The Global Influenza Strategy (2019-2030), the Immunization Agenda 2030, and the Global Action Plan for Influenza Vaccines (2006-2016) encourage countries to strengthen national influenza programmes by identifying and addressing barriers to vaccination to achieve high uptake. World Health Assembly resolution 56.19 provides a target of 75% influenza vaccination coverage for older adults and people with chronic conditions, yet in 2023, only 13 Member States achieved this coverage rate. To support countries in reaching this global target, the World Health Organization (WHO) has developed a package of quantitative and qualitative resources - the Behavioural and Social Drivers of Influenza Vaccination ( referred to as the BeSD IN).
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The BeSD IN builds from the resources developed for COVID-19 and routine childhood immunization. It provides a brief guidebook; a standardized survey with recommended questions for priority groups; priority indicators (a short list of questions that can be used to establish baselines and track trends); recommended interview questions for vaccinators, decision-makers, and community leaders; and the recommended process for analyzing and using the data collected.
To ensure applicability across regions and contexts, WHO, with partners including the Task Force for Global Health, and national focal points, field-tested the BeSD IN package in Argentina, Jordan and South Africa in 2023. Additional countries, including Australia and Spain, have recently used the BeSD IN resources to gather and use local data to improve their influenza vaccination programmes. With support from the PIP Framework, Jordan recently published its findings in Vaccine: X, highlighting pragmatic actions that the Ministry of Health and health facilities can take to enhance influenza vaccine uptake. These include targeted public health campaigns to correct misconceptions, especially among the elderly and pregnant women; improving accessibility by organizing mobile clinics; offering subsidized vaccines; and giving healthcare providers the necessary training to respond to hesitancy among the priority groups. In 2024, Argentina conducted a BeSD survey among pregnant women, focusing on the drivers of and barriers to influenza, COVID-19, and RSV vaccination. Results of this study will be used to tailor interventions to improve coverage in this group.
To access the BeSD IN resources, please send a message to influenzavaccination@who.int. WHO anticipates that these resources will be available online in English shortly. Additional language versions ( Arabic, French, Spanish, and Russian) are anticipated to be available. WHO encourages countries to conduct acceptance and demand assessments at the end of vaccination campaigns so that the findings can inform planning for the next campaign.
To learn more about the BeSD IN resources or request technical support, please send a message to influenzavaccination@who.int.