Barriers to and drivers of vaccination – insights and recommended actions: targeting vaccination inequities in Tajikistan

Overview

Tajikistan has maintained high national vaccination coverage through the pandemic, but some inequities and risks of disease outbreaks remain at the subnational level. An analysis of vaccination coverage data identified some lower performing areas where the highest number of unvaccinated or partially vaccinated children were found. The WHO Regional Office for Europe, in collaboration with the Ministry of Health and Social Protection of Tajikistan, conducted qualitative research between September and October 2023 in three of these areas, aiming to identify barriers to and drivers of childhood vaccination uptake. Key findings include the fact that health workers and caregivers have concerns about adverse events following immunization and side-effects, which influence vaccine recommendations and caregiver perceptions of risk. Inconsistent medical exemptions and false contraindications increase perceived risks among parents. Health workers expressed a need for more training, especially in communication and handling contraindications. Differences between groups of caregivers were revealed in terms of knowledge gaps and the importance of social influence on vaccine acceptance. To address these challenges, key action areas include developing and revising training materials, building health workers’ capacity, strengthening health facilities, and engaging caregivers through community outreach and education programmes.