Missed Opportunities for Vaccine Equity

NCT04834960 | Completed

• 1 other identifier: I1429
• Study Type: interventional
• Target: 900
• Locations: 2 countries
• Sites: 2

Brief Summary

Despite the overwhelming impact of vaccines on child health and the tremendous progress in vaccine coverage globally, challenges of vaccine inequities persist. Missed opportunities for vaccination (MOV) is defined as any contact with health services by an individual who is eligible for vaccination which does not result in the recommended vaccines being given. This is common in several countries, and it presents a window of opportunity to provide vaccine services to those vulnerable children accessing healthcare facilities. The overall purpose of this project is to reduce missed opportunities for vaccinations by targeting hospitalized children who are vulnerable to poor health outcomes, but who are also within easy access of the healthcare system. The research team proposes implementing the Missed Opportunities for Vaccination Equity (MOVE), an intervention to improve timeliness and coverage of vaccination, and increase demand for vaccination services, through a combination of sensitization of children's caregivers and health workers, manual vaccination data capture in the ward, and re-purposed vaccination resources. The strategy engages key stakeholders in the design of the intervention through a co-creation workshop; their involvement in the design and execution of the intervention will improve sustainability in the long-term. This intervention builds on existing healthcare systems, and, when scaled up, can target inequities in vaccination coverage in the general population, without placing additional strain on the healthcare system in terms of workforce or financial resources.

Conditions

Under-vaccinated

Keywords

vaccination; under-vaccination; missed opportunities for vaccination

Outcome Measures

Primary Outcomes (5)

• Proportion of Children Fully Vaccinated Hospital Discharge

  The number fully vaccinated at admission + number given catch-up vaccination while in hospital, and up to the date at discharge / the number of all enrolled children. This outcome measures the desired outcome of full vaccination coverage among children who pass through in-patient health facilities. This is the main outcome of interest and will be compared in the pre-intervention and post-intervention phases.

  time of admission to discharge (about 1-2 weeks)

• Partially Vaccinated or Un-vaccinated Children at Admission

  This is the proportion of those children who are under-vaccinated at hospital admission.

  time of admission to discharge (about 1-2 weeks)

• Proportion of Under-Vaccinated children Deemed "Missed Opportunities of Vaccination"

  The number of eligible children who do not receive their due catch-up vaccines prior to hospital discharge / the number of children identified as under-vaccinated at hospital admission.

  time of admission to discharge (about 1-2 weeks)

• Proportion of all Enrolled Children at Admission Given Vaccination Advice

  The number of all enrolled children at admission who get vaccination-related advice and/or referrals during the hospital stay / the number of all enrolled children participating in the study.

  time of admission to discharge (about 1-2 weeks)

• Proportion of Incompletely Vaccinated Children Caught up After Discharge

  The number of incompletely vaccinated children at hospital discharge who get caught up on vaccinations within 1-4 weeks of hospital discharge / the number of children identified as under-vaccinated at hospital discharge.

  time of admission (about 1-2 weeks) to 1 month post discharge

Study Arms (1)

MOV Intervention

OTHER

Pre-intervention and post-intervention design

Other: Minimizing Missed Opportunities for Vaccination (MOV)

Interventions

Minimizing Missed Opportunities for Vaccination (MOV) OTHER

This bundle of interventions has four components that include: (1) Disseminate (vaccination awareness among healthcare providers and child caregivers); (2) Document (vaccination status); (3) Deploy (vaccines); and (4) Discharge (provide advice/referrals for catch-up and routine vaccinations).

MOV Intervention

Eligibility Criteria

• Age: 0 Months - 23 Months
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children between the ages 0-23 months who are admitted into the emergency or inpatient unit of the hospital
• Caregiver has access to the child's vaccination card or has direct knowledge of the child's vaccination history
• Caregiver willing to provide informed consent for the study

You may not qualify if:

• Health condition that precludes the use of vaccines such as a primary or secondary immune deficiency, such as HIV, malignancy requiring chemotherapy, or ongoing steroid therapy
• Allergies or contraindications to any vaccine (or component thereof) in the national schedule

Sponsors & Collaborators

• Johns Hopkins Bloomberg School of Public Health: lead
• Post Graduate Institute of Medical Education and Research, Chandigarh: collaborator
• Aminu Kano Teaching Hospital: collaborator

Study Sites (2)

Post Graduate Institute of Medical Education and Research, India (PGIMER)

Chandigarh, India

Location

Aminu Kano Teaching Hospital

Kano, Kano State, Nigeria

Location

MeSH Terms

Interventions

Vaccination

Intervention Hierarchy (Ancestors)

Immunotherapy, Active; Immunization; Immunotherapy; Immunomodulation; Biological Therapy; Therapeutics; Immunologic Techniques; Investigative Techniques; Primary Prevention; Preventive Health Services; Health Services; Health Care Facilities Workforce and Services; Communicable Disease Control; Public Health Practice; Public Health; Environment and Public Health

Study Officials

• Anita Shet, MD, PhD

  Johns Hopkins Bloomberg School of Public Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This is a 'pre-post' study design, where the intervention is designed and implemented by the regular non-research clinical staff. This intervention has four components that are described in the 'intervention' section.

Study Record Dates

• First Submitted: April 5, 2021
• First Posted: April 8, 2021
• Study Start: September 24, 2020
• Primary Completion: September 16, 2021
• Study Completion: September 16, 2021
• Last Updated: October 6, 2022

Record last verified: 2022-10

Data Sharing

• IPD Sharing: Will not share

Locations

NG (1); IN (1)