Community Engagement and Local Collaboration: A Framework to Enhance Women’s Participation in a COVID-19 Vaccine Immunogenicity Study in Liberia

Background Morbidity and mortality from the COVID-19 pandemic has spurred urgent COVID-19 vaccination efforts worldwide. In April 2021, Liberia launched its COVID-19 vaccination campaign, achieving 63% vaccination coverage in Montserrado County by July 2022. In August 2021, the Partnership for Research on Vaccines and Infectious Diseases in Liberia initiated the International Study on COVID-19 Vaccines to Assess Immunogenicity, Reactogenicity, and Efficacy. This study was funded by the US National Institutes of Health and is an observational study to evaluate the immune response to COVID-19 vaccines over two years across multiple countries, including Liberia. However, health facility-based recruitment targeting vaccinated individuals revealed low enrollment of women in Liberia, underscoring the need to enhance women's participation in the study. Methods A mitigation plan was developed. Stakeholder mapping and advocacy meetings were conducted to garner community support and align the study with local health priorities. Media engagements were held to promote study recruitment. Mobile teams were deployed to local community centers to provide education, dispel rumors, and facilitate vaccination and study enrollment. Results Listening sessions identified barriers hindering women's vaccine acceptance and study enrollment, prompting the development of tailored strategies. Barriers to vaccinations included women's inability to access vaccination sites and rumors about vaccine effects on reproduction. Thirteen community meetings were held, resulting in an increase in the proportion of women in the study from 34% in September 2021 to 46% in April 2022. Conclusions Community-driven interventions facilitated vaccine uptake and increased participation in our study, emphasizing the significance of ongoing community engagement in clinical research.