Drivers and barriers for measles rubella vaccination campaign: A qualitative study

Background: The measles-rubella (MR) vaccination campaign was launched in Kerala on 3rd October 2017 aiming to eliminate MR by 2020.The drive was carried out in schools, community centers, and medical institutions. The initial phase of the MR campaign met with many controversies that affected its coverage. Objectives: The objectives of the study were to analyze the drivers and barriers for acceptance of MR vaccination in the field area of a primary health center (PHC), which reported a low coverage (62%) during the initial phase of the campaign. Methods: A qualitative study consisting of key informant interviews of parents of vaccinated and unvaccinated children, medical officers of the PHC, Junior Public Health Nurse (JPHN), and Accredited Social Health Activist (ASHA) workers, and the principals of government and private schools where the campaign was conducted was also interviewed. Results: The major barrier to acceptance of MR campaign was the anti-vaccination propaganda in social media. The messages falsely linked fertility issues with the vaccine. The purpose of this campaign was not properly understood by the parents. The campaign was implemented within a short span of time resulting in coordination issues between the stakeholders. However, it was observed that religious affiliations played a major role in reducing coverage. The drivers to acceptance of MR vaccination campaign were the team effort of the healthcare providers who constantly motivated parents to vaccinate their children. Conclusion: Addressing the anti-vaccination propaganda has become the need of the hour. The inclusion of all stakeholders including religious leaders in the planning and implementation of the campaign is essential for its success