1
DRAFT COVID-19 VACCINE SOCIAL MOBILISATION AND RISK
COMMUNICATION STRATEGY FOR MALAWI 2021-2023
March 2021.
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Table of Contents
Foreword. .................................................................................................................................. 3
Acknowledgements .................................................................................................................. 1
Executive Summary ................................................................................................................. 1
Abbreviations and Acronyms ................................................................................................. 1
1. BACKGROUND AND INTRODUCTION .................................................................... 3
2. VACCINE TO BE USED IN THE FIRST PHASE. ...................................................... 5
3. SITUATION ANALYSIS. ............................................................................................... 5
4. GUIDING PRINCIPLES. ................................................................................................ 2
5. GOAL. ............................................................................................................................... 4
6. OBJECTIVES. .................................................................................................................. 4
7. THEORETICAL UNDERPINNING THE STRATEGY. ............................................ 5
7.1 Diffusion of Innovation Theory. .................................................................................... 5
................................................................................................................................................ 5
7.2 WHO Strategic Advisory Group of Experts (SAGE) Vaccine Hesitancy model ..... 1
8. COMMUNITY ENGAGEMENT IMPLEMENTATION IN THE COVID-19
VACCINE. .............................................................................................................................. 12
9. PARTICIPANT GROUPS/TARGET AUDIENCE AND CHANNELS OF
COMMUNICATION ............................................................................................................. 13
10. COVID-19 VACCINE KEY MESSAGES. ............................................................... 20
11. COVID-19 VACCINE CRISIS COMMUNICATION SCENARIOS, MESSAGES
AND RESPONSES................................................................................................................. 27
12. PROPOSED CRISIS RESPONSES ON ANTICIPATED ISSUES. ...................... 31
13. MONITORING, EVALUATION AND DOCUMENTATION .............................. 35
14. COORDINATION ...................................................................................................... 12
15. IMPLEMENTATION PLAN & BUDGET ESTIMATES ...................................... 13
16. KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL
MOBILIZATION FOR COVID-19 VACCINE INTRODUCTION ................................. 16
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17. COMMUNICATION TREE ...................................................................................... 24
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Foreword.
This strategy considers COVID-19 vaccine administration and Social and Behavior Change
Communication in close coordination with communications plans related to national COVID-
19 control and immunization. The strategy aims to promote confidence in COVID-19
vaccination, inform key and secondary audiences of the characteristics and public health value
of the new intervention; address questions, concerns, and gaps in information; reinforce routine
vaccination and continued use of existing COVID-19 control practices; and address
misconceptions, rumours, and issues in a timely and appropriate manner.
The communication strategy targets specific barriers to COVID-19 immunization and early
health seeking behaviour, and aims to overcome these barriers by clear and concise response
to queries on the vaccine, trainings and orientations to media and stakeholders that would result
in the increase of target populations seeking COVID-19 vaccine immunization. It also
promotes the use of already existing COVID-19 control and treatment interventions such as
the correct wearing of masks, frequent hand washing with soap and observing physical
distancing among others.
The strategy primarily targets the health workers and other social workers e.g. soldiers,
immigration officials, those involved in humanitarian work and those displaced including
religious and community leaders. It also seeks to get attention of policy makers, government
agencies, the media and other stakeholders in order to have an effective COVID-19 vaccination
programme resulting from good stakeholder collaboration.
The strategy uses the Diffusion of Innovation Theory that states that innovations, new ideas or
behaviours are spread within a community or from one community to another. In this regard,
the strategy will focus on use of multiple channels and approaches in delivery of messages and
materials for the vaccine. The Ministry of Health through the Expanded Programme on
Immunization is implementing a phased introduction of the COVID-19 vaccine in the country.
This is a new COVID-19 Vaccine Communication strategy for the period 2021 – 2023 and is
a guiding document for all partners to implement a successful COVID-19 vaccine programme
being the first of its kind in the country.
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It is my belief that the strategy will play a critical role in increasing knowledge, attitude and
resulting in more priority groups accessing the COVID-19 vaccine.
Hon. Khumbize Kandodo Chiponda, MP.
Minister of Health
1
Acknowledgements
The Ministry of Health is grateful to individuals and partners who contributed towards the
development and completion of the COVID-19 Vaccine Communication Strategy for Malawi.
The process started at the end of December 2021 with desk reviews by Health Education
Services and partners through virtual platforms. The Health Education Services need to be
commended for their tiresome work in coordinating meetings in coming up with this document.
We circulated this strategy widely to implementing partners and participants of the consultative
process and comments received to finalize this communication strategy. As such, we
particularly thank the Health Education Services and Expanded Programme for Immunization
for overseeing and guiding this process of developing the first COVID-19 Vaccine
Communication strategy. Special thanks go to UNICEF and WHO for technical support in
developing this document.
Special thanks to Mavuto Thomas (Ag. Deputy Director of Preventive Health Services-Health
Education Services), Austin Makwakwa (Principal Health Promotion Officer-HES), Tobias
Kunkumbira, Alvin Chidothi Phiri, Ellah Chamanga (Senior Health Promotion Officers-HES),
Dr. Mike Chisema (Programme Manager-EPI), Temwa Mzengeza (Deputy Programme
manager-EPI), Brenda Mhone (Surveillance-EPI), Doreen Ali (Deputy Director-CHS),
Precious Phiri (CHS).
Special recognition also goes to Hudson Kubwalo (Health Promotion-WHO), Parvina
Muhamed Khojaeva (Head of C4D-UNICEF), Chancy Mauluka (C4D Specialist-UNICEF),
Henry Chimbali (Communication-WHO), Joel Suzi (Deputy Chief of Party-HC4L), Rachel
Thomas (CRS), Evin Joyce (Community Engagement-UN Resident Coordinators Office),
Upile Kachila (Program Manager-CCPF), Christel Saussier (EOC Technical Advisor, I-TECH)
and Dr. Bob Alexander (RCCE Specialist).
Dr. Charles Mwansambo
Secretary for Health
Ministry of Health.
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Executive Summary
COVID-19 continues to be a critical public health challenge for the Government and People of
Malawi. While risk perception to COVID-19 among the general population has been
fluctuating and in November 2020 dropped to 33% (31% urban, 34% rural), general awareness
is still high at 99%, with the majority indicating that they heard about it from the radio (87%)
followed by religious leaders and health personnel (37%).
The majority of respondents also indicate that COVID-19 can be transmitted through coughing
and sneezing (76.4%, staying in crowded places (70.8%), and contact with infected surfaces at
54.4%.
The strategy employs a Diffusion of Innovation Theory that recognises that innovations, new
ideas or behaviours are spread within a community or from one community to another.
For this reason, different approaches will be utilised including advocacy to create an enabling
environment for preventive behaviours, community mobilization to increase participation and
community ownership and behaviour change communication (BCC) to promote individual
preventive behaviours and discourage negative community perceptions and reduce vaccine
hesitancy.
Integrating COVID-19 vaccine communication with communication for other COVID-19
interventions will be critical. Just like OCV, this vaccine complements other recommended
interventions to prevent the disease. Audiences should therefore understand the role of the
COVID-19 vaccine in relation to other COVID-19 prevention methods. As such, careful
messaging will need to address the fact that the COVID-19 vaccine reduces deaths, the risk of
hospitalization and severe diseases from COVID-19. Those who receive the vaccine could still
get COVID-19 and should continue to use recommended prevention measures.
This strategy also recognizes the importance of strengthening partnerships at all levels and
building the capacities of all relevant personnel in an ongoing basis. The HES is expected to
determine the SBCC capacity needs of relevant personnel within government and among
community based organizations and work with the relevant development agencies,
government departments and tertiary institutions of learning to provide such capacity. In
promoting uptake of the COVID-19 vaccine, this strategy recommends that other COVID-19
preventive methods be promoted as well to combat the disease.
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Abbreviations and Acronyms
ADC Area Development Committee.
AEFI Adverse Event Following Immunization.
AESI Adverse Event of Special Interest.
CBO Community Based Organisation
CCPF Chipatala cha pa Foni.
CHAGs Community Health Action Groups.
CoM College of Medicine.
COVAX COVID-19 Vaccines Global Access.
CSOs Civil Society Organisation.
DIO Diffusion of Innovation.
EMA European Medicines Agency.
FAQs Frequently Asked Questions.
FBO Faith Based Organisation.
FLWs Frontline Workers.
HC4L Health Communication for Life.
HES Health Education Services.
HCMC Health Centre Management Committee.
HCW Health Care Workers.
HAS Health Surveillance Assistant.
IEC Information, Education, Communication.
iNGO International Non-Governmental Organization.
HPO Health Promotion Officer.
KAP Knowledge, Attitude, Practice.
MEIRU Malawi Epidemiology and Intervention Research Unit.
MoH Ministry of Health.
PA Public Address.
PRO Public Relation Officers.
PSA Public Service Announcement.
PwDs Persons with Disabilities.
PHIM Public Health Institute of Malawi.
OCV Oral Cholera Vaccine.
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RCCE Risk Communication & Community Engagement.
SAGE WHO Strategic Advisory Group of Experts.
SMS Short Message Service.
SOPs Standard Operating Procedures.
UNICEF United Nations International Children's Emergency
Fund.
VDC Village Development Committee.
VHC Village Health Committee.
WHO World Health Organization.
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1. BACKGROUND AND INTRODUCTION
COVID-19 is a respiratory illness that is fast spreading across the world. It is a new strain/type
of coronavirus and was first found in Wuhan, China in December 2019. World Health
Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern
(PHEIC) on 30th January 2020, and a pandemic on 11th March 2020.1
Malawi declared a state of emergency on 20th March 2020. The first COVID-19 case was
recorded on 2nd April 2020 in Malawi. By 7th February 2021 Malawi had registered 27,195
cases, 856 deaths, of the cases 1,984 are imported and 25,211 are locally transmitted. The cases
have substantially increased and the country was experiencing second wave of the pandemic,
also on the increase were the number of admission in the COVID-19 treatment centres and
number of COVID-19 related deaths. The second wave has also been characterized by new
strains of the coronavirus being reported in several countries including Malawi. Risk of
COVID-19 infection is also high among Health Care Workers (HCW) as 1,407 cases have been
reported among health workers with 10 deaths cumulatively as of 7th February 2021.2
Malawi is still a hot spot area for COVID-19. The country has registered high numbers of cases
in most of the areas in wet and hot seasons. Therefore, the introduction of the COVID-19
vaccine to complement the already existing prevention interventions will be essential to control
the pandemic. Vaccination is a safe and effective way of protecting people against harmful
diseases, prior to contact with the causative agent of the disease and it uses the body’s natural
defences to build resistance to specific infections and makes your immune system stronger. It
is one of the most effective and impactful public health measure as it helps to reduce mortality
and morbidity from various disease including COVID-19. To get protected from COVID-19 is
critically important because for some people, it can cause severe illness or death and
vaccination is one of many steps that can protect people from COVID-19. Stopping a pandemic
requires using all the tools available. Vaccines work with your immune system so your body
will be ready to fight the virus if you are exposed while other preventive measures such as
masks, hand wash and social distancing, help reduce your chance of being exposed to the virus
or spreading it to others. When these are combined, they offer the best protection. Widespread
use of vaccine can reduce rate of spread in the community and reduce chances of a new variant.
1 https://www.who.int/emergencies/diseases/novel-coronavirus-2019 2 Public health institute of Malawi epidemiological report
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Introducing of any new vaccine especially with new target populations, through potentially
new delivery strategies is challenging and require a comprehensive communication strategy.
Ensuring acceptance and uptake of COVID-19 vaccination among target groups in Malawi
presents a unique set of difficulties but is key to successful reduction of transmission and
containment of the pandemic.
The COVID-19 Communication Strategy is intended to guide timely dissemination of accurate
information about COVID-19 vaccine, address hesitancy about the vaccine, ensure acceptance
of the vaccine, motivate and encourage its uptake. This strategy will also serve to guide
programme designers and implementers at national and district levels to design communication
interventions for disseminating information about COVID-19 vaccines and vaccination process
across the country.
To ensure acceptance and uptake of COVID-19 vaccination, the country will adopt an
integrated approach that starts with listening to and understanding target populations, to
generate behavioural and social data on the drivers of uptake and to design targeted strategies
to respond.
The Risk Communication and Community Engagement (RCCE) sub-committee on COVID-
19 in Malawi is a sub-committee under health cluster which is responsible for Risk
Communication and Community Engagement. The sub-committee has been vibrant in
mobilising resources and providing technical support in implementing RCCE activities at
national and district level. Despite the social and behaviour change activities that have been
implemented across the country to promote adoption of COVID-19 preventive measures, there
has been little reduction in COVID-19 risk and morbidity. The communities have relaxed in
adhering to COVID-19 prevention measures in all settings despite the cases of COVID-19
fluctuating.3 The COVID-19 pandemic has also brought an infodemic where there is a lot of
information and misinformation circulating on different platforms.
The strategy will ensure it builds a supportive and transparent information environment, and
addresses misinformation through social listening and assessments that inform digital
3 Knowledge Attitude Practice Survey on COVID RCCE response
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engagement initiatives through engagement of communities by civil society organizations,
particularly for vulnerable target populations.
The strategy will also ensure that health workers have requisite knowledge of COVID-19
vaccines as first adopters, trusted influencers and vaccinators, giving them the skills to
communicate effectively and persuasively with target populations and communities.
The strategy will prepare implementers to respond to any reports of adverse events following
immunisation (AEFI) and have planning in place to mitigate any resulting crises of confidence.
2. VACCINE TO BE USED IN THE FIRST PHASE.
In the first phase of the COVID-19 vaccination, the country will use Oxford/AstraZeneca
vaccine. It is also known as AZD1222 or ChAdOx1-S (recombinant). Developed by the Oxford
University, United Kingdom, and Astra Zeneca. The vaccine is a colorless to slightly
opalescent solution provided in a multi-dose vial. This vaccine has acceptable safety profile, it
is efficacious and in terms of cold chain, it is compatible with our current cold chain equipment
and stored in a refrigerator at 2°C – 8°C. The recommended dosage is two doses with an
interval of 8 to 12 weeks and the vaccine is administered through injection. In the initial phase
it will target 20% of the population which include the frontline health workers and other social
workers, the elderly and those with comorbidities e.g. diabetes, High blood pressure and other
heart conditions, asthma.
3. SITUATION ANALYSIS.
Since early 2020, there has been general hesitancy around COVID-19 vaccine on social media.
According to the UNICEF social listening tool (talk Walker)4 has gathered that some of the
reasons cited for denial of the vaccines.
By end December 2020, overall tone of immunization content was trending negative in the
region, including Malawi. Around 40% of content had a negative tone, with only 8% of articles
and posts displaying positive content. Examples included posts encouraging vaccine refusal
4 https://app.talkwalker.com/app/project/c6fd639a-9332-4366-bcde-
d6016fda4c9d/shared_dashboard/export_UNICEFESARO_wGpCxJlD.html#/SHARED_DASHBOARD#co=project&cid=c6fd639a-9332-4366-bcde-d6016fda4c9d&psid=export_UNICEFESARO_wGpCxJlD.html&keyid=undefined&data=eyJyIjp7ImEiOnsiYWN0aXZlUGFnZUlkIjoiODYyMzQ1MmEtOGZhOC00Yzc4LThlNTgtOGU3ODgxYzg3YmVjIn0sImkiOiJTSEFSRURfREFTSEJPQVJEIiwicyI6W119fQ==
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and conspiracy claims that Bill Gates is using the COVID-19 vaccine rollout to control people.
The following narratives were tracked in relation to the COVID-19 vaccines:
3.1 Religious fears.
There were claims that the COVID-19 vaccine carry the mark of the devil that will change
human DNA which revived old and new conspiracies, with claims that it will be used to
implement a de-population agenda. Some posts in the region discussed whether the COVID-
19 vaccines will be regarded as permissible under Islamic law as halal.
3.2 Effectiveness of the vaccine.
The news of a different variant of the virus spreading in South Africa and other countries raised
concerns that the vaccines will not be as effective in preventing infections.
3.3 Safety concerns and misinformation.
Specific adverse effects discussed online included potential strong allergic reactions and a
potential increased risk of HIV infection. There were equally false claims that the vaccine will
cause infertility have been tracked. Other online conversations referred to false claims of side
effects of COVID-19 that affect people’s feet and male genitalia.
The vaccine has been developed over a short period of time. Therefore, its safety has not been
scientifically proven. Some say the vaccine is not for COVID-19 but other infections while
others fear it will cause death.
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3.4 Pandemic Fatigue
Pandemic fatigue is increasing. This is due to the stress caused by uncertainty, lower risk
perceptions and reduced trust in government responses.5
By September 2020, according to rapid assessment activities conducted by UNICEF, HC4L
and MEIRU, knowledge of COVID-19 was over 90% while self-efficacy to practice the
recommended behaviours trailed over 70%. However, risk perception was low at around 40%.
It is imperative to increase risk perception to enable preventive behaviours that include demand
for vaccination.
Findings of KAP survey conducted in November 2020.
The College of Medicine (CoM), Public Health Institute of Malawi (PHIM) and UNICEF also
conducted a KAP survey in November 2020. Preliminary qualitative results indicated that low
risk perception as a result of staunch religious believes. Concerns revolved around loss of
business and decreased economy activities; closure of schools as a critical problem facing the
youth, while others were much concerned with isolation.
Quantitatively the preliminary results indicate that 99% of the population heard of COVID-19,
mostly from radio (87%) followed by religious leaders and health personnel (37%).
In regard to how COVID-19 is transmitted, the majority of respondents mentioned that
COVID-19 can be transmitted through coughing and sneezing (76.4%) and staying in crowded
places (70.8%). Contact with infected surfaces was only mentioned as a potential source of
infection by 54.4% of respondents.
However, risk perception dropped to 33% (31% urban, 34% rural) as less were afraid of the
pandemic at the time of the research. On the positive side, 90.6% were confident they would
prevent the disease.
5 UNICEF Evaluation of Insights Report, 2020
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The table below illustrates confidence levels for some preventive practices:
Table 1
3.5 Sources of Information
Majority of participants indicated that they get information from radio, TV and health workers.
Others reported that they get information from church leaders and at funerals. Participants
reported getting trusted information regarding COVID-19 from health workers. However, it
was also noted that radio, television and social media plays a critical role in informing people
regarding COVID-19.
4. GUIDING PRINCIPLES.
Risk and crisis communication and community engagement will be guided by the following
principles:
o Nationally-led — The responsibility to implement RCCE lies with the government
through Ministry of Health. However, they are supported by other line Ministries i.e.
Ministry of Information, Ministry of Civic Education and National Unity, Ministry of
Local Government and local, national and international civil society and the
communities themselves. Multi-sectoral approach will be utilized.
o Community-centred — Effective RCCE will start with understanding the knowledge,
capacities, concerns, structures and vulnerabilities of different groups in communities
– enabling adaptation of approaches, improving outcomes and impact. It will take a
holistic, humanitarian approach that addresses the risk of COVID-19 and crisis
0102030405060708090
Can use facemask every time
you go out
Can avoid toucheyes and nose
Can keep 1 meterdistance
Can always covermouth withelbow when
coughing
Can stay at homefor long time
Can put on facemask every time
you go out
Confidence to Prevent COVID-19
Overall Urban Rural
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surrounding vaccines but also include other community needs, including protection,
water and sanitation, economic stability, mental health and psychosocial support and
broader development issues.
o Participatory — Communities (with priority given to at-risk or vulnerable groups) will
be supported to lead in the analysis, planning, design, implementation, and monitoring
and evaluation of RCCE and crisis activities.
o Integrated — RCCE and crisis communication will be integrated and harmonized
within the public health, humanitarian and development responses to COVID-19. At a
programmatic level, RCCE will be mainstreamed across all sectors to ensure
participation and to improve effectiveness.
o Inclusive — Support will be prioritized to the most vulnerable, marginalized or at-risk
groups. RCCE approaches will be made accessible, culturally appropriate youth,
disability and gender-sensitive. Communities in remote areas who don’t always have
access to mainstream and social media will be reached with messages and appropriate
materials.
o Accountable — In responding to COVID-19, public health, humanitarian and
development actors will be accountable and transparent to affected communities.
RCCE approaches will ensure communities can access information about and
participate in decision-making about the response. They will also document and
respond to community feedback on the response.
o Innovative – The communication strategy will embrace innovation to pilot, implement
and scale up new ideas and messaging. The use of new technologies e.g. mobile phones
or smart phones, social messaging platforms and others. The platforms will also enable
implementers to tracks immunization: rollout-uptake-feedback. The systems that utilise
push reminder messages to clients informing them of where and when to access the
vaccine will be used. This will also provide clients an ability to provide feedback on
their experience i.e. if there are some side-effects, hesitancy issues etc. The systems
will be integrated into other existing platforms. Additionally, implementers will be able
to send tips and reminder SMSs to clients informing them of their vaccination schedule,
where and when etc. Anyone with a basic phone will have the chance to access this
information.
As a new vaccine, new additional information that becomes available will be used to
update this document regularly to ensure reliable and up-to-date information reaches
all Malawians, including those living in remote and hard-to-reach areas.
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5. GOAL.
The goal is to ensure that more than 90% of the targeted population accept to get
vaccinated against COVID-19.
6. OBJECTIVES.
i. COVID-19 vaccination. ii. COVID-19 RCCE.
By June 2021: Increase to >95%, knowledge
of COVID-19 vaccine (benefits, schedule, side
effects, place and time of vaccination) among
all individuals in Malawi.
By June 2021: Promote to over 80%, positive
attitudes regarding COVID-19 vaccine (safety,
efficacy, willingness/intention) among eligible
population.
By June 2021: Increase to >80%, public
demand for COVID-19 vaccine uptake among
eligible population.
By December 2021: Increase risk perception
of COVID-19 to 70% by end of 2021.
By June 2021: Promote/maintain preventive
practices (handwashing, distancing, and face-
masking in public) of COVID-19 among
individuals to > 90%).
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7. THEORETICAL UNDERPINNING THE STRATEGY.
7.1 Diffusion of Innovation Theory.
DOI refers to the spread of new ideas and behaviours within a community or from one
community to another. The theory suggests that some individuals and groups are quicker to
pick up new ideas, or “innovations,” than others. It categories the adopters as innovators,
early adopters, early majority, late majority, and laggards. The theory explains that if a
person or organisation wants to promote wide spread adoption of a new behaviour, the person
or organisation should market the new behaviour to each adopter group differently using
distinct communication channels, messages and tactics.
Figure 2: DIO
Community leaders,
Youth leaders,
Mother groups,
Health practitioners,
Community volunteers.
Mar Aug Oct Nov
100
-
90 -
80 -
70 -
60 -
50 -
40 -
30 -
20 -
10 -
0 -
Faith-based leaders,
High-level officials,
Health
practitioners,
Well-known
personalities &
celebrities,
Community
volunteers.
Start.
Innovators
Gate keepers that
will be used to
inform the public
that COVID-19
vaccine is available
Community leaders,
Faith-based leaders,
Youth leaders,
Health practitioners,
Community volunteers.
Gain.
Early Adaptors Influential leaders that
people trust will be
featured in communication
products
Community leaders,
Youth leaders,
Mother groups,
Health practitioners,
Community volunteers.
…
Maintain.
Accelerate.
Early Majority
Peer education and
interpersonal
communication will be
used to get more people to
get the vaccine.
Late Majority
Use local leaders to motivate
communities to get the vaccines;
Form allies with them to be part
of communication team
Applying Diffusion of Innovation to generate demand for COVID-19 vaccine uptake
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7.2 WHO Strategic Advisory Group of Experts (SAGE) Vaccine Hesitancy model
This strategy will use WHO Strategic Advisory Group of Experts (SAGE) Vaccine Hesitancy
model which has been used to explore factors that affect the uptake of vaccine in various
countries. The SAGE model will guide all the communication of COVID-19 vaccine as it
anticipated that people have a lot of misinformation and myths about the vaccines that can
affect uptake of the vaccine.
SAGE model is based on the fact that that attitudes to vaccination is a continuum ranging
from complete acceptance to total refusal. Vaccine hesitancy is defined as a locus within this
continuum and could result in acceptance of some vaccines and refusal of others, delayed
vaccination and tentative acceptance, thereby influencing overall immunization utilization.
The model differentiates between contextual, individual and groups and vaccine or
vaccination-specific factors that influence immunization acceptance and utilization (WHO,
2014).
The three domains of SAGE model will be used to guide the development of all communication
products to promote uptake of COVID-19 vaccine as outlined below:
a. Contextual influence.
This explains factors that people who are supposed to get the vaccine cannot control but affect
their uptake of vaccines. Contextual influence arises due to socio- economic, cultural,
environmental, health system, or political factors. The strategy will consider the following
when developing communication products
i. Communication and media environment: The national and community media will
be briefed of COVID-19 and will be part of the communication team for them to have
up to date COVID-19 vaccine information and issues so that they can publish and
broadcast accurate information that can demystify myths and misinformation.
Information on COVID-19 and updates will be shared on national and community
media platforms.
ii. Use of influential leaders, and anti- or pro-vaccination organizations: The
development of communication products will involve influential persons, religious
organizations mainly who have been involved in mobilizing resources for COVID-19
case management and organizations or people who are anti and pro vaccination in all
2
communication meetings and will use such people in print and audio visual products to
promote uptake of COVID-19 vaccine.
b. Vaccine and vaccination-related issue.
These include the risk and benefits of taking the vaccine, the scientific evidence available to
back up the efficacy of the vaccine. The schedule, mode of delivery and the supply of the
vaccine and the knowledge base and attitude of health workers towards the vaccine. The
communication of the vaccine will make sure that all the mentioned issues are incorporated in
the communication to promote up take of vaccine.
The communication team will make sure that the health workers are updated with current
information to develop positive attitude toward COVID-19 vaccine. The communication team
will develop and continuously update communication materials for the health workers to aid
discussions with clients
c. Individual and group influences.
This describes factors that clients and the people around them can motivate or demotivate them
to get the vaccine. These are personal, family and/or community members’ perceptions and
experience with vaccination. The beliefs, attitudes about vaccines, health and prevention, their
knowledge about COVID-19 vaccines, their trust in health system and health providers,
perceived risk and/or benefit of the vaccine and belief that immunisation as a social norm or
not needed or harmful.
The communication will make sure that it builds trust of communities towards the health
systems and health providers by providing platform for dialogue between community members
and health workers.
The communication team will identify the influencers of the clients and will develop
communication products of the influencers to motivate the clients to get the vaccine.
The communication will also engage the communities to make immunization as a social norm
and that it prevents deadly diseases like COVID-19.
Testimonies of individuals will be broadcasted or published and uploaded in all media
platforms to motivate the others to get the vaccine.
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Figure 3: SAGE conceptual model and relationship to vaccine uptake
CONTEXTUAL INFLUENCES
Influences arising
due to historic,
socio-cultural,
environmental,
health
system/institutional,
economic or political
factors.
Communication
and media
environment.
Influential
leaders and
anti- or pro-
vaccination
lobbies.
Religion,
culture, socio-
economic
status.
Uptake of
COVID-19
vaccine
among
targeted
people.
VACCINE/ VACCINATION– SPECIFIC
ISSUES
Directly
related to
vaccine or
vaccination
Risk/ Benefit
(epidemiological and
scientific evidence).
Mode of administration.
Mode of delivery (e.g.,
routine program or mass
vaccination campaign).
Reliability and/or
source of supply of
vaccine.
Vaccination schedule.
Knowledge base and/or
attitude of healthcare
professionals
INDIVIDUAL AND GROUP INFLUENCES
Influences
arising from
personal
perception
of the
vaccine or
influences of
the
social/peer
environment
Personal, family and/or
community members’
experience with
vaccination, including
pain.
Beliefs, attitudes about
vaccines, health and
prevention.
Knowledge of the
vaccines.
Health system and
providers-trust and
personal experience.
Risk/benefit (perceived,
heuristic).
Immunisation as a social
norm vs. not
needed/harmful.
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8. COMMUNITY ENGAGEMENT IMPLEMENTATION IN THE COVID-19
VACCINE.
The International Association for Public Participation (IAP2) has established a Public Participation
Spectrum to determine the possible types of engagement with stakeholders and communities. This
spectrum also illustrates the increasing level of public impact of community engagement from
‘inform as the lowest level’ to ‘empowerment’ as final decision-making placed in the hands of the
public to the matters that affect the public such as COVID-19 Vaccine.
Hence, the implementation of community engagement for COVID-19 Vaccine will be based on
the model which hinges on the spectrum of community engagement. It outlines the dimensions of
Community Engagement as stipulated in the figure 4 below:
Table 4: Levels of Engagement in COVID-19 Vaccine.
12
8.1 Techniques of community engagement in COVID-19 Vaccine
A wide variety of techniques will be used by services to engage with communities and service
users. Before the engagement process starts, it is important to ensure that the purpose of the activity
and the level of engagement available is clear to everyone. Five main techniques of the ‘ladder for
participation’ will help us work better together in the COVID-19 Vaccine. These are:
Ladder for community
participation
Description
1. Keeping community
informed on the COVID-
19 Vaccine
Ensuring that people know what is happening with services
and local events – especially those that that are important to
individuals and communities (newsletters, information on the
council website)
2. Asking community what
they think on COVID-19
Vaccine.
Consultation with people when there are a number of options
for the decision to be made (surveys, focus groups, citizen
panel questionnaires, etc.)
3. Deciding together on
COVID-19 Vaccine.
People will become involved in helping decision making on
things that we are responsible for delivering (tenant groups)
4. Acting together on
COVID-19 Vaccine.
Bringing together community groups and the government and
partners to work together to make things better (Planning for
Real)
5. Supporting independent
community initiatives on
COVID-19 Vaccine
Helping people set up independent community groups to
focus on things that are important to them (Community Asset
Transfer)
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9. PARTICIPANT GROUPS/TARGET AUDIENCE AND CHANNELS OF
COMMUNICATION
a. Participant groups/target audience
Priority audiences addressed in this strategy are based on data from WHO guidelines, national
guidelines and studies which identified the priority and key populations for COVID-19
Vaccination. The target audience are the target population for the vaccination and their influencers.
The primary audience include: Health workers in private and public health care facilities, older
people aged 60 and above, people that have chronic conditions and social workers who interact
with many people on daily basis like teachers, security institutions i.e. Police, Prisons and
immigration staff among others.
The secondary audience include: The leadership of association of medical doctors, nurses,
environmental health, pharmacy, laboratory and other allied health association, associations on
PLHIV, cancer, diabetics and others The nurses’ council and medical council of Malawi, Teachers
association of Malawi. The leadership of elderly people in Malawi, pensioners’ association of
Malawi, religious groupings, Malawi interfaith association, Pentecostal churches of Malawi,
traditional leaders, youth groups, disability organizations and community-based volunteers’ e.g.
CHAGs.
The tertiary audience include: Members of parliament, health right activists, Malawi healthy
equity, MISA Malawi, media fraternity
14
b. Participants Audiences and Channels of Communication
1.0 COVID-19 vaccine Concentration
Primary target
audience
Audience description Proposed Approaches and
Channels
Health workers All people engaged in actions
whose primary intent is to enhance
health in private and government
facilities.
Health workers infected with
COVID-19 may contribute to
health care-associated infection
transmission of infection to their
patients and people they care for,
including those at high risk for
developing severe COVID-19
disease and complications.
Interpersonal
Communication: Face to Face
Orientation, Focus Group
discussions, digital media e.g.
WhatsApp groups, power-point
slide decks.
Mass media: Radio/TV
programs & spots.
Elderly. People aged 60 years and above due
to their age-related lowered
immunity exposing them to higher
risk of many infections including
COVID-19
Interpersonal
Communication: community
dialogues
Community Mobilisation:
Door to Door, Mobile van
announcements, influential
leaders, religious leaders,
community-based volunteers’
e.g. CHAGs.
15
Mass Media: radio and TV
spots/programs.
Print media: Posters, flyers,
leaflets, stickers.
Persons with
underlying
health conditions
People of all ages that are diabetic,
live with HIV, have high blood
pressure, asthma and other chronic
conditions who are at significantly
higher risk of severe disease or
death due to COVID-19.
Interpersonal
Communication: community
dialogues.
Community Mobilisation:
Door to Door, Mobile van
announcements, influential
leaders, religious leaders,
community-based volunteers’
e.g. CHAGs.
Mass Media: radio and TV
spots/programs.
Print media: Posters, flyers,
leaflets, stickers.
16
2.0 COVID-19 RCCE.
Teachers,
security staff,
immigration
staff, MRA staff,
drivers, sex
workers,
hospitality staff.
Due to the nature of their job, these
workers interact with a lot people and
most of the time it can become difficult
to adhere to preventive measures.
Interpersonal
Communication: Face to
Face Orientation, digital
media e.g. WhatsApp
groups, power-point slide
decks.
Mass media: radio/TV
programs & spots.
People around
borders/POEs
(general
populations).
They are at high risk of getting infected
with COVID-19 as they may get exposed
to travelers.
Mass communication:
leaflets, banners, radio
programs/spots.
Community
Mobilisation: community
dialogues, meetings, Door
to Door, Mobile van
announcements, influential
leaders, religious leaders,
community-based
volunteers’ e.g. CHAGs.
Travelers. They are highly exposed to COVID-19
during travel.
Mass communication:
leaflets, banners.
17
General
population.
They may have low risk perception due
to misconceptions and myths.
Interpersonal
Communication:
Community dialogues.
Interpersonal
Communication (for
children and youth):
Creativity Competitions
(art, story, theatre, video)
on themes that promote
vaccine uptake (from T/A-
level).
Community
Mobilisation: Door to
Door, Mobile van
announcements, influential
leaders, religious leaders,
community-based
volunteers’ e.g. CHAGs.
Mass Media: radio and
TV spots/programs.
Print media: Posters,
flyers, leaflets, stickers.
Children &
Young People
Children are particularly vulnerable to
the socio-economic impacts and, in some
cases, by pandemic mitigation measures
e.g. school closures. They may not be
able to access appropriate information or
Interpersonal
Communication:
interactive guides,
sensitization at school by
18
understand the recommended behaviours
and also suffer from the psychosocial
impacts of the pandemic. There may also
be disruptions in care due to the socio-
economic impacts.
On the other hand, children and young
people may be great spreaders of the
word to their families and communities.
School Health Committees
or teachers.
Mass Media: comic
books, animations.
Community
Mobilisation: Door to
Door, Mobile van
announcements, influential
leaders, religious leaders,
community-based
volunteers’ e.g. CHAGs.
The homeless They may live isolated from society and
not have a network of family and friends
to share information.
They may be more focused on surviving
and obtaining food than accessing
official public health information and
may be suspicious or fearful of
government services while being at high-
risk of getting severe COVID-19.
Interpersonal
Communication: Guides
for child protection
frontline workers.
GBV Survivors Gender-based violence (GBV) increases
during every type of emergency,
including disease outbreaks. Care and
support for GBV survivors may be
disrupted, including safety, security and
justice services.
Interpersonal
Communication: Victim
support materials
(integrated with COVID-
19 messages).
19
Print media: Posters,
flyers, leaflets, stickers.
Persons with
disabilities.
Even under normal circumstances,
people with disabilities are less likely to
access health care, education and
employment and to participate in the
community. They are more likely to live
in poverty, experience higher rates of
violence, neglect and abuse, and are
among the most marginalized in any
crisis-affected community. They are
often excluded from decision-making
spaces and have unequal access to
information on outbreaks and availability
of services, especially those who have
specific communication needs.
Interpersonal
Communication: Special
materials for PwDs e.g
Braille, sign language.
Print media: Posters,
flyers, leaflets, stickers.
Youth 15 to 30 year olds, especially school
graduates living at home, and people
already volunteering in community
initiatives, currently unemployed.
Interpersonal
Communication:
Creativity Competitions
(art, story, theatre, video)
on themes that promote
vaccine uptake (from
T/A-level).
Multi-media: WhatsApp
groups, U-Report, Radio.
20
10. COVID-19 VACCINE KEY MESSAGES.
Approaches to messages
Communication to the health workers and community about the vaccine to clarify the intended
role of COVID-19 vaccine in the control and prevention of COVID-19 is very much needed.
The right information on COVID-19 vaccine would be needed to promote acceptance and uptake
of the vaccine, by addressing peoples’ questions, concerns, vaccine’s safety, and demystify myths
and rumours that would circulate. The communication on COVID-19 vaccine would raise
awareness of the safeguards in place to protect public health and safety.
In this context, the strategy would address the following:
● Build on generally positive attitudes toward vaccines: Evidence suggests that childhood
vaccination has high acceptance and uptake because the vaccines have demonstrated to
prevent life threatening diseases like polio and measles. Recently we have also seen no
cases of Cholera outbreaks in hotspots where Oral Cholera Vaccine (OCV) has been
administered successfully. The messages should be framed basing on child immunization
as an intervention that has an impact in reducing life threating diseases.
● Manage expectations about the COVID-19 vaccine: Administration of the COVID-19
vaccine may raise unrealistic expectations about the vaccine’s protective ability. People
may think that the vaccine will eliminate COVID-19 within a short period of time.
Messages should be framed that the vaccine is an additional intervention to already existing
preventive measures of hand washing with soap, physical distancing and wearing of masks
and messages should stress continued use of existing COVID-19 preventive measures.
Explanations on why vaccine alone is not sufficient to protect against and eliminate
COVID-19 will be given to assist with adherence to other preventive measures.
● Emphasize COVID-19 symptoms: Signs and symptoms of COVID-19 may be similar to
other diseases like malaria, pneumonia and cough. This has implications as communities
21
may say that COVID-19 vaccine has no or little effect in reduction of COVID-19 cases.
Messages should promote early health seeking behaviours and testing if people have signs
and symptoms similar to that of COVID-19 to rule out or confirm COVID-19 and act
accordingly.
● Explain who should get the vaccine and why: Messages should describe the priority
beneficiaries of the COVID-19 vaccine and the reasons for targeting them.
● Explain the schedule and delivery mode: Communities should be informed on the
schedule, where the vaccine will be administered and the number of doses to promote
uptake of the vaccine whilst observing COVID-19 preventive measures.
● Phased introduction of the COVID-19 vaccine: The messages should explain why the
phased approach is being used and that people that are at high risk of contracting COVID-
19 or at high risk of having severe form of COVID-19 will receive the vaccine in the first
phase and others will get in the subsequent phases up until 80% of the population is
vaccinated.
● Vaccine safety and efficacy: Messages should provide assurance of the safety of the
vaccine and efficacy in reducing number of COVID-19 cases if herd immunity is reached.
● Communicate the dates and places where the vaccine will be delivered: The messages
should provide information on where and when to get the vaccine to avoid doubts and
confusion thus possible missed opportunities for vaccine administration.
Examples of specific messages about vaccination with the COVID-19 vaccine.
Health workers, community leaders, and other trusted and reliable sources may provide messages
for parents and other caretakers of young children. The messages would need to be audible, easy
to understand, visible in local languages, and directed at both men and women. When possible,
infographics should be used. Messages for parents or caretakers of young children and their trusted
sources may take the following approach:
22
Key messages on COVID-19 vaccine
COVID-19 disease
COVID-19 is infectious and spreads quickly. It can cause serious illness to any person;
some cases have caused death.
COVID-19 attacks everyone but people that have underlying health conditions of diabetes,
blood pressure, HIV, heart condition regardless of age are at high risk.
People that are 60 years and above are more likely to contract COVID-19 infection because
most of them their immunity is lowered due to age
People with COVID-19 have had a wide range of symptoms reported – ranging from mild
symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the
virus. People with these symptoms may have COVID-19:
Most common symptoms:
- Fever.
- Dry cough.
- Tiredness.
Less common symptoms:
- Aches and pains.
- Sore throat.
- Diarrhoea.
- Conjunctivitis.
- Headache.
- Loss of taste or smell.
- A rash on skin, or discolouration of fingers or toes.
Serious symptoms:
- Difficulty breathing or shortness of breath.
- Chest pain or pressure.
- Loss of speech or movement.
23
Please keep in mind that:
COVID-19 symptoms vary significantly from one person to another and while some
people, especially those with underlying medical conditions, can experience severe
symptoms, others can be absolutely asymptomatic.
COVID-19 symptoms can be similar to malaria symptoms!!
The use of mosquito nets significantly reduces the risk of malaria.
There is no proof that anti-malaria drugs help cure COVID-19 and they should be taken
only if you have been tested positive for malaria!! The misuse of anti-malaria drugs or any
other drug can cause serious side effects and illness and even lead to death.
Stay home and self-isolate even if you have minor symptoms such as cough, headache,
mild fever, until you recover. Call your health care provider or hotline for advice. Have
someone bring you supplies. If you need to leave your house or have someone near you,
wear a medical mask to avoid infecting others.
If you have a fever, cough and difficulty breathing, seek medical attention immediately.
Call by telephone first, if you can and follow the directions of your local health authority.
Continue to practice preventive measures of washing hands, properly wearing masks and
ensuring social distance.
COVID-19 Vaccine
The vaccine is an additional intervention to other COVID-19 prevention measures of hand
washing with soap, physical distancing and wearing of masks.
The vaccine will reduce the risk of contracting COVID-19.
The vaccine will reduce the number of cases of COVID-19 if all more people will get the
vaccine.
The vaccine will be administered in a phased approach as there are limited supplies of the
vaccines globally.
24
Who should be vaccinated first?
● While vaccine supplies are limited, it is recommended that priority be given to health
workers at high risk of exposure and older people, including those aged 65 or older.
● Vaccination is recommended for persons with conditions that increase the risk of severe
COVID-19. These include, people with having heart disease, respiratory diseases e.g.
asthma and diabetes regardless of age.
● People living with HIV or those with low immunity are part of a group recommended for
the vaccination, and may be vaccinated after receiving information and counselling.
● Vaccination can be offered to people who have had COVID-19 in the past. But individuals
may wish to defer their own COVID-19 vaccination for up to six months from the time of
infection, to allow others who may need the vaccine more urgently to go first.
● Vaccination can be offered to breastfeeding women if they are part of a group prioritized
for vaccination. The women do not need to discontinue breastfeeding after vaccination.
Should pregnant women be vaccinated?
● While pregnancy puts women at higher risk of severe COVID-19, very little information
is available to know if the vaccine is safe during pregnancy.
● Pregnant women at high risk of exposure to COVID-19 (e.g. health workers) or who have
high risk conditions (e.g. heart disease, asthma e.t.c) may be vaccinated in consultation
with their health care provider.
Who is the vaccine not recommended for?
● People with a history of severe allergies need to consult the health worker to advise them
if they can take the vaccine.
25
● The vaccine is not recommended for persons younger than 18 years until further studies
are conducted.
● It is not recommended for someone who is COVID-19 positive.
What’s the recommended dosage?
● The recommended dosage is two doses with an interval of 8 to 12 weeks.
● At the moment it is not known if people can be protected after taking a single dose.
● The vaccine is administered through injection.
Is the vaccine safe?
● Malawi will be using the Oxford/AstraZeneca vaccine. WHO has approved
Oxford/AstraZeneca for emergency use in all countries. The WHO’s SAGE recommended
the vaccine for all age groups 18 and above.
● The European Medicines Agency EMA has thoroughly assessed quality, safety and
efficacy of the vaccine, approved it and has recommended the vaccination for people aged
18 and above.
● WHO has also approved the vaccine as it complies with all the requirements
of quality, safety and efficacy set out internationally.
● Malawi team of experts on vaccine safety and poison board of Malawi, which both are
independent bodies, have also approved that the vaccine is safe and can be administered to
Malawians.
26
Does the vaccine have any side effects?
Some people might experience some mild side effects that can happen after vaccination
e.g. soreness at the site of injection, fatigue, headache, and muscle pain within 24 to 48
hours after immunization. But these disappear after some time.
Does the vaccine work?
● Oxford/AstraZeneca vaccine has an efficacy rate of more than 60%.
● When you take the Oxford/AstraZeneca vaccine you have a higher chance that if you
contract the virus may not get sick from the disease. However, some people may still suffer
from the disease due to different reasons like immunity.
● Taking 2 doses with an interval of 8 to 12 weeks between the 2 doses increases protection.
Does the vaccine work against new variants of Coronaviruses?
● Oxford/AstraZeneca is still recommended for use even if new Coronavirus types are
present in a country. Countries will assess the risks and benefits of taking the vaccine for
their population.
Does the vaccine prevent infection and transmission?
● The vaccine has efficacy rate of more than 60%.
● We still do not know if someone who has been vaccinated can still carry and transmit the
virus to other people who have not been vaccinated.
27
● It is important to maintain preventive measures e.g. masking, physical distancing, hand
washing, use of elbow when coughing or sneezing, avoiding crowds, and ensuring good
ventilation of rooms.
11. COVID-19 VACCINE CRISIS COMMUNICATION SCENARIOS, MESSAGES
AND RESPONSES
The forecast of scenarios include:
o Side effects: soreness at the site of injection, fatigue, headache, and muscle pain
o Suspicion about poor vaccine quality
o Actual event arising from vaccine: Loss of trust of the current and subsequent vaccines
o Vaccine replacement/recall
o Health workers refusing to get vaccinated, sensitization of health workers might also be
necessary.
o Relaxation of COVID-19 preventive measures once the vaccination process starts
COVID-19 Vaccine
scenario.
Development of side
effects: soreness at the site
of injection, fatigue,
headache, and muscle
pain:
COVID-19 Vaccine
scenario.
Other adverse effects e.g.
fainting or death.
COVID-19 Vaccine scenario.
Developing COVID-19
symptoms after vaccination
Key message:
It is normal to experience
side effects within 24 to 48
hours after immunization
Key message:
There can be other effects not
related to COVID-19 vaccine,
which could have happened if
Key message:
COVID-19 Vaccine reduces
the risk of getting infected.
28
the person had not taken the
vaccine. Always follow
recommendations to avoid
vaccination if you are already
infected.
Supporting message.
Seek prompt medical
attention if side effects
continue or if you are
concerned about their
severity
Supporting message.
COVID-19 Vaccine does not
increase people’s risk to other
life threatening conditions
Supporting message.
After vaccination continue
observing all COVID-19
preventive measures.
COVID-19 Vaccine scenario.
Suspect poor vaccine quality.
COVID-19 Vaccine
scenario.
Actual event arising from
vaccine: Loss of trust of
the current and subsequent
vaccines.
COVID-19 Vaccine
scenario.
Vaccine replacement or
recall: Demand
explanations, apology and
compensations.
Key message:
All vaccines including COVID-
19 Vaccine are tested and found
to be safe for use.
Key message:
Many children in Malawi have
safely received vaccinations
for other diseases.
Key message:
Government can recall or
replace a vaccine if it is
proven that it has
detrimental or potential
29
Oxford/AstraZeneca has been
approved by the WHO.
Vaccination is one of the best
ways to prevent diseases. We
now have vaccines to prevent
more than 20 life-threatening
diseases, helping people of all
ages live longer, healthier
lives. Immunization currently
prevents 2-3 million deaths
every year from diseases like
diphtheria, tetanus, pertussis,
influenza and measles.
The most commonly used
vaccines we have today have
been in use for decades, with
millions of people receiving
them safely every year.
effect to the lives of
people.
Supporting message.
In emergency setting and to
protect lives some vaccines can
be developed quickly e.g. the
Ebola vaccine and COVID-19
Vaccine. These are still tested
for safety.
This is possible because
Regulation Authorities divert
resources to speed up processes
and reduce timelines for the
Supporting message.
COVID-19 Vaccine is safe.
Government can recall/replace
a vaccine if it is proven that it
have detrimental effect to the
lives of people.
Government can recall/replace
a vaccine if it is proven that it
has detrimental or potential
effect to the lives of people.
Supporting message.
When you have issues
with our services seek
advice from the nearest
health facility.
30
evaluation and authorisation of
those vaccines.
Whatever the setting, a vaccine
is authorized if the scientific
evaluation has demonstrated that
their overall benefits outweighs
their risks. A vaccine's benefits
in protecting people against the
disease must be far greater than
any side effect or potential risks.
31
12. PROPOSED CRISIS RESPONSES ON ANTICIPATED ISSUES.
Issue Scenario Seriousn
ess (low,
medium,
high)
Crisis activities Preventive
actions e.g.
training e.t.c
New study New findings
showing that
COVID-19 Vaccine
has lower efficacy
High
Ministerial
statement.
Panel discussion
by experts (live).
Production and
dissemination of
fact sheets.
Health worker
orientations.
Media
orientations.
Community
sensitizations.
Vaccine
reaction
(AEFI,
AESI)
Development of
unlisted side effects
(normal and
abnormal, mild or
serious).
Medium
High
Investigation
(within 24 hours
after an
AEFI/AESI report)
and prompt
feedback.
Follow up/close
supervision of the
cases.
Holding statement
(MoH Hq)
Health worker
orientations.
Community
sensitization.
Surveillance and
supervision.
32
Vaccine
recall or
suspension
Product quality
related issues.
Program related
immunization error.
High Review
communication
materials
(Question and
answers, fact
sheet, press
statement, holding
statement).
Investigation
(within 24 hours
after an
AEFI/AESI
report).
Press statement.
Holding statement.
Community
meeting.
Press briefing
(Question and
answers, fact
sheet).
Training health
workers on
COVID-19
vaccine &
related AESIs.
Community
engagement.
Media briefing.
33
Media
report and
rumour.
AEFIs/AESIs.
Rumours about other
things than AEFIs.
High.
Medium
Media briefing.
Press release.
Public
announcements.
Community
awareness
meetings.
Community
engagement.
Media briefing.
Orientations of
health workers.
Training of
PRO’s.
Press
conference.
Community
awareness
meetings.
Community
engagement.
Vaccine
replaceme
nt
Suspect poor
vaccine quality-
affect uptake.
Loss of trust of the
current and
subsequent vaccines.
Demand
explanations,
apology and
compensations.
High
Media briefing.
Press release.
Public
announcements.
Holding
statements.
Press conference.
Community
awareness
meetings.
Orientation of
health workers,
Media houses &
PRO’s.
Press
conference.
Community
awareness
meetings.
Community
engagement.
35
13. MONITORING, EVALUATION AND DOCUMENTATION
Monitoring tools will be adapted from the HPV monitoring framework and be utilised for data
collection at national, district and community levels. An online dashboard will be created for i)
District health Promotion Officers and ii) national partners (CSOs, iNGOs and government
partners) to fill data on reach and provide insights collected from the field as well as
recommendations that will be discussed in RCCE meetings. To ensure that there is regular situation
analysis, other digital platforms will be utilized e.g. U-report, Chipatala cha pa Foni (CCPF), a
toll-free health hotline. M&E tools will therefore include:
o National-level data collection forms
o District-level data collection forms
o Community-level data collection forms
o Online dashboard (national and district)
o U-report
o CCPF
o Formal Survey by academia
Proposed Set of Core Indicators for Monitoring & Evaluation
Final Outcome (Impact) Indicators.
% of fully immunized eligible individuals in the targeted hotspots.
% of beneficiaries and/or their parents who believe that all eligible individuals
should take the COVID-19 vaccine.
% of beneficiaries and/or their parents who are willing to be vaccinated (or give
consent to be vaccinated).
36
Outputs and Interim Outcomes Indicators.
Knowledge, Awareness, Perception of Risk, Acceptance and Trust.
% of eligible individuals who have heard about the COVID-19 vaccine and know
what it is meant for.
% of eligible individuals who know what measures should be taken if they have been
in contact with someone who has COVID-19.
% of eligible individuals who believe they are at high/low/no risk of getting COVID-
19.
% of eligible individuals old who agree to take the COVID-19 vaccine for preventing
COVID-19.
% of eligible individuals who agree that they would consent to their child/relative
receiving the COVID-19 vaccine.
% of eligible individuals who believe that the COVID-19 vaccines is safe.
% of eligible individuals who believe that the COVID-19 vaccine is effective in
preventing COVID-19.
% of all eligible individuals who gave consent for COVID-19 vaccination.
% of all eligible individuals who intend to give consent for COVID-19 vaccination
(in the future)
Coverage with Equity.
% of eligible individuals who took their first dose/all doses of COVID-19 vaccine.
% of eligible individuals who were fully immunized with 2 doses of COVID-19
vaccine in hard to reach areas.
Vaccination Experience and Frontline Worker Commitment.
% of beneficiaries and/or their parents who reported that the vaccination experience
was positive.
37
% of beneficiaries and/or their parents who had, or agreed to, proactively promote
COVID-19 vaccination in their communities or among their peers.
% of front-liners who ensured that >90% of all eligible individuals in their
designated catchment area were reached with messages/interventions.
Establishing COVID-19 Vaccination as a Norm.
% of beneficiaries and/or their parents who believe that all eligible individuals
should take the COVID-19 vaccination.
% of beneficiaries and/or their parents who believe that their community or peer
group expects all eligible persons to take COVID-19 vaccination.
% of eligible individuals who believe that their friends or family would want them to
self-isolate if they have been in contact with someone who has COVID-19.
Media Support and Commitment.
% of positive and supportive COVID-19 vaccine reports in the media compared to
negative reports.
Input and Process Indicators: Coordination, Planning, and Operations
National Level
# of Communication Sub-committee or Working Group meetings that took
place.
# of communication and social mobilization activities or events planned
compared to # of activities or events actually implemented, at national level.
# of planned communication materials/products produced COVID-19 vaccine.
38
# of planned communication materials/products disseminated on COVID-19
vaccine (distributed or broadcast).
# of parents/guardian of eligible individuals who had been reached by COVID-
19 vaccine key messages (heard on broadcast media or through interpersonal
communication by front-line workers).
# of community leaders (at village/community level) who had been reached by
COVID-19 vaccine key messages (heard on broadcast media or through
interpersonal communication by front-line workers).
District Level
# of districts with communication and community engagement micro-plans
(including specific plans for reaching all eligible individuals in the hotspots).
# of communication and social mobilization activities or events planned
compared to # of activities or events actually implemented, per district.
# of frontline health-workers actually trained or sensitized versus # planned, per
district.
# of planned locations per district that received IEC materials in a timely
manner.
# of districts who reported sufficiency of communication resources (funds, fuel,
IEC materials, front-liners).
# of districts who conducted sensitization and engagement activity in each of the
GHVs.
# of reports of rumours, misinformation, or AEFIs.
# of reports of rumours, misinformation, or AEFIs that were resolved within 72
hours.
12
14. COORDINATION
Coordination mechanisms will be maintained at strengthened at the following levels:
a. National Level:
Chaired by the Deputy Director of Health Education Services (HES), The COVID-19 RCCE
Committee will be maintained and strengthened to increase participation of line Ministries i.e.
Ministry of Information, Ministry of Civic Education and National Unity and Ministry of Local
Government and local and international partners and Civil Society. The committee will be
responsible for
o Mapping interventions
o Monitoring implementation
o Coordinating monitoring and evaluation activities e.g. joint monitoring, coordinating
partners conducting rapid assessment
o Providing guidance for leveraging resources
o Providing guidance for strategic approaches
b. District Level:
Chaired by the District Health promotion Officer, the COVID-19 RCCE Committee will be
maintained and strengthened to increase participation of partners. The committee will be
responsible for:
o Mapping interventions.
o Monitoring implementation.
o Coordinating monitoring and evaluation activities e.g. joint monitoring, coordinating
partners conducting rapid assessment.
o Providing guidance for leveraging resources.
o Providing guidance for strategic approaches.
13
c. Community Level:
Chaired by the Health Promotion Focal person at Health Center level, the COVID-19 RCCE
Committee will be maintained and strengthened to increase participation of partners. The
committee will be responsible for
o Mapping interventions
o Monitoring implementation by community agents
o Coordinating monitoring and evaluation activities e.g. joint monitoring, coordinating
partners, monitoring and reporting AEFIs
15. IMPLEMENTATION PLAN & BUDGET ESTIMATES
Thematic Area
Activities
Y
R
1
Y
R
2
Y
R
3
US $
Materials
development
1
Development of Social
Mobilisation, Risk/Crisis
Communication Strategy and
Vaccine communication materials
34,493
2 Pre-Testing of COVID-19 vaccine
materials
28,699
3 Printing of Publicity materials 43,974
Media
interface and
capacity
building.
4 Conduct Regional Press
Orientations
33,418
5 Conduct Regional Media Tours 215,385
14
6 Media press releases on COVID-19
Vaccine
228,955
Mobile
community
announcements
7 Advance Publicity 157,692
8 Hoisting of banners in strategic
places in cities and districts
1,301,444
Airing of radio
& TV
programs,
PSA's & jingles
in different
languages
9
Production of Radio and TV, Radio
Programs, PSAs and Jingles in
different languages
268,377
10
Airing of Radio and TV, Radio
Programs, PSAs, Jingles and Live
Panel Discussions
251,110
Community
engagement
11 Briefing of local leaders, block
leaders & political leaders.
190,513
12 Briefing of religious leaders 641
13 Conduct Door to Door meetings by
HWs in 29 districts
43,226
14 Engagement with Civil Society 304,487
Conduct orientation meetings with
community groups:
15
Care mother groups, CBOs,
FBOs, CHAG’s, VHCs,
HCMCs, HMCs, VDCs,
ADCs.
Awareness meetings conducted by
community groups:
Care mother groups, CBOs,
FBOs, CHAG’s, VHCs,
HCMCs, HMCs, VDCs,
ADCs.
Monitor vaccine implementation
using the Community Health
Register.
Review meetings with communities
on implementation of vaccine.
Online
presence
15 Strengthen the online presence 28,699
16 Virtual National Launch of COVID-
19 vaccine by H.E.
43,974
M & E
25,564
17
Monitoring of Communication
interventions with district task
teams
33,418
18 Procurement of vehicles and PA
Systems
215,385
Grand Total 3,425,964
16
16. KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL
MOBILIZATION FOR COVID-19 VACCINE INTRODUCTION
This section gives an overview of key communication products and materials anticipated for 2021.
From 2022 products will need to revised or developed separately, based on the level of
“routinization” achieved for COVAX vaccination services, as well as, the fact that there is
expected to be a much lower level intensity of communication activities.
Key Communication Products and Materials
… (1)
Intended
audience
Purpose
Coordination and Technical Support
1 COVID-19 Vaccine Introduction Strategy,
Communication & Social Mobilization
Strategy, and the Rapid Desk Review
document disseminated.
Key partners,
donor agencies,
and departments
of MOH, MOE
etc.
Ensuring shared
understanding of
goals, objectives,
and approaches.
2 A special consolidated Summary
Document of COVID-19 Vaccine
Introduction, Delivery, and
Communication & Social Mobilization
Strategy document and the Rapid Desk
Review document.
District Level
Offices of all
partners,
Ministries,
Traditional
Authorities,
District
Commissioners,
etc.
Ensuring consensus
and shared
understanding of
goals, objectives,
and approaches.
3 A succinct 4-page Basic Version of the
COVID-19 Vaccine delivery and
communication strategy.
Specifically for all
HSAs, school
Ensuring shared
understanding of
17
teachers, and other
front-liners.
goals, objectives
and approaches.
4 A succinct 4-page Advocacy Brochure of
the COVID-19 Vaccine delivery and
communication strategy.
Political
leadership and
donors.
Timely and
adequate resource
flow.
5 Slide-sets based on the various strategy
documents, desk review and key data.
Implementing
partners/managers.
For use in
workshops,
meetings.
6 A unifying Visual Identity, Logo, and
Tagline for the COVID-19 Vaccine
campaign established.
All audiences and
public.
Visibility and
building brand
affiliation and
loyalty.
7 Set of evidence-based, context-specific
Core Messages and FAQs for media and
high-level advocacy.
Decision-makers
and media-
persons,
gatekeepers.
High-level
advocacy meetings
and media
engagement.
Data, Baselines, and Benchmarks
8 Synthesis of all key research and data into
a common ‘information-for-action’
document.
Program Planners,
managers.
Shared view of
barriers, enablers.
Micro-Planning and Training
9 Guidance note/template for microplanning
community engagement and mobilization
activities.
All district-level
functionaries.
Support
microplanning,
budgeting
18
10 Informational flyer on crisis
communication plan and AEFI
management SOPs.
All district-level
functionaries.
Rapid response to
rumours, AEFIs.
11 Training module with supportive materials
on interpersonal communication +
Crisis/AEFI plan.
All front-liners. Rapid response to
rumours, AEFIs.
12 Orientation/sensitization of all
communication focal persons (through
special radio broadcasts and SMS
Platforms). This is primarily for those who
are not specifically nominated for face-to-
face training.
All
communication
focal persons,
including those
participating in
face-to-face
training.
Cost-effective mass
training using
distance education
methodologies.
13 Revised materials for refresher training of
front-liners if and as necessary (post-
Wave-1/Dose1).
All front-liners. Support community
engagement.
KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL MOBILIZATION
(Continued)
Key Communication Products and Materials
… (2)
Intended
audience
Purpose
Materials Development and
Dissemination/Deployment
19
14 Creative briefing note describing rationale,
purpose, and target audiences for all
broadcast and non-broadcast
communication products. Including
suggestions for any planned launch events.
Partners and all
designers,
producers.
Shared
understanding
among all partners
about key products.
15 Guidance note/plan for pre-testing of all
broadcast and non-broadcast
communication materials.
Partners and all
designers,
producers.
Rigorous pre-
testing of products.
16 Special guidance note on COVID-19
Vaccine messaging for online and social
media platforms, including tactics for
monitoring and dealing with negative social
media conversations.
Partners and all
designers,
producers.
Strategic and rapid
response to online
and social media
threats.
Non-broadcast materials (English and
Chichewa versions as required)
17 Core set of Key Messages and FAQs and a
short narrative (in print and electronic
form).
All key partners
and broadcasters.
Websites and
internal briefings.
18 Posters/banners/flags for COVID-19
Vaccine vaccination sites.
General public. Identification and
visibility of sites.
19 COVID-19 Vaccine flyers/brochures to
support interpersonal communication (IPC).
All eligible
recipients,
parents, and
community
influencers.
Support mass-scale
community
engagement by
front-liners.
20
20 Three different and specific versions of
COVID-19 Vaccine informational,
mobilization, advocacy communiques (in
the form of letters), signed by Minister (s).
Religious leaders,
district/traditional
authorities.
Targeted
consensus-building
and mobilization of
local leadership.
21 COVID-19 Vaccine media kit for
engaging/sensitization of media-persons.
Besides printed material, kit must also
include memory stick with photographs and
audio-visual materials.
National and
community media
gatekeepers and
journalists.
Media advocacy
and engagement for
supportive media
reporting.
Broadcast materials (English and
Chichewa versions as required)
22 Brand and COVID-19 Vaccine vaccination
promotion (in short audio, video, print
format): 30/60-second jingles and spots
promoting visual identity, logo, and tagline;
venue/time information prior to vaccination
days.
General public.
23 Testimonials (in audio, video, and print
format): 60-second radio and TV spots with
mix of vaccinated COVID-19 survivors,
parents, front-liners, community leaders
endorsing COVID-19 Vaccine vaccination.
Vaccinated
COVID-19
survivors,
parents,
guardians,
community
influencers, as
well as, the
general public.
Enhance value and
image of all girls;
build trust in
vaccine and
delivery system;
generate demand.
21
24 Interviews/Statements (in audio, video, and
print format): 1-3 minute duration on
COVID-19 Vaccine vaccination by
political and religious leadership for use on
national/community broadcast news
programming, workshops/meetings, training
sessions, websites, social media,
community video screenings.
Vaccinated
COVID-19
survivors,
parents/guardians
, community
influencers, as
well as, the
general public.
Build awareness on
COVID-19
Vaccine. Pre-empt
rumours,
misconceptions.
Build trust and
generate demand.
25 Panel discussion programming (in audio
and video formats): 10-30 mins duration for
national and (mainly) community broadcast
programming, and non-broadcast video
screenings.
Vaccinated
COVID-19
survivors,
parents/guardians
, community
influencers, as
well as, the
general public.
Build trust in
vaccine and
delivery system;
generate demand
26 Single or half-page newspaper
advertisement along with a multi-partner
press release: For release during national
COVID-19 Vaccine launch event.
Political and
social leadership.
Public information
and advocacy.
Brand visibility.
22
KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL MOBILIZATION
(Continued)
Key Communication Products and Materials …
(3)
Intended
audience
Purpose
Development, Piloting, and Implementation of
Innovations
27 Concept note and plan for development,
piloting, and establishment of U-Report
platform for COVID-19 Vaccine introduction
(including identification/training of
district/community-level U-reporters).
Key partners,
government,
donors.
Buy-in for real-
time: monitoring,
opinion polling,
rumour tracking.
28 Guidance note on piloting of U-Report/SMS
platform for COVID-19 Vaccine, with
database of FLWs.
Managers, front-
liners
Real-time
monitoring and
tracking.
29
Guidance note for the creation of WhatsApp
groups to monitor progress on vaccine roll-
out and rumours at TA-levels.
Health
Surveillance
Assistants,
District Health
Education
Officer, local
NGO partners.
Real-time
monitoring and
tracking.
Monitoring & Evaluation
30 Guidance note and tools for monitoring of
communication and community engagement
activities.
Supervisors,
Field monitors,
Planners.
Measuring
implementation
quality.
23
31 Guidance, tools, and indicator set for rapid
assessment and documenting lessons and
good practices.
Supervisors,
Field monitors,
Planners.
Measuring
implementation
quality.
32 Questions bank for ‘real-time’ targeted
opinion polls using U-report system, FLWs
SMS Platforms.
U-Report and
district level
managers.
Tracking trends in
real time.
33 Template for regular feedback and data
specifically for sub-national managers and
front-liners.
District level
program
managers.
Ensure
implementation
quality.
34 Advocacy brochure for resource mobilization
and sustainability, based on actual
expenditure data.
Policy/political
leadership,
donors
Advocacy for
sustainable
resources.
35 Guidance/template for comprehensive
documentation and a summative Case Study
report.
Partners and
district level
managers.
Comprehensive
documentation.
24
17. COMMUNICATION TREE.
List of Spokespersons and their contact details at headquarters and district level.
Seq Name District Contact details
1 Mr Joshua Malango MoH Headquaters 0884495839
2 Mr Masida Nyirongo Chitipa 0995605854
3 Ms Esterly Nyirenda Karonga 0884449600
4 Mr Bwanalori Mwamlima Rumphi 0881035113
5 Mr Lovemore Kawayi Mzimba North 0995305429
6 Mr Ulunji Luhanga Mzimba South 0884320656
7 Mr Christopher Singini Nkhata-bay 0888346227
8 Mrs Catherine Yoweri Kasungu 0888948015
9 Mr Garry Chilinga Nkhotakota 0994324626
10 Mrs Angela Nyongani Sakwata Salima 0888596995
11 Mr Samson Mfuyeni Ntchisi 0999761510
12 Mr Davie Nuka Dowa 0995821078
25
13 Mr Frank Kaphaso Mchinji 0884111300,
0999391381
14 Mr Richard Mvula Lilongwe 0881604733
15 Mr Mwayi Liabunya Dedza 0881612474
16 Mrs Stella Kawalala Ntcheu 0888151764
17 Mrs Mercy Nyirenda Balaka 0999074095
18 Mr Clifton Ngozo Machinga 0999600435
19 Mr Arnold Mndalira Zomba 0999223897
20 Mr Joshua Cosmas Zuze Chiladzulu 0998047410,
0888660779
21 Mr Dan Chilomo Phalombe 0888865801
22 Mr Chipiliro Mjojo Mulanje 0999342484
23 Mr Fanuel Makina Thyolo 0881126712
24 Mrs Chrissy Banda Blantyre 0888382345
25 Mr George Mbotwa Nsanje 0884223970
26 Mr Harlod Kabuluzi Mangochi 0888621644