Diphtheria and the risk of outbreaks of vaccine-preventable diseases in low-resource settings

This study aims to highlight the complex and multifaceted nature of vaccination drivers, uptake, and hesitancy in the face of the recent outbreak of diphtheria in Nigeria and its significant impact on the regional and global burden of disease. The outbreak has highlighted the continuing threat and vulnerability of vaccine-preventable disease (VPD) outbreaks or epidemics due to the low vaccine uptake in the country and across Sub-Saharan Africa (SSA). This study first identifies recent drivers and challenges to vaccine uptake. It then promotes the need for regionally based, interdisciplinary approaches with a focus on visual communication strategies, particularly in low-literacy settings. Ultimately, visual communication strategies would benefit from a broader evidence base to better understand the effectiveness and impact of design in promoting vaccine uptake. The study recommends that in the Nigerian context, addressing the threat of VPD outbreaks should be embedded in communication strategies, especially when they are designed considering the local population. This should occur alongside strategies to reduce psychological impact factors like stress associated with travel time for vaccination and waiting time at healthcare facilities. Vaccination programs should be linked to local sources of safety or individuals with high credibility to increase trust; healthcare workers should stop exaggerating the effectiveness of vaccines to stimulate demand; and fathers should be considered an important target group in intervention programs.