Journal of Health Governance, vol. 22 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 4 September 2017

Katie Attwell and David T. Smith

The purpose of this paper is to develop a theoretical framework for understanding the identity politics associated with parental hesitancy and refusal of vaccines for…

1870

Abstract

Purpose

The purpose of this paper is to develop a theoretical framework for understanding the identity politics associated with parental hesitancy and refusal of vaccines for their children (“vaccine hesitancy or refusal” or “VHR”). Understanding these identity politics helps policymakers to craft appropriate communication interventions that do not make the problem worse.

Design/methodology/approach

Social identity theory is a way of understanding how group identities develop around the lifestyle practices that often include refusal to vaccinate, and how this group identity is accentuated by conflict with the pro-vaccinating societal mainstream. This paper critically appraises existing studies of VHR to explore this groupness across many different contexts.

Findings

Groupness is evident across many different contexts. There are also key group characteristics: preference for natural birth and breastfeeding, nature as a concept and use of complementary and alternative medicine.

Research limitations/implications

The paper is speculative and theoretical, using existing sources. Future studies will need to demonstrate empirically with new data. However, this theoretical approach sets up a new research agenda.

Social implications

These findings can help governments and policymakers minimise social conflict that risks further polarising vaccine conversations and wedging parents on the fence.

Originality/value

This paper argues that the decision to vaccinate or not is an inherently social one, not a matter of pure individual rationality. This is a novel approach to engaging with what is often characterised and studied as an individual decision.

Details

International Journal of Health Governance, vol. 22 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 4 September 2017

Laura A. Rhodes, Dennis M. Williams, Macary W. Marciniak and David Jay Weber

The purpose of this paper is to describe the history of pharmacist involvement as vaccine providers in the USA and discuss examples of growing interests in other parts of…

Abstract

Purpose

The purpose of this paper is to describe the history of pharmacist involvement as vaccine providers in the USA and discuss examples of growing interests in other parts of the world.

Design/methodology/approach

Literature searches were performed in PubMed as well as pharmacy-related journals.

Findings

Pharmacists have been involved with the storage and management of vaccines for more than a century. Based on the unmet needs in meeting national goals for vaccination rates among adults in the USA, efforts led to training and recognizing pharmacists as vaccine providers which is now within the scope of practice for a pharmacist in all US states and territories. Pharmacists complete a comprehensive training program in vaccine sciences, regulatory considerations, as well as demonstration of skills in administering vaccines. Over 300,000 pharmacists have been trained in vaccine delivery and this represents the majority of the pharmacist workforce in the USA. There are examples of the beneficial impact of pharmacist involvement as vaccine providers in community pharmacy settings.

Research limitations/implications

This review is based on a thorough review of the literature but was not conducted in a systematic fashion.

Originality/value

This review provides a historical perspective and evidence of the benefit of pharmacists as vaccine providers.

Details

International Journal of Health Governance, vol. 22 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 16 March 2022

Devasheesh Mathur

The article aims to critically examine India's COVID-19 vaccination policy by analyzing the problem, politics and policy developed during the pandemic. The article would…

Abstract

Purpose

The article aims to critically examine India's COVID-19 vaccination policy by analyzing the problem, politics and policy developed during the pandemic. The article would help the policy-makers and healthcare administrators to understand the situation in a holistic manner.

Design/methodology/approach

The article employs Kingdon's multiple streams framework, which separately analyzes the problem at hand, the politics that are at work and the policy which is being developed when the problem and politics streams are activated. Directed approach to content analysis is adopted in this article.

Findings

The article provides a holistic overview of vaccine development and the vaccination policy during the COVID-19 pandemic in India.

Practical implications

The analysis would help policy-makers and healthcare administrators to have a bird's-eye view of the COVID-19 vaccine development and the vaccination drive.

Originality/value

The article is a macro-level analysis of an extremely important situation of COVID-19 vaccine development and the subsequent vaccination drive for the world's largest democracy, which is also one of the largest drugs and vaccine manufacturing countries. The article captures the bird's-eye-view of the problem of vaccine development, the policy of funding as well as procurement, and the politics of vaccine distribution in the country.

Details

International Journal of Health Governance, vol. 27 no. 2
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 4 September 2017

Angela K. Shen, Alice Y. Tsai and Guthrie S. Birkhead

The purpose of this paper is to outline the organization and governance of the US vaccine and immunization enterprise. It describes the major components of the US system…

Abstract

Purpose

The purpose of this paper is to outline the organization and governance of the US vaccine and immunization enterprise. It describes the major components of the US system including the various relationships between major federal government entities, stakeholders, and advisory committees that inform government policymaking at various points in the system.

Design/methodology/approach

The authors describe the complex interdependent network of partners that engage in a wide range of activities such as disease surveillance, research, vaccine development, regulatory licensure, practice recommendations, financing, service delivery, communications, and post-licensure monitoring.

Findings

The US system of governance is highly participatory and focuses on a transparent and open engagement, with input from a wide range of partners to inform decision-making. This collaborative framework allows many inputs to be heard and helps support the US vaccine and immunization system as it evolves to meet the continued public health needs in the USA through the optimal use of safe and effective vaccines.

Originality/value

This is an invited article on the US vaccine and immunization enterprise. The development and availability of vaccines in the USA has had profound impact on mortality and morbidity and public health (Centers for Disease Control and Prevention, 2011). The success of this enterprise is a result of a blended public and private sector system with partnerships at the federal, state, and local levels of government to optimize the use of safe and effective vaccines. Governance structures have been established to support the interaction and decision-making among the federal and non-federal actors toward the common goal of controlling and preventing infectious diseases.

Details

International Journal of Health Governance, vol. 22 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 4 September 2017

Daniel M. Gordon and Corwin A. Robertson

The purpose of this paper is to describe the role of the vaccine manufacturer in the global vaccine enterprise.

Abstract

Purpose

The purpose of this paper is to describe the role of the vaccine manufacturer in the global vaccine enterprise.

Design/methodology/approach

Narrative review.

Findings

Pharmaceutical companies involved in the vaccine enterprise play critical and often unrecognized roles in the global health management arena. In addition to the obvious role of vaccine production and distribution, companies are often involved in the identification of infectious agents for which vaccines may be of benefit, basic and applied research, process development, pre-clinical and clinical evaluations of vaccine candidates, as well as continuous post-licensure safety monitoring efforts. Vaccine manufacturers interact with health and regulatory agencies, academia and agencies interested in supporting cost-effective means of vaccine distribution to areas most in need of life-saving vaccines.

Originality/value

This review provides the reader with an understanding of the many roles of the manufacturer in the global vaccine enterprise.

Article
Publication date: 4 September 2017

Holly B. Schuh, Maria W. Merritt, Takeru Igusa, Bruce Y. Lee and David H. Peters

The purpose of this paper is to demonstrate how public health and systems science methods can be combined to examine the structure and behavior of Afghanistan’s routine…

Abstract

Purpose

The purpose of this paper is to demonstrate how public health and systems science methods can be combined to examine the structure and behavior of Afghanistan’s routine childhood immunization system to identify the pathways through which health system readiness to deliver vaccination services may extend beyond immunization outcomes.

Design/methodology/approach

Using findings from an ecological study of Afghanistan’s immunization system and a literature review on immunization program delivery, the routine immunization system was mapped using causal loop diagrams. Next, a stock-and-flow diagram was developed and translated to a system dynamics (SD) model for a system-confirmatory exercise. Data are from annual health facility assessments and two cross-sectional household surveys. SD model results were compared with measured readiness and service outcomes to confirm system structure.

Findings

Readiness and demand-side components were associated with improved immunization coverage. The routine immunization system was mapped using four interlinking readiness subsystems. In the SD model, health worker capacity and demand-side factors significantly affected maternal health service coverage. System readiness components affected their future measures mostly negatively, which may indicate that the reinforcing feedback drives current system-structured behavior.

Originality/value

The models developed herein are useful to explore the potential impact of candidate interventions on service outcomes. This paper documents the process through which public health and systems investigators can collaboratively develop models that represent the feedback-driven behavior of health systems. Such models allow for more realistically addressing health policy and systems-level research questions.

Details

International Journal of Health Governance, vol. 22 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 4 September 2017

Jason Walton

The purpose of this paper is to define the role non-governmental organizations (NGOs) play across the vaccine development and delivery spectrum within the vaccine

Abstract

Purpose

The purpose of this paper is to define the role non-governmental organizations (NGOs) play across the vaccine development and delivery spectrum within the vaccine enterprise. As demonstrated in this paper, NGOs can play a critical role in prioritizing and accelerating the development and introduction of new vaccines against diseases that disproportionally burden children, women, and communities in the poorest countries around the world.

Design/methodology/approach

The author has used case studies from decades of work by PATH, an international NGO, to help develop and implement vaccines, to illustrate the roles of NGOs can play during each of the stages along the development and delivery spectrum.

Findings

There are four key considerations that can help determine the ability of a given vaccine to be introduced and scaled within a health system: accessibility, affordability, acceptability, and availability. As more vaccine candidates are identified and move along the development and delivery pathway, there will be increased demand for NGOs to continue playing a pivotal role to address these considerations.

Originality/value

This paper aims to highlight a few of the lessons learned from PATH's four decades of experience in the hope they will contribute and be applied to the evolving environment of vaccine enterprise.

Details

International Journal of Health Governance, vol. 22 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 18 October 2018

Ria Christine Siagian and Jorge Emilio Osorio

The purpose of this paper is to identify, analyze and describe the novel approaches that affect vaccine development in lower-middle income countries (LMICs).

Abstract

Purpose

The purpose of this paper is to identify, analyze and describe the novel approaches that affect vaccine development in lower-middle income countries (LMICs).

Design/methodology/approach

The vaccine market in LMICs currently focuses on traditional Expanded Program for Immunization vaccines instead of new ones. Unlike the successful introduction of those traditional vaccines, the introduction of new vaccines appears to be very slow, mainly due to financial issues. This paper systematically reviews a set of published papers on vaccine development and analyzes them against a specific region-setting framework.

Findings

Public–private partnership alone could not ensure long-term vaccine sustainability. Several factors that encourage domestic vaccine development were identified. The findings demonstrate that the regulatory approach of hybrid collaboration and market opportunity strategies can be a major breakthrough for domestic vaccine development in LMICs.

Research limitations/implications

Further research is required to include qualitative and quantitative methods for policy analysis, as all of the discussion in this research focused on literature reviews. The authors did not discuss how strategic decisions are affected from a political perspective and this needs to be specified in future research. Think tanks, considerably and fundamentally, affect policy ideas and decisions. However, important breakthroughs continue to be made at the same time.

Social implications

The development of vaccines in LMICs is expected to be a mechanism to overcome the inadequate access to vaccines in those countries, as solving this problem requires tackling issues from both the supply and demand sides.

Originality/value

This is a literature review that creates recommendation and approaches for domestic vaccine development in LMICs. This review aims to encourage LMICs to produce their own vaccines for sustainability of the vaccine access through vaccine development lifecycle, instead of expecting donor that provides funding and vaccines (vaccine access) in certain period of time. Donor is not always the solution for the problem, since vaccine development requires finance to function infrastructure. There are many efforts in revoking this, including World Health Organization through several reports; however, this effort still has many doubts. Therefore, the article would like to try to see this as a viable solution from the policy perspectives, with several examples to make recommendations more practical.

Details

International Journal of Health Governance, vol. 23 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

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