2023-09-28 14:46:10 +00:00
|
|
|
abstract: 'Extending the benefits of vaccination to everyone who is eligible
|
|
|
|
|
|
|
|
|
|
requires an understanding of which populations current vaccination
|
|
|
|
|
|
|
|
|
|
efforts have struggled to reach. A clear definition of
|
|
|
|
|
|
|
|
|
|
``hard-to-reach{''''} populations - also known as high-risk or
|
|
|
|
|
|
|
|
|
|
marginalized populations, or reaching the last mile - is essential for
|
|
|
|
|
|
|
|
|
|
estimating the size of target groups, sharing lessons learned based on
|
|
|
|
|
|
|
|
|
|
consistent definitions, and allocating resources appropriately. A
|
|
|
|
|
|
|
|
|
|
literature review was conducted to determine what formal definitions of
|
|
|
|
|
|
|
|
|
|
hard-to-reach populations exist and how they are being used, and to
|
|
|
|
|
|
|
|
|
|
propose definitions to consider for future use. Overall, we found that
|
|
|
|
|
|
|
|
|
|
(1) there is a need to distinguish populations that are hard to reach
|
|
|
|
|
|
|
|
|
|
versus hard to vaccinate, and (2) the existing literature poorly defined
|
|
|
|
|
|
|
|
|
|
these populations and clear criteria or thresholds for classifying them
|
|
|
|
|
|
|
|
|
|
were missing. Based on this review, we propose that hard-to-reach
|
|
|
|
|
|
|
|
|
|
populations be defined as those facing supply-side barriers to
|
|
|
|
|
|
|
|
|
|
vaccination due to geography by distance or terrain, transient or
|
|
|
|
|
|
|
|
|
|
nomadic movement, healthcare provider discrimination, lack of healthcare
|
|
|
|
|
|
|
|
|
|
provider recommendations, inadequate vaccination systems, war and
|
|
|
|
|
|
|
|
|
|
conflict, home births or other homebound mobility limitations, or legal
|
|
|
|
|
|
|
|
|
|
restrictions. Although multiple mechanisms may apply to the same
|
|
|
|
|
|
|
|
|
|
population, supply-side barriers should be distinguished from
|
|
|
|
|
|
|
|
|
|
demand-side barriers. Hard-to-vaccinate populations are defined as those
|
|
|
|
|
|
|
|
|
|
who are reachable but difficult to vaccinate due to distrust, religious
|
|
|
|
|
|
|
|
|
|
beliefs, lack of awareness of vaccine benefits and recommendations,
|
|
|
|
|
|
|
|
|
|
poverty or low socioeconomic status, lack of time to access available
|
|
|
|
|
|
|
|
|
|
vaccination services, or gender-based discrimination. Further work is
|
|
|
|
|
|
|
|
|
|
needed to better define hard-to-reach populations and delineate them
|
|
|
|
|
|
|
|
|
|
from populations that may be hard to vaccinate due to complex refusal
|
|
|
|
|
|
|
|
|
|
reasons, improve measurement of the size and importance of their impact,
|
|
|
|
|
|
|
|
|
|
and examine interventions related to overcoming barriers for each
|
|
|
|
|
|
|
|
|
|
mechanism. This will enable policy makers, governments, donors, and the
|
|
|
|
|
|
|
|
|
|
vaccine community to better plan interventions and allocate necessary
|
|
|
|
|
|
|
|
|
|
resources to remove existing barriers to vaccination. (C) 2019 Elsevier
|
|
|
|
|
|
|
|
|
|
Ltd. All rights reserved.'
|
|
|
|
|
affiliation: 'Ozawa, S (Corresponding Author), UNC Eshelman Sch Pharm, CB 7574,Beard
|
|
|
|
|
Hall 115H, Chapel Hill, NC 27599 USA.
|
|
|
|
|
|
|
|
|
|
Ozawa, Sachiko; Yemeke, Tatenda T., Univ N Carolina, UNC Eshelman Sch Pharm, Div
|
|
|
|
|
Practice Adv \& Clin Educ, Chapel Hill, NC 27515 USA.
|
|
|
|
|
|
|
|
|
|
Ozawa, Sachiko, Univ N Carolina, UNC Eshelman Sch Pharm, Dept Maternal \& Child
|
|
|
|
|
Hlth, Chapel Hill, NC 27515 USA.
|
|
|
|
|
|
|
|
|
|
Evans, Daniel R., Duke Univ, Sch Med, Durham, NC USA.
|
|
|
|
|
|
|
|
|
|
Pallas, Sarah E.; Wallace, Aaron S., CDC, US Ctr Dis Control \& Prevent, Global
|
|
|
|
|
Immunizat Div, Atlanta, GA USA.
|
|
|
|
|
|
|
|
|
|
Lee, Bruce Y., Johns Hopkins Bloomberg Sch Publ Hlth, Publ Hlth Computat \& Operat
|
|
|
|
|
Res PHICOR, Baltimore, MD USA.
|
|
|
|
|
|
|
|
|
|
Lee, Bruce Y., Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore,
|
|
|
|
|
MD USA.
|
|
|
|
|
|
|
|
|
|
Lee, Bruce Y., Johns Hopkins Univ, GOPC, Baltimore, MD USA.'
|
|
|
|
|
author: Ozawa, Sachiko and Yemeke, Tatenda T. and Evans, Daniel R. and Pallas, Sarah
|
|
|
|
|
E. and Wallace, Aaron S. and Lee, Bruce Y.
|
|
|
|
|
author-email: ozawa@unc.edu
|
|
|
|
|
author_list:
|
|
|
|
|
- family: Ozawa
|
|
|
|
|
given: Sachiko
|
|
|
|
|
- family: Yemeke
|
|
|
|
|
given: Tatenda T.
|
|
|
|
|
- family: Evans
|
|
|
|
|
given: Daniel R.
|
|
|
|
|
- family: Pallas
|
|
|
|
|
given: Sarah E.
|
|
|
|
|
- family: Wallace
|
|
|
|
|
given: Aaron S.
|
|
|
|
|
- family: Lee
|
|
|
|
|
given: Bruce Y.
|
|
|
|
|
da: '2023-09-28'
|
|
|
|
|
doi: 10.1016/j.vaccine.2019.06.081
|
|
|
|
|
eissn: 1873-2518
|
|
|
|
|
files: []
|
|
|
|
|
issn: 0264-410X
|
|
|
|
|
journal: VACCINE
|
|
|
|
|
keywords: Hard-to-reach; Definition; Vaccination; Immunization; Unvaccinated
|
|
|
|
|
keywords-plus: 'HUMAN-PAPILLOMAVIRUS VACCINATION; ROUTINE IMMUNIZATION COVERAGE;
|
|
|
|
|
|
|
|
|
|
MIDDLE-INCOME COUNTRIES; HEALTH-CARE; INFLUENZA VACCINATION; CHILDREN;
|
|
|
|
|
|
|
|
|
|
BARRIERS; RECOMMENDATIONS; INCREASE; SERVICES'
|
|
|
|
|
language: English
|
|
|
|
|
month: SEP 3
|
|
|
|
|
number: '37'
|
|
|
|
|
number-of-cited-references: '106'
|
|
|
|
|
orcid-numbers: 'Ozawa, Sachiko/0000-0001-7608-9038
|
|
|
|
|
|
|
|
|
|
Evans, Daniel/0000-0002-9818-5001
|
|
|
|
|
|
|
|
|
|
Wallace, Aaron/0000-0003-2264-3229
|
|
|
|
|
|
|
|
|
|
Pallas, Sarah/0000-0002-9719-6278
|
|
|
|
|
|
|
|
|
|
Yemeke, Tatenda/0000-0002-1489-627X'
|
|
|
|
|
pages: 5525-5534
|
|
|
|
|
papis_id: 91faa1a429daf4ac7e6bfc12c827df4e
|
|
|
|
|
ref: Ozawa2019defininghardtoreach
|
|
|
|
|
researcherid-numbers: 'Ozawa, Sachiko/Z-4944-2019
|
|
|
|
|
|
|
|
|
|
'
|
|
|
|
|
tags:
|
|
|
|
|
- review
|
|
|
|
|
times-cited: '36'
|
|
|
|
|
title: Defining hard-to-reach populations for vaccination
|
2023-10-01 08:15:07 +00:00
|
|
|
type: article
|
2023-09-28 14:46:10 +00:00
|
|
|
unique-id: WOS:000485212400005
|
|
|
|
|
usage-count-last-180-days: '3'
|
|
|
|
|
usage-count-since-2013: '16'
|
|
|
|
|
volume: '37'
|
|
|
|
|
web-of-science-categories: Immunology; Medicine, Research \& Experimental
|
|
|
|
|
year: '2019'
|
