Developing a tool kit to build vaccine confidence and ensure equitable COVID-19 vaccination implementation strategies in low-and-middle income countries: a multi-stakeholder implementation science and co-development study

Strategies for implementing equitable vaccine programs are needed to build public confidence in COVID-19 vaccination and improving vaccination rate in high-risk and marginalized people. It is particularly important to developing countries where politics, logistic challenges, and low vaccination willingness in some groups have slowed down vaccination roll-out. In this proposal, we will take the COVID-19 vaccination roll out in the Philippines as an example to identify key principles and develop strategies for delivering vaccines to high-risk and marginalized people to build their confidence in vaccination programs and develop a tool kit to guide the implementation of vaccination programs in developing countries. The study design is guided by the health equity implementation framework in four phases: 1) a situational analysis to understand the processes of current COVID-19 vaccination roll out in the Philippines, as well as the barriers and facilitators towards vaccine uptake, 2) developing a tool kit for improving vaccine delivery to high-risk and marginalized people in the Philippines, 3) piloting the tool kit and assessing its feasibility in the Philippines, 4) adapting the tool kit for other low and middle income countries (LMICs). Developed drawing on learnings from COVID-19 vaccination roll out in the Philippines, our user friendly and contextualized tool kits for guiding equitable vaccine delivery will support vaccination programs in LMICs to reach the most vulnerable and build vaccine confidence in communities. This will benefit ongoing vaccine roll-out, future booster vaccination programs, and other novel vaccine delivery programs should they be required.