Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme
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Price, Jessica; Gurley, Nikki; Gyapong, Margaret; Ansah, Evelyn Korkor; Awusabo-Asare, Kofi; Gyasi, Samuel Fosu; Nkhoma, Pearson; Nyondo-Mipando, Alinane Linda; Okello, George; Webster, Jayne; Desmond, Nicola; Hill, Jenny and Gordon, W. Scott. 2023. Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme. Vaccines, 11(12), 1801. ISSN 2076-393X [Article]
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Text (Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme)
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Abstract or Description
Background: The WHO recommended the use of the RTS,S/AS01 malaria vaccine (RTS,S) based on a pilot evaluation in routine use in Ghana, Kenya, and Malawi. A longitudinal qualitative study was conducted to examine facilitators and barriers to uptake of a 4-dose RTS,S schedule.
Methods: A cohort of 198 caregivers of RTS,S-eligible children from communities where RTS,S was provided through the pilot were interviewed three times over a ≈22-month, 4-dose schedule. The interviews examined caregiver perceptions and behaviors. Children’s vaccination history was obtained to determine dose uptake.
Results: 162 caregivers remained at round 3 (R3); vaccination history was available for 152/162 children. Despite early rumors/fears, the uptake of initial doses was high, driven by vaccine trust. Fears dissipated by R2, replaced with an enthusiasm for RTS,S as caregivers perceived its safety and less frequent and severe malaria. By R3, 98/152 children had received four doses; 34 three doses; 9 one or two doses; and 11 zero doses. The health system and information barriers were important across all under-dose cases. Fears about AEFIs/safety were important in zero-, one-, and two-dose cases. Competing life/livelihood demands and complacency were found in three-dose cases. Regardless of the doses received, caregivers had positive attitudes towards RTS,S by R3.
Conclusions: Findings from our study will help countries newly introducing the vaccine to anticipate and preempt reasons for delayed acceptance and missed RTS,S doses.
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Item Type: |
Article |
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| Additional Information: |
Funding: This research and Article Processing Charge was funded by the World Health Organization grant number 202570977. |
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| Data Access Statement: |
In addition to data contained within the article, additional data are available in the Supplementary Materials including the quantitative dataset on socio-demographics and child vaccination history and qualitative summaries (from R1 to R3) on each under-dose case and qualitative replies from all cases at R3 to malaria frequency and severity statements. |
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| Keywords: |
malaria vaccine pilot evaluation; vaccine acceptance; vaccine trust; vaccine uptake barriers |
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| Departments, Centres and Research Units: |
Social, Therapeutic & Community Engagement (STaCS) |
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| Dates: |
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| Item ID: |
34428 |
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| Date Deposited: |
01 Dec 2023 14:05 |
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| Last Modified: |
01 Dec 2023 14:05 |
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Peer Reviewed: |
Yes, this version has been peer-reviewed. |
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