Vaccines prevent millions of child deaths each year. Over the past few years, however, global immunization coverage has stagnated, particularly in low- and middle-income countries. This was even before the COVID-19 pandemic increased the number of unvaccinated children by 3.4 million. In 2020, the World Health Organization estimated that 23 million children under age one had not received all their vaccinations. Our work in immunization seeks to generate evidence around strategies to improve routine child immunization and reduce vaccine hesitancy and zero-dose children in low- and middle-income countries .
With COVID still raging across the world, the topic of immunization is receiving more attention than it has in decades. Today, the world is waiting to see if immunizations will help turn the corner and end the biggest health and humanitarian crisis in a generation. Given this, policymakers and implementers need to know what works to increase immunization rates, for whom, and at what cost. 3ie’s recent EGM and systematic review offer insight that may help tackle some aspects of the current crisis, while highlighting evidence gaps that need urgent attention.
Innovations in increasing immunization evidence program
A 3ie scoping study indicated the potential of innovative community-based approaches to overcome the barriers to immunization coverage in low- and middle-income countries. It also highlighted a clear lack of evidence on the effectiveness of these approaches. Launched in 2015, 3ie’s immunization evidence program is a USD 7.4 million initiative that supported seven impact evaluations and six formative evaluations of innovative interventions and community engagement approaches to improve immunization outcomes in countries with low or stagnating immunization rates.
The formative evaluations test the appropriateness, feasibility and acceptability of the interventions, whilst the impact evaluations assess the effectiveness and scalability of innovative interventions. We have also synthesized findings from the formative evaluations, completed an evidence gap map (EGM) and produced a systematic review (SR) on this topic. While the synthesis and SR are to be published soon, you can read the SR protocol here and explore the EGM here.
As part of the program, we are also completing a review of reviews that synthesizes the best available evidence on effective interventions for improving routine child immunization outcomes and developing implementation friendly description of interventions.
Vaccine hesitancy project
With support from Gates Foundation India, we are currently carrying out a mixed-methods synthesis to understand the drivers of vaccine hesitancy in select WHO and Gavi-priority countries such as India, Nigeria, and Uganda.
Key activities and workshops
27 February 2020 | Learning from innovations in increasing immunization
Participants discussed findings and insights from the program as well as preliminary findings from a formative evaluation synthesis and a forthcoming evidence gap map of effectiveness studies in immunization. The discussions unpacked the term ‘community engagement’ and the challenges and lessons in designing, implementing and learning from the evaluations of community engagement-based interventions to improve immunization. The conference brought researchers and policymakers together to discuss how to conduct and use costing analyses. To read more, click here.
11-12 July, 2017 | Mid-term learning workshop
Participants discussed the challenges associated with implementing technology-enabled interventions in real-world contexts; training frontline health workers with high workloads but limited literacy, skills and exposure to innovations; and experiences with integrating interventions into existing healthcare systems at the institutional and financial levels. To read the workshop report, click here.
News and features
In this article, Monica Jain and Avantika Bagai discuss the innovative approaches of engaging communities for improving immunization coverage in India and how 3ie’s studies will inform us which community engagement interventions work, where, how and at what costs | The Asian Age, May 2018
Blog | All eyes on immunization: what do we know about effective vaccination campaigns?, April 2021
Blog | What do we know about what works to increase routine vaccination coverage, April 2020
Blog | A shot in the arm: why engaging with a range of stakeholders matters, April 2019
Blog | Improving child immunization through technologies for engaging communities: challenges and lessons, April 2018
Media article | Evidence-based strategies for improving the immunization of children in India, The Asian Age, May 2018
Program brief |Filling evidence gaps on what works to improve immunisation outcomes