Trust, Communication and Knowledge must be central to any vaccination campaign

Date of publication:

The Health Information and Quality Authority (HIQA) has published the advice it submitted to inform and assist the National Public Health Emergency Team (NPHET) on factors that influence vaccination uptake. The advice is accompanied by an evidence summary and protocol.

The report examined:

  • the potential barriers to and facilitators of vaccination uptake
  • interventions to improve vaccination uptake.

With a number of COVID-19 vaccines currently under consideration by the European Medicines Agency (EMA), it is important to understand the factors that influence and the measures that improve vaccine uptake. HIQA examined the evidence relating to uptake of influenza vaccination (seasonal or pandemic) due to similarities in the groups that will be prioritised for vaccination.

Dr Máirín Ryan, HIQA’s Deputy CEO and Director of Health Technology Assessment, said: “COVID-19 vaccination, when used in conjunction with public health measures such as physical distancing, face masks, and hand hygiene, has the potential to significantly reduce the disease burden across the world.

Ireland has already shown how widespread adoption of public health measures can limit the spread of coronavirus. This success was largely based on knowledge and consensus. Trust, communication and knowledge are core to informed decision-making and should be central to any vaccination campaign.

We know from our research that healthcare workers are an important at-risk population group, as well as being a trusted source of information on health matters. It is vital that healthcare workers and leaders in local communities are provided with evidence-based information ahead of any vaccination programme.”

HIQA has advised that a COVID-19 vaccine communication campaign should include information on how the vaccines work, evidence on their safety and effectiveness, and provide clarity on the processes regulatory agencies, such as the EMA, follow when approving vaccines as well as the requirements for post-marketing continuous evaluation. This information will help the general public make informed decisions.

Dr Ryan said: “Reviewing the evidence on the effectiveness of a vaccine doesn’t stop when a vaccine campaign begins. As the COVID-19 vaccine is rolled out in Ireland and across the world, updated evidence in relation to effectiveness and safety must be made available in an open and accountable manner, so trust can be maintained.”  

COVID-19 is unique in terms of its impact. Societal experiences following months of public health measures aimed to contain the COVID-19 pandemic will also likely impact on vaccination uptake preferences and behaviours. As time progresses, a different picture of which measures work best may develop.

This review and advice was developed by HIQA following requests from NPHET and can be found at the link at the top of the page.

Further information:
Marty Whelan, Head of Communications & Stakeholder Engagement
085 805 5202,

Notes to Editor:

  • This morning HIQA is publishing:

    • Advice submitted to NPHET on factors influencing, and measures to improve, vaccination uptake
    • Rapid evidence summary of factors influencing, and measures to improve, vaccination uptake
    • Protocol on factors influencing, and measures to improve, vaccination uptake
  • In light of the similarities between influenza and COVID-19 in terms of the populations who may be prioritised for vaccination, influenza vaccination (including seasonal and pandemic influenza) was considered a surrogate for COVID-19 for the purpose of this rapid evidence summary.
  • Due to the abundance of studies in the scientific literature, an ‘overview of reviews’ was undertaken, limited to reviews that investigated factors affecting influenza vaccination uptake and measures to improve influenza vaccination uptake internationally. In total, 41 reviews were identified.
    • Data from nine high-quality reviews on the barriers and facilitators to an individual’s uptake of vaccination against influenza were considered.
    • Twenty-one systematic reviews were identified relating to interventions aimed at increasing influenza vaccine uptake.
    • A wide range of similar interventions were assessed that varied significantly in terms of intensity and resources required for delivery. Studies included both individual-level (for example patient letters and phone calls) and system-level (for example provider prompts) interventions. None related to mass media campaigns.
  • The rapid evidence review to identify factors influencing vaccine uptake found:
    • a number of overarching themes namely: perceived risks and benefits, knowledge, social influences and patient-specific factors (for example sociodemographic factors). These were found to act as either barriers or facilitators depending on the context.
    • perceived benefit from vaccination and recommendations from healthcare professionals were consistently found to be important facilitators for vaccination uptake.
    • interventions (including multicomponent interventions) can successfully increase vaccine uptake across a range of eligible groups. Studies included both individual-level (for example patient letters and phone calls) and system-level (for example provider prompts) interventions; none related to societal-level interventions. These interventions vary greatly in terms of intensity.
    • consideration must be given to the resource requirements and the acceptability of interventions to the target population.
  • Since September 2020, HIQA has provided evidence based advice in response to requests from NPHET.
  • HIQA’s advice to NPHET is informed by research evidence developed by HIQA’s COVID-19 Evidence Synthesis Team, with expert input from HIQA’s COVID-19 Expert Advisory Group.
    • The topics HIQA researches are outlined and prioritised by NPHET to ensure that they have rapid access to the best available evidence relevant to the SARS-CoV-2 outbreak.
  • HIQA’s COVID-19 Evidence Synthesis Team produces a variety of outputs including rapid health technology assessments, scoping reports, rapid reviews of public health guidance, and evidence summaries, supplemented by an evidence-to-advice framework to guide the development of advice, where appropriate.
  • HIQA’s COVID-19 Expert Advisory Group is a multidisciplinary group, comprising nominated representatives from the relevant clinical specialties and areas of expertise, methodology experts, and public representation.