Open Access Highly Accessed Correspondence

“Communicate to vaccinate”: the development of a taxonomy of communication interventions to improve routine childhood vaccination

Natalie Willis1, Sophie Hill1*, Jessica Kaufman1, Simon Lewin23, John Kis-Rigo1, Sara Bensaude De Castro Freire4, Xavier Bosch-Capblanch5, Claire Glenton2, Vivian Lin7, Priscilla Robinson6 and Charles S Wiysonge89

Author affiliations

1 Centre for Health Communication and Participation, Australian Institute for Primary Care & Ageing, La Trobe University, Bundoora, VIC 3086, Australia

2 Norwegian Knowledge Centre for the Health Services, PO Box 7004, St. Olavs plass, N-0130, Oslo, Norway

3 Health Systems Research Unit, Medical Research Council of South Africa, Cape Town, South Africa

4 International Union for Health Promotion and Education (IUHPE/UIPES), 42 Boulevard de la Liberation, 93203 Saint Denis Cedex, France

5 Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland

6 School of Public Health, La Trobe University, Bundoora, VIC 3086, Australia

7 School of Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia

8 Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Anzio Road, Observatory 7925, South Africa

9 Vaccines for Africa Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Road, Observatory 7925, South Africa

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Citation and License

BMC International Health and Human Rights 2013, 13:23  doi:10.1186/1472-698X-13-23

Published: 11 May 2013



Vaccination is a cost-effective public health measure and is central to the Millennium Development Goal of reducing child mortality. However, childhood vaccination coverage remains sub-optimal in many settings. While communication is a key feature of vaccination programmes, we are not aware of any comprehensive approach to organising the broad range of communication interventions that can be delivered to parents and communities to improve vaccination coverage. Developing a classification system (taxonomy) organised into conceptually similar categories will aid in: understanding the relationships between different types of communication interventions; facilitating conceptual mapping of these interventions; clarifying the key purposes and features of interventions to aid implementation and evaluation; and identifying areas where evidence is strong and where there are gaps. This paper reports on the development of the ‘Communicate to vaccinate’ taxonomy.


The taxonomy was developed in two stages. Stage 1 included: 1) forming an advisory group; 2) searching for descriptions of interventions in trials (CENTRAL database) and general health literature (Medline); 3) developing a sampling strategy; 4) screening the search results; 5) developing a data extraction form; and 6) extracting intervention data. Stage 2 included: 1) grouping the interventions according to purpose; 2) holding deliberative forums in English and French with key vaccination stakeholders to gather feedback; 3) conducting a targeted search of grey literature to supplement the taxonomy; 4) finalising the taxonomy based on the input provided.


The taxonomy includes seven main categories of communication interventions: inform or educate, remind or recall, teach skills, provide support, facilitate decision making, enable communication and enhance community ownership. These categories are broken down into 43 intervention types across three target groups: parents or soon-to-be-parents; communities, community members or volunteers; and health care providers.


Our taxonomy illuminates and organises this field and identifies the range of available communication interventions to increase routine childhood vaccination uptake. We have utilised a variety of data sources, capturing information from rigorous evaluations such as randomised trials as well as experiences and knowledge of practitioners and vaccination stakeholders. The taxonomy reflects current public health practice and can guide the future development of vaccination programmes.

Childhood; Vaccination; Immunisation; Communication; Low- and middle-income country; Intervention; Consumer; Taxonomy; Parents