Abstract
Background/Objectives: Public health activities and the roll-out of new vaccines such as the HPV vaccine in Mali have been disrupted by both the COVID-19 pandemic and by political unrest from March 2020 until recently. The HPV vaccine was introduced into the childhood vaccine program in 2024. Given the persistent threat of ongoing infectious disease epidemics, there is a pressing need to understand the factors influencing vaccine uptake in Mali and other low- and middle-income countries. Methods: To address this need, the GAIA Vaccine Foundation (GAIA VF), a nongovernmental organization (NGO), conducted a study of vaccine confidence in Bamako, the country's capital and primary population center, between September 2021 and March 2022 at 12 community based primary care clinics and 1 rural primary care clinic. The study was coupled with a vaccine outreach and education campaign at each site. Results: Study staff collected information on vaccine confidence in surveys from 3445 community participants. Healthcare providers were also recruited from the 13 sites for vaccine-related training, and 140 of these participants completed pre- and post-surveys on their vaccine knowledge and confidence. Survey results indicate that community members trust their primary care providers more than they trust the government. However, primary care providers trust government sources of information more than other sources for guidance on vaccines. Conclusions: As new vaccines are introduced, engaging key healthcare leaders to inform healthcare providers and developing primary care provider-led community outreach will be critically important to gaining community confidence prior to and during vaccination campaigns in the future.