The Maternal Immunization Readiness Initiative (MIRI) focuses on current attitudes and policies regarding maternal COVID-19 vaccination, and preparing countries for uptake of maternal respiratory syncytial virus (RSV) and group B streptococcus (GBS) vaccines, which are anticipated to become available during the next decade. MIRI projects, which are funded by the Bill & Melinda Gates Foundation, have focused on three areas: demand generation and communication, health facility readiness for maternal vaccine introduction, and mapping of country-level COVID-19 maternal vaccination policies over time.
Demand Generation and Communication
Work on demand generation and communication, which is led by the Johns Hopkins Bloomberg School of Public Health, aims to gather insights on knowledge, attitudes, and behaviors relevant to maternal immunization for demand generation strategies using in-depth interviews and cross-sectional surveys among pregnant and lactating people, community members, healthcare providers, and policymakers in Kenya and Bangladesh. Objectives of this work have included an exploration of disease conceptualization of COVID-19, RSV, and GBS among pregnant and lactating people and other key stakeholders and decision-making processes for uptake of maternal vaccines among these communities. These findings are being used to design communication strategies which will be tested and optimized with target audiences.
An additional mixed-methods study led by Johns Hopkins Bloomberg School of Public Health and WHO focuses on maternal vaccine decision-making among pregnant and postpartum people in four countries - Brazil, Ghana, Kenya, and Pakistan. Within these groups, our study aims to understand the risk perception of COVID-19 disease, document knowledge of COVID–19 vaccines, identify sources of information, and identify decision-making factors and processes. The study also aims to assess attitudinal and behavioral correlates with COVID-19 vaccine status as well as intentions to receive future maternal vaccines such as RSV, GBS, tuberculosis, and malaria vaccines.
Health Facility Readiness
Comprehensive health system readiness for new maternal vaccines requires assessment of and response to needs across a range of domains at national, sub-national, and facility levels. The Health Facility Readiness project, led by Jhpiego, aimed to create tools to assess readiness at the facility level for offering COVID-19 and other currently available maternal vaccines to pregnant people, as well as new maternal vaccines anticipated to be available in the near future. A Health Facility Readiness Assessment Tool for Maternal Immunization Services has been developed and adapted for use at facilities providing antenatal care (ANC) in Kenya and Bangladesh. In addition to assessing facility readiness for vaccine introduction, the tool can also be used to monitor ongoing quality of ANC as new maternal vaccines are offered. A form of the tool which can be adapted for use in other countries is posted on the AlignMNH Resource Library (hyperlink: https://www.alignmnh.org/resources/resource-library/?_full_text=readiness).
COVID-19 Maternal Immunization Policy
The COVID-19 Maternal Immunization Policy project, led by the Johns Hopkins Berman Institute of Bioethics and the Bloomberg School of Public Health, aimed to assess the policy environment for maternal immunization against SARS-CoV-2. Through maps, tables, and country profiles, the COVID-19 Maternal Immunization Tracker (COMIT) provided a global snapshot of public health policies implemented between 2021 and 2023 that influenced access to COVID-19 vaccines for pregnant and lactating people.
| Titre | Auteur | Année | Type | Langue |
|---|---|---|---|---|
| COVID-19 Maternal Immunization Tracker | Johns Hopkins University | 2021 | Repository | Anglais |
| Global disparities in public health guidance for the use of COVID-19 vaccines in pregnancy | Eleonor Zavala, Carleigh B. Krubiner, Elana F. Jaffe, Andrew Nicklin, Rachel Gur-Arie, Chizoba Wonodi, Ruth R. Faden, Ruth A Karron | 2022 | Journal article | Anglais |
Demand Generation and Communication
| Titre | Auteur | Année | Type | Langue |
|---|---|---|---|---|
| “Why has this new vaccine come and for what reasons?” key antecedents and questions for acceptance of a future maternal GBS vaccine: Perspectives of pregnant women, lactating women, and community members in Kenya | Rupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Clarice Lee, Jessica Schue, Ruth A. Karron | 2024 | Journal article | Anglais |
| A qualitative inquiry in understanding trusted media sources to reduce vaccine hesitancy among Kenyans | Berhaun Fesshaye, Clarice Lee, Alicia M. Paul, Eleonor Zavala, Prachi Singh, Ruth A. Karron, Rupali J. Limaye | 2023 | Journal article | Anglais |
| A socio-ecological comparison of the COVID-19 vaccine decision- making processes among pregnant and lactating women: Findings from Kenya and Bangladesh | Prachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron, Rupali J. Limaye | 2023 | Poster/infographic | Anglais |
| A socio-ecological exploration to identify factors influencing the COVID-19 vaccine decision-making process among pregnant and lactating women: Findings from Kenya | Rupali J. Limaye, Alicia M. Paul, Rachel Gur-Arie, Eleonor Zavala, Clarice Lee, Berhaun Fesshaye, Prachi Singh, Wincate Njagi, Paul Odila, Paul Munyao, Rosemary Njogu, Stephen Mutwiwa, Lisa Noguchi, Christopher Morgan, Ruth A. Karron | 2022 | Journal article | Anglais |
| Characterizing Attitudes Toward Maternal RSV Vaccines Among Pregnant and Lactating Persons in Kenya: Key Considerations for Demand Generation Efforts for Vaccine Acceptance | Rupali J. Limaye, Molly Sauer, Rosemary Njogu, Prachi Singh, Berhaun Fesshaye, Ruth A. Karron | 2023 | Journal article | Anglais |
| Conceptualizing the COVID-19 Pandemic: Perspectives of Pregnant and Lactating Women, Male Community Members, and Health Workers in Kenya | Alicia M. Paul, Clarice Lee, Berhaun Fesshaye, Rachel Gur-Arie, Eleonor Zavala, Prachi Singh, Ruth A Karron, Rupali J. Limaye | 2022 | Journal article | Anglais |
| COVID-19 vaccine decision-making among pregnant and lactating women in Bangladesh | Rupali J. Limaye, Prachi Singh, Alicia M. Paul, Berhaun Fesshaye, Clarice Lee, Eleonor Zavala, Sydney Wade, Hasmot Ali, Hafizur Rahman, Shirina Akter, Ruth A. Karron, Towfida Jahan Siddiqua | 2023 | Journal article | Anglais |
| COVID-19 vaccine eligibility of pregnant and lactating women in Bangladesh: Gap between policy and policy interpretation among policymakers and healthcare workers | Rupali J. Limaye, Berhaun Fesshaye, Prachi Singh, Eleonor Zavala, Shirina Akter, Towfida Jahan Siddiqua, Hafizur Rahman, Hasmot Ali, Ruth A. Karron | 2023 | Journal article | Anglais |
| Future GBS vaccines: Perspectives from pregnant and lactating people, healthcare providers, community members, and policymakers in Kenya | Berhaun Fesshaye, Prachi Singh, Molly Sauer, Ruth A. Karron, Rupali J. Limaye | 2023 | Poster/infographic | Anglais |
| Lack of clear national policy guidance on COVID-19 vaccines influences behaviors in pregnant and lactating women in Kenya | Eleonor Zavala, Berhaun Fesshaye, Clarice Lee, Stephen Mutwiwa, Wincate Njagi, Paul Munyao, Rosemary Njogu, Rachel Gur-Arie, Alicia M. Paul, Taylor A. Holroyd, Prachi Singh, Ruth A. Karron, Rupali J. Limaye | 2022 | Journal article | Anglais |
| Maternal Immunization Readiness Initiative (MIRI) Kenya Results Dissemination | Rupali J. Limaye, Berhaun Fesshaye, Prachi Singh, Emily Miller, Ruth A. Karron | 2023 | Poster/infographic | Anglais |
| Maternal Immunization Readiness Initiative (MIRI) Kenya Results Dissemination Day 1 Slides | Rupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron | 2023 | Presentation | Anglais |
| Maternal Immunization Readiness Initiative (MIRI) Kenya Results Dissemination Day 2 Slides | Rupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron | 2023 | Presentation | Anglais |
| Maternal Immunization Readiness Initiative (MIRI) Kenya Results Dissemination Day 3 Slides | Rupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron | 2023 | Presentation | Anglais |
| RSV awareness, risk perception, causes, and terms: Perspectives of pregnant and lactating women in Kenya to inform demand generation efforts for maternal RSV vaccines | Rupali J. Limaye, Berhaun Fesshaye, Prachi Singh, Ruth A. Karron | 2023 | Journal article | Anglais |
| Sources of COVID-19 Vaccine Promotion for Pregnant and Lactating Women in Bangladesh | Berhaun Fesshaye, Sydney A. Wade, Clarice Lee, Prachi Singh, Eleonor Zavala, Hasmot Ali, Hafizur Rahman, Towfida Jahan Siddiqua, Shirina Akter, Ruth A. Karron, Rupali J. Limaye | 2023 | Journal article | Anglais |
Health Facility Readiness
| Titre | Auteur | Année | Type | Langue |
|---|---|---|---|---|
| Adaptable Health Facility Readiness Assessment Tool for Maternal Immunization Services | MIRI Project | 2023 | Tool | Anglais |
| The Kenya Health Facility Readiness Assessment Tool for Maternal Immunization Services | MIRI Project | 2023 | Tool | Anglais |
Exploring Knowledge, Attitudes, and Practices Related to Vaccine Decision-Making among Pregnant People in Brazil, Ghana, Kenya, and Pakistan
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