Facing the pandemic: The implementation of local devices for vaccination in Brussels
(2022) International Workshops on Public Policy 3rd Edition — Location: Budapest (28.June.2022)
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- Authors
Creten, Alexis 
Mahieu, Céline
- Abstract
- Context: In Brussels, the COVID-19 vaccination campaign started in February 2021 through “large centres” before shifting to small local devices spread all over the city territory This strategic change aimed to “leave no on behind”, that is to meet the needs of a socially and culturally diverse population. At the governance level, Belgium and more particularly Brussels is known for the impressive number and complexity of its institutions. Health governance does not escape to this trend with 10 ministers sharing health-related competencies and responsibilities in the country, what complexify the implementation of a strong response to an urgent thread. Methodology: In this paper, we present a case study realized in the city of Brussels, where we qualitatively analysed the implementation of the Belgian vaccination strategy through both types of instruments, that is, large vaccination centres implemented at the level of the Brussels Region and small vaccination devices implemented at the local scale. We carried out direct observation and group and individual interviews with citizens and with health professionals and social workers involved in the regional centres and in the local devices. In parallel to this field work, which enabled us to reach 104 respondents over three months, we regularly met with Brussels decision-makers responsible for the vaccination strategy, who were part of our research follow-up committee. Thus, we also examined the evolution of the vaccination strategy at the political level. Results: During the second phase of the vaccination campaign, we observed a diversification of the vaccination devices all over the regional territory. Three main types of devices can be distinguished: - The “invitation”: based on a formal invitation which give Brussels’ citizen access to a large vaccination centre, - The “proposal”: with small devices set up in the public spaces to get closer to the population, - The “relationship”: based on the trust relationship existing between a person and a health or social worker. Each time present specific characteristics (temporality, environment, accessibility, etc.) that allow them to meet different needs like asking questions or being reassured, and therefore to reach different populations. We argue that this diversity is essential to implement successfully public health measures and actions in socially and culturally diverse cities like Brussels. However, this diversity constitutes a big challenge in terms of governance. Indeed, we observed redundancies and overlaps between these devices. Fragmentation of responsibilities and a lack of communication and collaboration hinders the implementation of the Brussels’ vaccination campaign. Discussion: In conclusion, we will focus on these problems of communication and collaboration in relation to jurisdictional conflicts between different professional groups and occupations. Indeed, the vaccination reinforces decades long conflicts between professionals about the limits of their roles. It was particularly the case between physician and pharmacist associations when the government announced its intention to allow pharmacist to vaccinate against COVID-19. This role tension concern also new temporary professions created in response to the pandemic that have to defend and justify themselves in order to perpetuate their existence when the crises will be over.
- Affiliations
Citations
Creten, A., Thunus, S., & Mahieu, C. (2022). Facing the pandemic: The implementation of local devices for vaccination in Brussels. International Workshops on Public Policy 3rd Edition, Budapest. https://hdl.handle.net/2078.5/104666