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Misinformation, Society and the COVID-19 Pandemic: Exploring the Impact of COVID-19 Misinformation on Childhood Immunization in Pakistan

By: Jamie Minchin, Senior Associate, Vaccine Acceptance and Demand and Meaghan Charlton, Senior Manager, Vaccine Acceptance

As COVID-19 continues, the pandemic has complicated existing vaccination efforts across the globe. In Pakistan, COVID-19 has the potential to complicate an already complicated vaccine situation, as Pakistan has a complex history of polio eradication campaigns and resultant vaccine hesitancy. Further research is needed to better understand how caregivers avoiding hospitals and primary care centers will impact immunization rates and the acceptance of a COVID-19 vaccine.

Sabin’s Vaccine Acceptance and Demand initiative is proud to support a virtual project exploring the role of mobile health-based (mHealth) interventions to improve childhood immunization coverage during the COVID-19 pandemic in Pakistan. The project will be led by Assistant Research Professor Abdul Momin Kazi from the Aga Khan University Department of Pediatrics and Child Health in Karachi. The funding is provided through Sabin’s Social and Behavioral Interventions for Vaccination Acceptance Small Grants Program.

“As a research group, we explore new, innovative strategies to improve routine immunization coverage, with a primary focus on using technology as a research tool to improve vaccine uptake and bring about behavior change,” relayed Kazi when asked about the project. “In this study, we will explore COVID-19 misinformation and its impact on routine immunization and the uptake of a COVID-19 vaccine, highlighting the role of mobile health-based interventions and social media during the current pandemic.”

Digital health innovations through methods such as short message service (SMS), direct phone outreach, smartphone applications and wearable technology have enabled remote social science interventions in increasingly low-resourced contexts. Kazi and his colleagues have previously explored the use of mobile phone interventions in polio eradication, for example using SMS messaging and reminders to circulate knowledge about vaccines and improve routine childhood immunization. However, social media platforms and messaging also connect users to vaccine misinformation since they are platforms used by anti-vaccination supporters, indicating a need for interventions that address vaccine misinformation online.

The project team’s research informing their mHealth intervention will explore the perceptions among caregivers and healthcare workers towards childhood routine immunization coverage at three sites in Pakistan: Karachi (a peri-urban site), Matari (a rural site located 185 kilometers north of Karachi) and the Community Health Center vaccination clinic at The Aga Khan University Hospital in urban Karachi. In Pakistan context, the research team acknowledges that access to healthcare, mobile technology and information about vaccines varies from community to community, warranting a deeper understanding of the sub-national variation at each research site.

Kazi and the research team will build upon their previous research that demonstrated the importance of tailoring vaccine messaging to communities and in the local language. This project will build upon the premise that community-specific messaging matters to determine what other social considerations should be incorporated into vaccine messaging. Incorporating this local knowledge, the research team will develop a community-informed mobile outreach intervention to mitigate vaccine misinformation.

The Pakistan research team’s work has the potential to demonstrate the importance and impact of vaccine messaging when it is informed by local knowledge and co-developed with the local community. Its findings have implications for the way in which practitioners develop future mHealth interventions and for the acceptance of a COVID-19 vaccine.

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