Table 4

Recommendations for the implementation of COVID-19 vaccines in LMICs, based on lessons from meningitis A, yellow fever and Ebola virus disease vaccination campaigns

RecommendationDomains
Prioritise the availability of operational funds to support community engagement and social mobilisation well in advance of vaccination activities.
  • Planning and coordination

  • Community engagement and social mobilisation

Develop a community engagement strategy that emphasises the principles of community involvement, co-development and iterative adaptation. Vaccination teams should meet iteratively with community members, actively seek their questions and input on strategy development, and adapt vaccination strategies accordingly.
  • Community engagement and social mobilisation

  • Target groups and delivery strategies

  • Vaccine confidence

Engage local, trusted health workers (including community health workers) to support vaccination activities, ensuring a continued connection between communities and the vaccination campaign.
  • Vaccination teams

  • Community engagement and social mobilisation

Develop rapid processes to recruit and manage an expanded vaccination workforce for the response. Care should be taken to balance response staffing requirements with the need to maintain existing services.
  • Vaccination teams

Evaluate and refine training strategies to ensure vaccination teams are well equipped to conduct vaccination activities. Identify teams who are not able to access remote training and design suitable alternatives.
  • Vaccination teams

Provide vaccination teams with clear guidance on the management of multidose vaccine vials, including which population groups should be offered leftover vaccine doses where the vial cannot be appropriately stored and used at a later time.
  • Vaccination teams

  • Logistics and supply

Ensure national ownership, access and capacity to analyse vaccination campaign data, including the use of electronic data capture systems.
  • Vaccination monitoring and safety surveillance

Work with technical leads across the outbreak response (eg, surveillance, vaccination) to streamline the collection, aggregation and analysis of different indicators to support vaccination campaign monitoring.
  • Vaccination monitoring and safety surveillance

Bring together response pillar leads and routine health programme leads to discuss opportunities to integrate health services during vaccination campaigns. Any integration of services should be well resourced and well coordinated between services and with communities, to mitigate potential adverse impacts.
  • Target groups and delivery strategies

  • LMICs, low- and middle-income countries.