Combining Community-Based Surveillance and Social Mobilization to Address Vaccine Hesitancy During a Measles Outbreak in Kyrgyzstan

Title: Combining Community-Based Surveillance and Social Mobilization to Address Vaccine Hesitancy During a Measles Outbreak in Kyrgyzstan Author and organization: Asel Toktomambetova, Head of Health department of Red Crescent Society of Kyrgyzstan, Myrza Mukhtarov, Ministry of Health of the Kyrgyz Republic Introduction – Objectives In early 2025, Kyrgyzstan faced a measles outbreak with over 9,000 cases and nine deaths by June; 94% of cases were unvaccinated due to vaccine hesitancy driven by misinformation and religious beliefs. The Red Crescent Society of Kyrgyzstan (RCSK), supported by the IFRC and the Ministry of Health, implemented an integrated approach combining community-based surveillance (CBS) and social mobilization. This project evaluated whether combining volunteer-led CBS and collaboration with community leaders could improve early detection, address hesitancy, and boost immunization uptake. Methodology From April to October 2025, RCSK mobilized 380 trained volunteers across five high-risk regions. Volunteers conducted door-to-door visits, school sessions, and community discussions to provide accurate information and track rumors. Feedback was systematically analyzed to tailor messages. Utilizing a standardized protocol, volunteers identified signs and symptoms based on community case definition for measles and escalated alerts to health authorities for immediate investigation and follow-up. Results and Discussions The operation reached 127,985 people with awareness and immunization services activities. Out of 99 escalated CBS alerts, 88 cases were confirmed positive, reflecting an 88% predictive value positive that exceeded the 80% target. CBS also tracked migration clusters to vaccinate mobile families. Engaging 754 religious leaders as trusted communicators built credibility against religious vaccine hesitancy. Community feedback collected through household visits highlighted that men's opposition heavily influenced household decisions, while women were highly exposed to misinformation, allowing for gender-tailored outreach. This multi-pronged approach successfully restored community trust and enhanced collaboration with health authorities. Conclusions Trained volunteers are vital links between communities and health systems. Integrating CBS with community feedback and faith-based engagement enhances outbreak preparedness, addresses localized vaccine hesitancy, and ensures a responsive, people-centered public health intervention.