Access to adult vaccination for older people in remote, rural and hard-to-reach communities

The United Nations (UN) has previously stressed the risk of COVID-19 for indigenous communities since they are among the most vulnerable, with higher rates of communicable and non-communicable diseases, poorer sanitation and inadequate access to healthcare. Additionally, indigenous peoples often experience stigma and discrimination in healthcare settings and distrust in government, resulting in difficulty with COVID-19 management and vaccine delivery.

According to a recent report by the Thomas Reuters Foundation, Brazilian indigenous communities have been particularly devastated by COVID-19, with nearly a thousand deaths within this population due to the pandemic. Many of those who died were indigenous elders, over the age of 60. Like many indigenous peoples, elders transmit traditional knowledge, practices and languages to future generations. For Brazil’s indigenous communities, the loss of elders represents the death of traditions, culture and knowledge. COVID-19 destroyed a “library” of knowledge and identity held by community elders.

As COVID-19 vaccination is well underway in many countries, it is important that the principles of prevention, access and equity are upheld throughout the rollout of vaccination strategies. These principles are detailed in the Immunization Agenda 2030, which outlines a global strategy to ensure equitable and community-centred delivery of immunization services to ensure good health and well-being for everyone. Exercising these principles means ensuring that hard-to-reach and vulnerable communities have access to vaccines and contextually appropriate information on vaccine preventable diseases. COVID-19 vaccination of remote and hard-to-reach populations is an opportunity to bolster adult immunization strategies, expand immunization infrastructure and establish adult vaccination policy for other vaccine preventable diseases, such as influenza, pneumonia and shingles. Implementation of vaccination policy for older people may help preserve the culture and traditions of communities, allowing libraries to remain intact longer.

In Brazil, COVID-19 vaccination of indigenous communities is a priority, however some older people in the community oppose the vaccine. Glades Kokama, a leader of the Kokama indigenous community in the Amazon region, says, “Some (elders) believe in the vaccine, but some don’t. We try to explain it to them, but we have to respect our elders.” Combating vaccine hesitancy amongst older people is needed to improve healthy ageing through vaccination. It is important that communication is targeted and specific to the population context and needs. For indigenous and hard-to-reach communities, distribution of information and promotion of vaccination requires partnership with community leaders and culturally appropriate messaging.

The International Federation on Ageing (IFA) is committed to addressing barriers to adult vaccination for older people by expanding knowledge and access to vaccination, and improving vaccination messaging. The 15th Global Conference on Ageing entitled “Rights Matter” provides a global platform to inspire, enquire, learn and advocate for immunization policies and practices that create an environment that enables older people to do what they value. Visit the conference website to learn about the pre-conference Vaccines 4 Life Summit “Beyond the Pandemic: Driving Policy to Improve Adult Immunization Rates” and the Presidential Symposium on Adult Vaccination “Together Towards Tomorrow: Post-pandemic Action on Adult Vaccination”.

To learn more about adult vaccination for older people and combating vaccine hesitancy, contact these experts.

• Lois Privor-Dumm, Director of Adult Vaccines, Senior Advisor, Policy Advocacy and Communications at the International Vaccine Access Center

• Dr. José F. Parodi, Professor of Geriatrics and Public Health in the Faculty of Human Medicine at the Universidad de San Martin de Porres of Peru (FMH-USMP) and Director of Center for Ageing Research – CIEN of the FMH-USMP.

• Dr. Holly Seale, Associate Professor at the School of Population Health, Faculty of Medicine and Health, University of New South Wales.