JMIR Publications

ABSTRACT

Background:

Measles and polio pose significant public health challenges globally, particularly in low-resource settings like the Philippines, where vaccine coverage falls significantly short of the World Health Organization’s targets. This research addresses the "last mile" challenge in routine immunization efforts by bridging the vaccination gap in marginalized populations.

Objective:

We will implement a cluster randomized controlled trial to evaluate the impact of an education toolkit to improve confidence in measles and polio vaccines among communities living in extreme poverty in the Philippines.

Methods:

Developed in collaboration with local stakeholders, our intervention features a 10-minute video and vaccination reminders provided by health trainers. A total of 180 communities with 5,400 participants will be randomly assigned to the intervention and control arms. Leveraging an existing community-based education program on health and livelihood run by our local partner, the proposed intervention will be delivered to participants in the intervention arm of the existing program, while those in the control arm receive standard lectures on health education. The primary outcome is the first-dose measles-containing-vaccine (MCV) coverage among participants’ children among 1-year-olds. Secondary outcomes will include two-dose MCV coverage among children between 2 to 6 years old, polio vaccination coverage among 1-year-olds, and participants’ knowledge of measles and polio vaccines. The absolute differences in these outcomes between the intervention and control arms will be estimated using the generalized estimating equations while adjusting for baseline levels and covariates. Additionally, we will conduct process evaluation.

Results:

Participant recruitment was launched on 31 January 2024 and completed on 29 February 2024. 3,613 participants have been recruited for the trial. Data collection is ongoing as of submission of the manuscript.

Conclusions:

Findings from this trial will provide critical insights into effective strategies for enhancing vaccine confidence and uptake in marginalized populations. By leveraging community-based approaches and local partnerships, this study aims to improve public health responses to vaccine-preventable diseases and contribute to the global eradication efforts for measles and polio. Furthermore, findings will inform scalable interventions that can be adapted to similar contexts, potentially reducing health disparities and advancing global health equity. Clinical Trial: ClinicalTrials.gov Identifier - NCT06218368