Lessons from the 2024 avian influenza vaccination campaign in Finland: a qualitative inquiry.

Highly pathogenicity avian influenza H5N1 (HPAI H5N1) viruses cause a continuous threat to wild avian populations. During recent years, spillover to both wild and domestic mammals has occurred with an increasing frequency. As a consequence of the recent developments in the epidemiological situation, the human-animal interface with the risk of human exposure to HPAI H5 has expanded. In 2024, Finland became a global forerunner to offer H5 vaccine to occupational risk groups, specifically fur and poultry workers, following an extensive HPAI H5N1 outbreak in 2023 in fur-farmed minks and foxes. Despite targeted efforts to reach the people at increased risk, only 8,6% of the target population received the first dose and 7,5% completed both doses. To seek a better understanding of the barriers behind low vaccine uptake a Behavioural and Cultural (BCI) insight approach was chosen. A rapid qualitative study was conducted in late 2024 (n = 17), utilising semi-structured interviews with health authorities, industry stakeholders, and risk group representatives in the Ostrobothnia region in Finland. Barriers were identified across three dimensions: (1) logistical failures, including poor timing and difficulties in reaching target groups (2) divergent risk perceptions, where economic livelihood overshadowed personal health risks; and (3) political distrust, stemming from perceived stigmatization by national health authorities. The results will provide vital information for future pre-pandemic communication and implementation strategies and helps to identify key stakeholders and target groups.