This brief synthesises social and behavioural science (SBS) research on the use of vaccines during health emergencies in sub-Saharan Africa, including vaccines undergoing clinical trials (‘experimental vaccines’). There are outbreaks of mpox, Marburg virus disease and Ebola (Sudan virus disease) in the region, and multiple clinical trials of vaccines for these diseases are in progress. Findings from SBS research can contribute to strategies to build confidence in vaccines and, importantly, the design of clinical trials and vaccine roll-out. To improve effective vaccine roll-out, it is critical to ensure that programmes consider social dynamics and community perspectives from the outset, rather than just at the end point of delivery.

This brief is based on a rapid review of published literature and draws on evidence from routine vaccination, vaccination in health emergencies and vaccine clinical trials during health emergencies. It highlights key issues and good practices that should be carried into the design and delivery of vaccine clinical trials during a public health emergency.

This brief complements the collection of SSHAP resources on the social dynamics of vaccines that includes:

• Social Science Research for Vaccine Deployment in Epidemic Outbreaks
• Key considerations: Risk communication and community engagement for mpox vaccination in eastern DRC
• Effective vaccine rollout and uptake in Sierra Leone
• Clinical and vaccine trials for COVID-19: Key considerations from social science
• Rapid review: Vaccine Hesitancy and Building Confidence in COVID-19 Vaccination

Key considerations

SBS considerations relevant to using vaccines in any context

• Social, cultural and political-economic contexts (both local and global) are drivers of (mis)trust in vaccines and vaccine providers. Prior experiences of accessing healthcare, perspectives of healthcare providers, positioning by international organisations and politicians, and histories of exclusion can influence how people make decisions about vaccination for themselves and their children. Two-way dialogue and public consultations around vaccine roll-out strategies can help build trust and identify crucial, context-specific social, cultural, political and economic factors that affect vaccine uptake.
• Vaccine hesitancy is not a ‘single story’ about a lack of information; engagements with vaccination are more complex. Low vaccine uptake is often blamed on concerns about the vaccine itself, yet SBS research shows that low uptake can be related to multiple factors, including poor experiences with healthcare facilities. Using SBS analytical methods to identify these dynamics can help develop trust-building interventions (e.g., dialogue sessions between healthcare workers and parents). Deeper issues of mistrust may take a long time to address, but short-term interventions that acknowledge and start to address the root causes of low confidence can help increase vaccine uptake.
• Under-resourced health systems have a reinforcing effect on vaccine hesitancy. Under-resourced health systems can negatively impact patients’ trust of the health system (and vaccines) and lead to low morale among healthcare workers. In turn, these can affect vaccination programmes. Whilst long-term efforts to generate strong and sustainable health systems are underway, efforts to boost morale and enhance transparent communication between patients and healthcare workers can help foster increased trust.
• Community engagement efforts can help address rumours, misinformation and disinformation about vaccines. Rather than dismissing concerns about vaccines as being due to a lack of information, community engagement efforts can directly acknowledge anxieties and generate dialogue about vaccines, and solicit public input to develop solutions.
• The way vaccines are delivered influences vaccine uptake; efforts must identify the most effective approaches in each context. Healthcare workers have adapted door-to-door engagement and last-mile vaccine interventions with success. Discussing locally appropriate strategies with recipients of the vaccine can help identify the most effective approaches in each context.
• Vaccine roll-out strategies should consider social and economic activities that may influence access to and demand for vaccination. For example, an understanding of local livelihood strategies can help determine when and how to deliver vaccination most effectively.
• ‘Community’ is often presented as a discrete, geographically bounded entity, but what constitutes a community can vary depending on context. The term also glosses over heterogeneity within communities – a simple notion of community can overshadow complex hierarchies. Integrating dynamic power analyses that identify changing patterns of authority within and across communities can ensure that, from the communities’ perspective, the right people are involved at the right time in different community engagement activities.

SBS considerations specific to a vaccine roll-out during a health emergency

• Involve communities in discussions around the ethics, logistics and politics of vaccine roll-out as part of preparedness or readiness activities, and at the outset of emergency situations.
• Vaccine roll-out during health emergencies needs careful planning, collaboration, flexibility and adaptability. Examples include adapting the approach to reporting serious adverse events (e.g., in the case of low internet connectivity) or reporting trial findings to a range of local stakeholders to improve transparency.
• Building community engagement efforts into long-term preparedness activities can help improve their effectiveness. During health emergencies, community engagement processes tend to be rushed and are often planned quickly, compromising their effectiveness. In the short term, rapid methods for public consultation are cost-efficient to apply even in a health emergency scenario, and they can improve vaccine uptake despite the significant time pressure imposed by an emergency.

SBS considerations specific to experimental vaccines

• Lessons from routine vaccination and vaccine roll-out during a health emergency can offer important insights for the delivery of experimental vaccines. Two key lessons are: 1) There is a need for early and sustained community engagement, and 2) There is a need for dynamic analysis of local contexts to identify factors determining (mis)trust of and access to vaccination.
• Design public consultation strategies before starting a clinical trial of an experimental vaccine during a public health emergency. Regulations around vaccines may need to be changed to support roll-out during a health emergency. Scenario planning is an effective tool to involve community members in the design of a trial and vaccine roll-out. Consultation with the public can offer insights into what is perceived to be acceptable, help manage mistrust that may be generated by shifting regulations, help people understand why a particular approach is being taken and help inform that approach.
• Expand community engagement efforts during vaccine trials to focus on the wider population, and not just potential participants.
• Communicate the risks and benefits of clinical trial participation during an emergency to ensure informed consent. Confirming that participants fully understand the risks, benefits and unknowns of a trial is a core ethical challenge, especially for rapidly developed vaccines (e.g., during a pandemic). Informed consent processes must consider local norms and the context of consent, including local decision-making structures.
• After a trial is over, it is vital to consider socially and culturally acceptable strategies for follow-up, exit and trial closure, results dissemination and eventual access to vaccines (or information about access to vaccines). At the end of a trial, follow-up should include community engagement efforts to discuss trial outcomes and next steps. This approach has been shown to help prevent negative stories from circulating about a trial after it is completed.

SBS evidence is vital for effective vaccine trials in emergencies

Vaccination trials during public health emergencies should draw on the foundation of SBS evidence on vaccination more broadly. This includes evidence on drivers of and barriers to vaccine confidence as well as on how social dynamics influence the effectiveness of different vaccine roll-out strategies.

Vaccine roll-out includes the process of distributing and administering vaccines to a population after regulatory approval or emergency authorisation.¹ There are many challenges to vaccine roll-out, particularly in resource-constrained settings, including for example, health worker shortages, lack of supplies and logistical support.^2,3 These challenges are made more difficult during disease outbreaks due to increased logistical challenges for health systems.² A lack of confidence in vaccines is a serious threat to vaccine roll-out and numerous recent events have revealed the critical role that confidence plays in vaccine uptake.⁴ Issues around confidence have threatened the uptake of vaccines for cholera, polio, Zika virus disease, Ebola virus disease (Ebola) and COVID-19 amongst others.²

While public perceptions of vaccine hesitancy commonly associate it with ‘knowledge deficits’, SBS research has revealed the importance of understanding social, cultural and political-economic contexts (both local and global) as drivers of (mis)trust in vaccines and vaccine providers.⁵ People have to make decisions about vaccination for themselves and their children, and these decisions can be influenced by prior experiences of accessing healthcare, perspectives of healthcare providers, the positioning of international organisations and politicians, as well as histories of exclusion. The 2003 polio controversy in northern Nigeria is one example where both local and global political and religious factors affected vaccination uptake. In this case, the controversy came from a lack of trust between citizens and the Nigerian state, and also citizens’ distrust of international health agencies and pharmaceutical companies.^6,7

Whilst clinical trials will face some of the challenges experienced during routine and emergency vaccination campaigns, such as vaccine hesitancy or heightened mistrust, experimental conditions raise their own challenges. Assessing vaccine efficacy during a public health emergency presents unique challenges – for example, cases may be spatially dispersed, and surges in infections may occur at different times and/or in different locations – but SBS approaches should inform design from the outset.⁸

SBS considerations relevant to all vaccine use

Findings from SBS research demonstrate the need to understand the wider context of vaccination during a health emergency. SBS evidence from routine vaccination tells us that both people’s perceptions of vaccines outside a health emergency and ‘normal’ engagement with health systems can influence vaccine uptake during health emergencies. The following sections highlight lessons learnt regarding the political, economic, social and cultural factors that influence routine vaccination as well as lessons learnt from vaccine trials outside health emergencies.

Experiences of health services

Health systems in sub-Saharan Africa have been mired by protracted and cyclical shocks that continue to affect the provision of care.⁹ Historically, health systems in the continent were designed to serve the needs of colonial administrations, leaving them unequipped to support the local population.¹⁰ Financing began to decline after structural adjustment programmes in the 1980s and 1990s and, whilst improvements have been made since then, insufficient financing continues to undermine health systems.^11–13 Progress has been uneven: some countries regularly meet World Health Organization targets, while other countries face a critical shortage of healthcare workers, drugs and equipment.¹⁴ These resource issues affect public perception of healthcare services and, importantly, vaccination.^15–18

A 2021 study in rural Sierra Leone conducted by community healthcare workers through citizen ethnography¹⁹ (ethnographic research led by citizens) explored vaccination challenges, analysed data, tested new community engagement strategies based on their findings and elicited local perspectives on these approaches. The study found that prior negative experience with health services – for any health issue – resulted in unwillingness to return to the health centre for vaccination.⁵ The researchers reported that experiences of humiliation or discrimination by healthcare workers fostered a sense of mistrust in the health system.⁵ A 2022 study from Malawi reported that not only did patients’ mistrust of the health system drive routine childhood vaccination hesitancy, but healthcare workers reported having to use their own personal resources to fill resource gaps, and this reduced their motivation to continue working with vaccination programmes.²⁰

SBS research shows that under-resourced health systems have a reinforcing effect on vaccination hesitancy, both in terms of patients’ mistrust of the health system (and vaccines) and in terms of reducing healthcare workers’ morale to participate in vaccination programmes.^5,20–25 Conversely, positive experiences with healthcare workers can drive confidence in routine vaccination.²⁰ In a malaria study in southern Sierra Leone from 2021, participants stated that they would be likely to vaccinate their children against malaria.²⁶ This was because of positive experiences with vaccination for other diseases such as measles, polio, hepatitis B, tuberculosis, diphtheria and yellow fever, all of which had no adverse effects.

The way vaccines are delivered also influences vaccine uptake. Some healthcare workers have adapted door-to-door engagement and last-mile vaccine interventions with success^27–29 (see example in Box 1). One study from Freetown, Sierra Leone (published 2021) found that door-to-door engagement with marginalised urban residents helped change perceptions about both routine vaccines and vaccines rolled out during a health emergency.²⁶ This approach made vaccines more accessible and also generated interactions that allowed residents who were sceptical about vaccines to ask questions and enrol in vaccination programmes. SBS research underscores the importance of sharing positive experiences of vaccination through community engagement and of ensuring that first contact for vaccination is a respectful interaction. Other studies have reported that mobile or door-to-door immunisation campaigns are preferred. For example, use weekend vaccination dates to reach those with poor healthcare access, use ‘vaccine champions’ for outreach, and ‘bundle’ health interventions in each trip.^{25,28,30–32} Improving access to vaccines has a double effect on uptake: strengthening confidence whilst increasing coverage.

Box 1. Last-mile vaccine delivery in rural Sierra Leone

Source: Authors’ own. References cited.

Community dynamics

SBS research has demonstrated the importance of understanding community context (such as livelihoods, power dynamics and socio-cultural beliefs and practices) and how this affects routine vaccination programmes.³³ It is equally important to account for social differences and heterogeneity within communities.

Social scientists have long challenged the common understanding of ‘community’.^34–37 Whilst ‘community’ is often used as a meaningful unit in public health research, what constitutes a ‘community’ can vary greatly depending on context. The word ‘community’ also glosses over heterogeneity within communities – a simple notion of community can overshadow complex hierarchies.³⁴ Often, the same community members are engaged in different public health programmes, whilst more marginalised or vulnerable people may be left out or ‘left behind’. Understanding complexity within communities – and which groups to engage with and when – is critical to effective vaccine engagement efforts.

Communities’ recent histories matter in relation to health interventions.^5,38–40 In Sierra Leone, for example, memories of the 2014-2016 Ebola outbreak continue to shape people’s attitudes to vaccination. A 2021 study reported community critiques of ‘strangers’ involvement in immunisation drives and the suspicion that generated.⁵ Similarly, at the time of writing, recent observations in Uganda’s western borderlands suggest that the militarised response to COVID-19 has not been forgotten and is continuing to contribute to delayed care-seeking (due to fears of quarantine) and heightened fears of vaccination for other diseases, such as yellow fever.⁴¹

Vaccine roll-out strategies should consider social and economic activities that may influence access and demand for vaccination. For example, an understanding of local livelihood strategies can help determine when and how to deliver vaccination most effectively. Research led by community healthcare workers explored the drivers of low vaccine uptake around a measles outbreak in a border town in Sierra Leone in 2021. The study found that the timing of the vaccine campaigns coincided with when mothers had crossed the border to sell their produce, and this meant that the mothers had been unable to vaccinate their children despite their willingness to do so.⁵

Vaccine hesitancy is not a ‘single story’ about a lack of information but can be complex and deeply rooted in context and experience.^5,24,42–45 SBS research has shown the disadvantages of communication efforts that treat the public as ‘ignorant’ of scientific information and which withhold or carefully curate information to avoid spurring additional vaccine hesitancy.^24,42,46,47 This ‘knowledge deficit’ approach may offer a more simple or manageable explanation than the ‘messiness’ of the local socio-political context.⁴⁴ Focusing only on information may suggest that the solution is more or better messaging, rather than a need to explore ways to address broader drivers of mistrust and strengthen the trustworthiness and accountability of service providers.⁴⁸

The concept of ‘vaccine anxieties’ is useful in exploring a more nuanced sense of worry, unease or concern, as well as a positive sense of a desire for something, which emphasises people’s agency in making decisions around vaccination.^24,49

Rumours, misinformation and disinformation should be addressed in context. A 2021 study on routine vaccination in rural Sierra Leone reported rumours about routine vaccines, including fears that vaccination might ‘bring Ebola back’.⁵ The study’s authors argued that engagements with vaccination were more complex, and rumours reflected broader anxieties associated with healthcare workers and interventions. These findings were then integrated into a district-level strategy to strengthen vaccine confidence, including involving trusted community leaders, carefully planned timing of vaccination campaigns and outreach around the farming cycle and trading commitments, use of community healthcare workers to ‘mediate’ between community members and healthcare worker staff, and reframing discussions around vaccination using local concepts and knowledge. Box 2 presents another example of how local perceptions shape vaccine uptake.

Box 2. Lessons learnt from a Rift Valley fever vaccine trial in south-western Uganda

Source: Authors’ own. References cited.

SBS considerations specific to vaccine roll-out during a health emergency

Exploring experiences of vaccine roll-out during a health emergency can offer important insights on how crisis contexts shape considerations for effectively introducing vaccination. During health emergencies, decision-makers must consider how to make a vaccine both available and acceptable, whilst identifying high-risk groups to prioritise. Time and resources are constrained in emergencies, but it is still important to consider local context and community engagement design at the outset. The 2014-16 Ebola epidemic in West Africa and the 2020-23 COVID-19 pandemic both demonstrated how inequities can be quickly exacerbated during an emergency. Some of the dynamics discussed above in relation to routine vaccination (e.g., heightened mistrust) might be exacerbated. There are, therefore, specific SBS considerations for an emergency roll-out of a vaccine, such as fear around the outbreak, mistrust in the humanitarian sector and international staff, and fear associated with going to a health clinic during an emergency. Emergencies also reshape social dynamics in ways that are significant for vaccine roll-out; for example, emergency funds and programmes can redistribute power and social influence, and this reshaping can happen in ways that are not always predictable. This means that emergencies require additional, responsive and dynamic research to understand how social realities change as the crisis unfolds and how social realities may influence perspectives of and access to vaccines.

SBS research has shown the importance of involving communities in discussions around the ethics, logistics and politics of vaccine roll-out during preparedness and readiness, as well as at the onset of an emergency.^50,51 Evidence from scenario planning in Sierra Leone demonstrated the importance of engaging citizens in discussions around how to effectively deliver COVID-19 and Ebola vaccines before the vaccines arrived in their communities.⁵⁰ Rather than waiting to tackle vaccine hesitancy at the point of delivery, using a scenario planning tool can engage citizens in decision-making around how to deliver vaccines and can highlight social, economic and ethical considerations for vaccine roll-out. For example, participants cited concerns around their local health facility and preferred a door-to-door vaccination strategy. Participants were also able to identify priority populations for early vaccination based on local vulnerabilities.

Vaccine roll-out during health emergencies needs careful planning, collaboration, flexibility and adaptability. During an Ebola vaccine trial in remote eastern Democratic Republic of the Congo (DRC), for example, trial managers had to adapt their approach to reporting serious adverse events.⁵² Rather than relying on internet connectivity, they engaged health facility staff to notify the study site coordinator if there was a serious adverse event at their facility. The trial managers also adapted their approach to reporting by regularly sharing results with participants and local health authorities through face-to-face engagements. See Box 3 for an example of how the Rwandan government planned a Marburg vaccine rollout and the effect this could have on public perceptions.

During emergencies in particular, community engagement processes tend to be rushed and are often planned quickly, compromising their effectiveness.⁵³ Research from Nigeria documented how community volunteers were given short notice to share information with communities about an upcoming diphtheria vaccination campaign during an outbreak in the north of the country.⁵³ Without a longer planning period, community engagement specialists often have to pivot existing plans and resources to respond to an emerging crisis, and this is why foundations laid during preparedness and readiness work can be so important.⁵³ As described above, public consultations before the start of a vaccination campaign can improve the effectiveness of roll-out and start to build trust in vaccination efforts. For marginalised groups, more tailored approaches are needed, such as working through trusted networks or civil society organisations to build trust without singling out or stigmatising people at risk. These pathways can help to build trust without focusing solely on vaccine hesitancy, which is a more limiting approach. Early and ongoing engagement can also establish consensus around the local effectiveness of vaccine roll-out strategies across different scenarios. The roll-out strategies can then be implemented if an emergency occurs. Such consultations should be built into emergency preparedness programming.

Box 3. Marburg virus disease, Rwanda

Source: Authors’ own. References cited.

SBS considerations specific to experimental vaccines

Conveying information should not underplay genuine reasons for mistrust due to unethical practices in clinical trials, both historically (including under colonial public health efforts) and in present times.^57,58 In recent years, the role of experimental vaccines during emergencies has become more established. Trialists and others involved in the planning and implementation of clinical research during an emergency can learn from the experiences of routine vaccination and emergency roll-out to identify avenues for building trust in their projects. However, the use of experimental vaccines also carries additional considerations.

Experiences with Ebola and COVID-19 provide rich insights into the choices for research design and vaccine roll-out. These health emergencies were characterised by increased uncertainty and circulating mis- and dis-information, bringing another level of complexity to vaccine roll-out. Such issues can be further heightened when a vaccine is experimental. Whilst there are potentially significant concerns from the public (i.e., hesitancy), questions related to trial design can also benefit from enhanced public engagement to strengthen trust. The following sections are organised by phase, from pre-trial to post-trial.

Pre-clinical trial set-up and design

Community engagement can help people understand why a particular approach is being taken and inform the approach itself. Community engagement strategies and opportunities for public consultation should be designed at the outset, before the beginning of a clinical trial during a public health emergency. Scenario planning is one effective tool to involve community members in the design of a trial and considerations around vaccine roll-out.⁵⁰ Experiences with public consultations around vaccine roll-out show that there are significant benefits to engaging citizens about questions of protocol design. In an emergency, trialists may have to make difficult decisions around inclusion and exclusion criteria, and local deliberations (or ‘grounded ethics’) may offer important insights.⁵⁹ For example, during the Ebola vaccine trials in Sierra Leone (from 2015) and DRC (from 2019), different trials had different rules about the inclusion of pregnant women, and these rules also changed over time.^60,61 Consultation with the public may not only offer insights into what is perceived to be acceptable but also help manage mistrust that may be generated by shifting regulations.

Social scientists have urged that community engagement efforts during vaccine trials be expanded to focus on the wider population as well as the target groups and potential participants. Community engagement can include mass media approaches to sharing information about trials and to raise awareness.⁶² Social scientists have also emphasised the importance of engaging with populations with specific vulnerabilities who may be underserved or viewed as more difficult to engage with, such as rural populations, those with limited literacy or populations on the move.³ Effective communication mechanisms should be put in place to respond to questions from community members who are included in or excluded from vaccination, and to answer questions about how vaccination is effective after exposure when this is not the case for other (more familiar) vaccines (e.g., measles).

SBS research has demonstrated clearly that the historical and political-economic context of emergencies will shape the dynamics of vaccination. A study from 2024 on the recruitment of people living with HIV for an Ebola vaccine trial highlighted how the trial converged experiences of two major epidemics.³⁸ The trial took place in a West African country where HIV is highly stigmatised (the study did not identify the country), but this local context was largely ignored and the clinical trialists did not conduct meaningful community engagement efforts.³⁸ Rumours circulated about experimentation on people living with HIV, and participants also worried about disclosure of their status.

Similarly, in Uganda, rumours during the 2022 outbreak of Ebola (Sudan virus disease) emerged around how the outbreak had been planned to displace artisanal gold miners from Mubende District, where the outbreak originated.⁶³ Memories of such rumours persist, and they may affect perceptions of future clinical trials.

Research on an Ebola vaccine trial during the COVID-19 pandemic in Goma, DRC, raised key issues related to both local and global political anxieties and also personal experiences.⁶⁴ Trial participants’ narratives linked foreign-led vaccine research to wider conversations around resource extraction, whilst the COVID-19 pandemic resurfaced critiques of Western biomedical colonialism. The authors of the study demonstrated how medical research can become a space in which to discuss these wider concerns, suggesting that when trials are conducted appropriately, they can themselves provide an opportunity to address vaccine anxieties. This points to the challenge of adapting trial operations in contexts of uncertainty whilst also maintaining trust in the trial itself.

Trial participation and informed consent

There are lessons to be learnt from vaccine clinical trials both in and outside of emergencies (see Box 4). In an emergency, SBS research has emphasised the need to clearly communicate the risks and benefits of clinical trial participation, ensure informed consent, and consider local decision-making structures.⁶⁵ Understandings of ethics cannot rely only on principles of trust, but must also account for citizenship and democratic governance.⁵⁹

Historically, minority populations, women and older people have been underrepresented in clinical trials, and working through trusted channels can help with trial recruitment. It is equally important to recognise groups that are marginalised, and the role that local healthcare workers may play not only in generating trust, but also in perpetuating stigma and discrimination. For example, Indigenous Batwa people were excluded from engagement efforts during the rollout of an Ebola vaccine trial (using the Merck rVSV-ZEBOV-GP vaccine) during the Ebola outbreak in eastern DRC in 2019.⁵⁸ Many Batwa people were frustrated that they were not consulted directly, whilst people from ethnic groups that had marginalised them were used as community engagement mediators.

Ensuring that participants fully understand the risks, benefits and unknowns of a trial is a core ethical challenge, especially for trials of experimental vaccines and during an emergency. Informed consent processes should use a process of ‘grounded ethics’, which considers local norms. A 2018 study in Sierra Leone sought to understand why participants in the EBOVAC-Salone trial put themselves forward for an experimental vaccine during a time of uncertainty and when negative rumours were circulating about the disease and the vaccine. Participants expressed feelings of ‘altruism’ or ‘sacrifice’ for their country and a desire to build others’ confidence in the vaccine.⁵⁹ This also reflects evidence reported in a malaria vaccine trial in the Gambia in 2001-2004, in which participants felt a sense of kinship with one another.⁶⁶

Rather than interpreting rumours as inherently negative, it is important to take them seriously as social commentary. In the EBOVAC-Salone trials, understanding rumours as a reflection of anxiety, including amongst those who chose to participate, allowed clinicians to better understand the context in which they were operating, to build empathy and to design trial interactions that respected participants and reflected an appreciation for the risks they were making.⁵⁹

Box 4. Using social and behavioural science research to inform a typhoid conjugate vaccine trial in Malawi

Source: Authors’ own. References cited.

Post-trial engagement

After a trial is over, it is vital to consider socially and culturally acceptable strategies for follow-up, exit and trial closure, results dissemination and information about how to access vaccines.⁶⁸ In terms of follow-up, community engagement efforts can focus on discussion of trial outcomes and next steps. This approach has been shown to help prevent negative stories from circulating about a trial after it is completed.⁶⁸ Community engagement also lays the groundwork for any future health research and ensures that trust-building is viewed as a continual, relational process with no specific ‘endpoint’.

References

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Authors: Megan Schmidt-Sane (IDS), Samantha Vanderslott (University of Oxford), Hana Rohan (independent consultant) and Luisa Enria (LSHTM).

Acknowledgements: This brief was reviewed by Juliet Bedford (Anthrologica), Annie Wilkinson (IDS), Shelley Lees (LSHTM), Hayley MacGregor (IDS), Nel Druce (FCDO) and Clare Chandler (FCDO). Luisa Enria’s input was facilitated through her UK Research and Innovation (UKRI) Future Leaders Fellowship (Ref. MR/T040521/1). Editorial support was provided by Harriet MacLehose. This brief is the responsibility of SSHAP.

Suggested citation: Schmidt-Sane, M., Vanderslott, S., Rohan, H., and Enria, L. (2025). Using social and behavioural science to inform the use of experimental vaccines during health emergencies. Social Science in Humanitarian Action Platform (SSHAP). www.doi.org/10.19088/SSHAP.2025.013

Published by the Institute of Development Studies: March 2025.

Copyright: © Institute of Development Studies 2024. This is an Open Access paper distributed under the terms of the Creative Commons Attribution 4.0 International licence (CC BY 4.0). Except where otherwise stated, this permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited and any modifications or adaptations are indicated.

Contact: If you have a direct request concerning the brief, tools, additional technical expertise or remote analysis, or should you like to be considered for the network of advisers, please contact the Social Science in Humanitarian Action Platform by emailing Annie Lowden ([email protected]) or Juliet Bedford ([email protected]).

About SSHAP: The Social Science in Humanitarian Action (SSHAP) is a partnership between the Institute of Development Studies, Anthrologica , CRCF Senegal, Gulu University, Le Groupe d’Etudes sur les Conflits et la Sécurité Humaine (GEC-SH), the London School of Hygiene and Tropical Medicine, the Sierra Leone Urban Research Centre, University of Ibadan, and the University of Juba. This work was supported by the UK Foreign, Commonwealth & Development Office (FCDO) and Wellcome 225449/Z/22/Z. The views expressed are those of the authors and do not necessarily reflect those of the funders, or the views or policies of the project partners.

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