Boost Community brings immunization professionals together online

As deputy director of public health in Ghana’s Northern Region, Dr. Hilarius Abiwu is drawing on insights from colleagues abroad as he navigates disruptions to local health service delivery posed by the COVID-19 pandemic.

“At every turn, there’s an opportunity to learn how to provide health care services — particularly immunization in a pandemic,” he said.

Before the pandemic, Abiwu and peers from other countries gathered annually at conferences, and rarely would they continue conversations in the time between. But over the past 15 months, they have come together on the online platform Boost Community, a global network of peers in the immunization field.

Through Boost, Abiwu has collaborated with colleagues in Ghana and elsewhere to share lessons on navigating lockdowns, maintaining service delivery, and getting local populations vaccinated against COVID-19. He has shared how his region has managed to keep administering routine vaccines during the pandemic, while peers in Ethiopia and Rwanda have discussed how they’ve used data to identify districts where health services are under the greatest strain so that they can be prioritized for receiving resources.

Boost is an initiative of the Sabin Vaccine Institute, a Washington-based nonprofit focused on expanding vaccine access and uptake globally. The platform evolved out of the International Association of Immunization Managers, which launched in 2013 and is one of several efforts to bring immunization professionals together. In January 2020, it was re-branded as Boost Community with a three-year grant for $3.5 million from the Bill & Melinda Gates Foundation. The timing — just before the COVID-19 pandemic — was fortuitous for its members.

Networks such as Boost are more essential than ever as health professionals work to recover lost ground on immunizations and vaccinate populations against COVID-19, which requires approaches that are different from the ones they are accustomed to using for childhood inoculations.

Adolphus Clarke, who manages the Liberian Health Ministry’s immunization program, was among the experts the Sabin Vaccine Institute consulted before launching Boost. He advised it to consider ways to engage professionals at all levels — not just those working within health ministries, but also front-line health workers who are actually putting shots in arms.

“We needed to bring on other immunization actors who may not be at the managerial level [or] at the national level, but at the lower level,” he said. “How can we hear them? How can we elevate their voices?”

Jennifer Siler, vice president of global community engagement at the Sabin Vaccine Institute, said there were three main takeaways from over 100 interviews it conducted before the launch.

First, there was no way for people working at the subnational level to engage with one another. Second, immunization professionals were often burned out, and the field saw high rates of turnover. And third, people did not feel heard, as national immunization decisions were frequently political, and they did not see a way to change the status quo.

Now, Boost provides 1,500 immunization professionals with access to training and resources on management and leadership, with topics ranging from tackling vaccine hesitancy to community-building to adaptive leadership. It also creates opportunities for members to share their challenges and what they’ve learned.

Boost is coordinating services with some of the other online platforms for professionals in the field, such as the Immunization Academy, a global learning initiative that produces short videos for immunization training and delivery and is also supported by the Gates Foundation.

“We appreciate that many of the challenges that immunization staff are grappling with do not have a right and wrong answer,” Siler told Devex by email. “Now more than ever, we are living in the grey space.”

Boost is working to support immunization personnel as they navigate uncertainty. That includes normalizing discussions about challenges and failures — which can be seen as weaknesses when raised, Siler said. Boost encourages its members to ask for help and support.

Adunola Oyegoke, an epidemiologist in Nigeria’s Federal Health Ministry, said one of the challenges she is facing involves parents who refuse to get their children vaccinated.

“They think the government is trying to inject children with the COVID-19 virus,” she said.

Through a Boost course, Oyegoke said she learned to put herself in parents’ shoes rather than being quick to judge and dismissing them as irresponsible.

One improvement she would like to see is a way to access Boost materials offline, since not all of her peers in Nigeria or other low- and middle-income countries have reliable access to the internet. Siler said Boost is working to provide this kind of offline access.

Moving forward, Boost is seeking ways to leverage its network of immunization professionals for COVID-19 response and other global health efforts.

For example, with support from the Skoll Foundation, the Sabin Vaccine Institute and partners created the COVID-19 Vaccine Equity Project. The effort aims to support immunization professionals from the Boost Community in leading the equitable distribution of vaccines.

“We’ve had a lot of important talk about getting the vaccines to countries, but once they’re there, how are we going to reach ... these populations?” Siler said at an event in January.

The project was launched in October with startup funding of $1 million for pilots in four countries. But insufficient funds have prevented the full-scale implementation envisioned for it.

The Sabin Vaccine Institute also received funding as part of the Alliance for Advancing Health Online, which was announced this week. The alliance, which was established with two $20 million commitments from Merck and Facebook, seeks to better understand the relationship between social media and vaccine confidence or hesitancy.

Boost will play a role in the Sabin Vaccine Institute’s work on virtual convenings and an online resource hub to explore the potential for social media interventions for increasing vaccine acceptance.

“We’re trying to build out this broader community of practice so that we can surface lessons learned more quickly and not wait until everything is completely baked and there’s a case study attached to it as everyone is rolling these things out in real time,” Siler said.

Update, June 14, 2021: This article has been updated to clarify that approximately 1,500 immunization professionals belong to the Boost Community network.

This coverage, presented by the Bay Area Global Health Alliance, explores the intersection between technology, innovation, and health. How are tech, innovation, and cross-sector partnerships being leveraged to accelerate equitable access to health care?