The Bambisana Study Protocol: A mixed methods pre- and post- test study assessing community and social media influence to increase influenza vaccination uptake among youth in Soweto, South Africa

Abstract Background Seasonal influenza has an estimated global reach of 3 to 5 million infections with 290 000 to 650 000 influenza-related deaths yearly. Despite its efficacy in reducing morbidity and mortality, influenza vaccination rates remain low globally and in South Africa. Youth between the ages of 18-34 years are not prioritised for influenza vaccines although influenza surveillance in South Africa shows that individuals aged 19 to 44 present the highest asymptomatic episodes and the lowest medically attended illness. This creates an opportunity to investigate if and how vaccine demand can be created in the absence of clear imperatives to vaccinate. The study tests the effectiveness of tailored, context-specific education, community engagement, including community and social media to increase influenza vaccination uptake. T ailored, context-specific education, community engagement, reliable vaccine supply and free, localised access are all critical for improving perceptions of, increasing confidence in, and motivating uptake of vaccination. This study explores strategies to increase vaccine uptake amongst marginalised youth 18-34 years old in Soweto, South Africa, where influenza vaccines are not universally accessible through the public health system for this age group. Methods The Bambisana Study uses an innovative approach - including community influencers and social media - to increase uptake of influenza vaccines through designing and testing an integrated communications strategy targeted at marginalised youth in Soweto, South Africa. The Bambisana study uses a mixed methods pre-test, post-test intervention design to test the effects of the interventions. Conclusion and Significance Enhancing perceptions of, bolstering confidence in, and fostering uptake of vaccination relies heavily on the efficacy of yearly influenza vaccination initiatives, personalized education tailored to specific contexts, active community involvement, consistent vaccine availability, and easily accessible, cost-free distribution channels at the local level.