How do policymakers make decisions about vaccination? 'Data from this review can support informed decision-making for vaccine introduction amongst policymakers and stakeholders in LMICs'. The paper identifies the following factors: disease burden, costs of disease, political prioritization; economic factors related to vaccine price, affordability, and financing; communications and sociocultural considerations. Citation, abstract and comment from me below.
CITATION: Factors influencing the prioritization of vaccines by policymakers in low and middle income countries: A scoping review
Dominique Guillaume, Diane Meyer, Dur-e-Nayab Waheed, Meike Schlieff, Kirthini Muralidharan, Victoria B Chou, Rupali Limaye
Health Policy and Planning, https://doi.org/10.1093/heapol/czac092
Published: 31 October 2022 the 34 articles
Vaccination decision making in low-and-middle-income countries (LMICs) has become increasingly complex, particularly in the context of numerous competing health challenges. LMICs have to make difficult choices on which vaccines to prioritize for introduction while considering a wide range of factors such as disease burden, vaccine impact, vaccine characteristics, financing, health care infrastructures, whilst being adapted to each country’s specific contexts. Our scoping review reviewed the factors that influence decision-making among policymakers for the introduction of new vaccines in LMICs. We identified the specific data points that are factored into the decision-making process for new vaccine introduction, while also documenting whether there have been any changes in decision-making criteria in new vaccine introduction over the last two decades. A comprehensive data-base search was conducted using a search strategy consisting of key terms and MeSH phrases related to policy, decision-making, vaccine introduction, immunization programs, and low-and-middle-income countries. Articles were screened following PRIMSA guidelines. A total of 843 articles were identified, with 34 articles retained after abstract screening, full-text screening, and grading with the mixed methods appraisal tool (MMAT). The Burchett et al. (2012) framework for new vaccine introduction was used to identify indicators for vaccine-decision making and guided data extraction. Articles in our study represented a diverse range of perspectives and methodologies. Across articles, the importance of the disease which included disease burden, costs of disease, and political prioritization, coupled with economic factors related to vaccine price, affordability, and financing were the most common criteria considered for new vaccine introduction. Our review identified two additional criteria in the decision-making process for vaccine introduction that was not included in the Burchett et al (2012) framework: communications and sociocultural considerations. Data from this review can support informed decision-making for vaccine introduction amongst policymakers and stakeholders in LMICs.
'Findings from our review show that social and cultural aspects of vaccine introduction may be influential in decision-making. Most studies that described sociocultural considerations were recently published. This may indicate a new and important criterion in decision-making; particularly as the vaccines that have been recently introduced largely differ from that of traditional childhood vaccines due to targeting older age groups. This is a critical finding as it indicates the need for including sociocultural considerations and potential communications efforts into decision-making criteria'
COMMENT (NPW): It's notable that this paper says little if anything about the role of research communication. This is mentioned only once in relation to one of the 34 included articles. 'Without a carefully formulated strategy to communicate research to policymakers, decision-making for vaccine introduction was found to be especially challenging'
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