COVID-19 vaccination implementation in six lower- and middle-income countries: Successes, challenges, and lessons for pandemic preparedness
Year: 2025
Type: article
Abstract: The COVID-19 pandemic challenged health systems in low- and middle-income countries (LMIC) to rapidly deploy vaccines, target adult populations, and integrate the COVID-19 vaccine into existing vaccination programs. This evaluation examined COVID-19 vaccination implementation and planning experiences of six LMICs. We aimed to identify common strategies and investments contributing to country-level readiness to scale up COVID-19 vaccination and gaps in pandemic preparedness. In-depth interviews were conducted with national COVID-19 vaccination program representatives from Côte d'Ivoire, Kyrgyzstan, Moldova, Pakistan, the Philippines, and Zambia. Interview questions covered activities, barriers, and facilitators related to vaccine integration; planning and financing; digital systems; vaccine infrastructure and delivery; adult immunization; the health workforce; and demand and communications. We used the framework analysis method to establish key themes from the recorded data and categorize our results. Countries with influenza vaccine platforms leveraged these to reach adults with COVID-19 vaccines. Community-based platforms were viewed to be an effective approach to vaccinate prioritized populations. Stand-alone delivery platforms and data systems for COVID-19 vaccination were viewed as inefficient and not cost-effective, and vaccine supply delays and shortages were a major issue. Participants highlighted that integrated planning, management, and financing for vaccination activities facilitated the COVID-19 vaccine roll out, and that National Immunization Technical Advisory Groups filled a gap by providing guidance on prioritizing populations for vaccination. Health workers were viewed as key influencers of vaccine uptake by patients and their vaccination was believed by participants to improve public trust in COVID-19 vaccines. These findings informed the following priority areas for targeted investment and technical support. 1. Improve vaccine procurement and supply. 2. Integrate financing and management of national vaccination programs broadly. 3. Digitize and integrate data systems. 4. Build health workforce capacity. 5. Establish and expand adult and life-course vaccination, including health workers. 6. Address hesitancy and misinformation.
Source: PLOS Global Public Health
Institution: The Task Force for Global Health
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,496
Awards: G3870496008, TASK FORCE FOR GLOBAL HEALTH SUPPORT TO CAPACITY BUILDING FOR GLOBAL, REGIONAL, AND NATIONAL IMMUNIZATION PROGRAMS - SINCE THE GLOBAL POLIO ERADICATION INITIATIVE WAS ESTABLISHED IN 1988, MORE THAN 2.5 BILLION CHILDREN HAVE BEEN IMMUNIZED AGAINST POLIO. WORLDWIDE ERADICATION EFFORTS HAVE SEEN THE NUMBER OF REPORTED CASES OF WILD POLIOVIRUS (WPV) DECREASE BY MORE THAN 99 PERCENT. TODAY, POLIO REMAINS ENDEMIC IN ONLY TWO COUNTRIES: AFGHANISTAN AND PAKISTAN. THE INSIDIOUS SPREAD OF THIS HIGHLY CONTAGIOUS DISEASE HIGHLIGHTS THE IMPORTANCE OF MAINTAINING A NETWORK OF HIGHLY TRAINED PROFESSIONALS WITH EXPERTISE IN PUBLIC HEALTH SURVEILLANCE AND APPLIED EPIDEMIOLOGY AND THE NEED AMONG MINISTRIES OF HEALTH FOR INCREASED SUPPORT DURING DISEASE OUTBREAKS AND ERADICATION CAMPAIGNS. WITH POLIO OUTBREAKS OCCURRING IN OTHER KEY FOCAL AREAS DUE TO CIRCULATING TYPE 2 VACCINE-DERIVED POLIOVIRUS (CVDPV2) IN COTE D?IVOIRE, LIBERIA, SUDAN, TAJIKISTAN AND NIGER WITH RISK OF FURTHER OUTBREAKS IN THE LAKE CHAD BASIN REMAINING HIGH, PROVISION OF TARGETED IN-COUNTRY SURVEILLANCE AND RESPONSE THROUGH SURGE SUPPORT HAS BECOME AN IMPORTANT TOOL IN THE FIGHT TO ERADICATE POLIO.THE RESURGENCE OF OTHER VACCINE PREVENTABLE DISEASES (VPD) SUCH AS MEASLES FURTHER SUPPORTS THE NEED TO STRENGTHEN ROUTINE IMMUNIZATION SYSTEMS IN VPD OUTBREAK COUNTRIES, AND SUPPORT THE DEVELOPMENT OF TOOLS, GUIDANCE AND ADVISORY GROUPS TO ENHANCE THE EFFECTIVENESS OF GLOBAL IMMUNIZATION PROGRAMS. THE CONSIDERABLE PROGRESS ACHIEVED OVER PAST DECADES TO ERADICATE POLIO, ELIMINATE MEASLES AND RUBELLA AND CONTROL OTHER VPDS INCLUDING TYPHOID, HEPATITIS B, CHOLERA, AND NEONATAL TETANUS THROUGH STRENGTHENED IMMUNIZATION SYSTEMS AT THE GLOBAL, REGIONAL AND NATIONAL LEVEL HAS BEEN PUT AT RISK DUE TO THE OUTBREAK OF CORONAVIRUS DISEASE (COVID-19).IT IS WITHIN THIS CONTEXT THAT THE TASK FORCE FOR GLOBAL HEALTH PROPOSES TO ENGAGE ITS EXPERIENCE AND EXPERTISE TO ELIMINATE THE THREAT OF VPDS BY BUILDING COUNTRY, REGIONAL, AND GLOBAL IMMUNIZATION CAPACITY TO PREVENT, DETECT, AND RESPOND TO VPDS. THIS REQUIRES STRENGTHENED AND E XPANDED SURVEILLANCE ACTIVITIES AND RAPID, TARGETED OUTBREAK RESPONSE.OUR OVERARCHING PURPOSE IS TO UTILIZE THE EXTENSIVE RESOURCES AND EXPERIENCE OF THE TASK FORCE FOR GLOBAL HEALTH TO BUILD THE CAPACITY OF NATIONAL, REGIONAL AND GLOBAL IMMUNIZATION PROGRAMS TO ELIMINATE THE THREAT OF VPDS, PARTICULARLY POLIO, WORLDWIDE. WITHIN THE TASK FORCE FOR GLOBAL HEALTH, THE TEPHINET PROGRAM AND THE CENTER FOR VACCINE EQUITY WILL ADVANCE THE KEY STRATEGIES LISTED IN THE CDC NOFO. WE WILL SCALE UP THE SUCCESSFUL PROGRAMS THAT WE IMPLEMENTED DURING THE PREVIOUS COAG AND ESTABLISH NEW PROGRAMS TO FURTHER BUILD REGIONAL, NATIONAL, AND GLOBAL CAPACITY TO ELIMINATE VPDS.TEPHINET WILL IMPROVE VACCINATION COVERAGE PERCENTAGES IN HIGH RISK AND SPECIAL POPULATIONS BY CONTINUING TO BUILD CRITICAL SKILLS RELATED TO ROUTINE IMMUNIZATION DELIVERY, IMMUNIZATION CAMPAIGNS, AND SURVEILLANCE AND OUTBREAK RESPONSE IN PAKISTAN AND OTHER HIGH PRIORITY COUNTRIES THROUGH ACTIVITIES INCLUDING NSTOP PAKISTAN, AFGHANISTAN IMMUNIZATIONS SYSTEMS STRENGTHENING, AND THE STRENGTHENING SURVEILLANCE AND IMMUNIZATIONS SYSTEMS PROJECT. MEASLES RAPID DIAGNOSTIC TESTING AND THE DEVELOPMENT OF SURVEILLANCE SOFTWARE TOOLS TO IMPROVE MEASLES OUTBREAK RESPONSE IN THE AFRICA, SOUTHEAST ASIA AND BRAZIL WILL BE ACHIEVED THROUGH TEPHINET SUPPORT. CVE?S IMPLEMENTATION OF THE POLIO ERADICATION GLOBAL OUTBREAK RESPONSE ACTIVITY WILL CONTINUE TO IMPROVE CVDPV2 OUTBREAK RESPONSES AND SURVEILLANCE CAPACITY. CVE WILL LEAD AND CONVENE IMMUNIZATION COALITIONS AND STRENGTHEN GLOBAL NITAG CAPACITY THROUGH ITS US COALITION ON GLOBAL IMMUNIZATION, COALITION FOR GLOBAL HEPATITIS ELIMINATION AND NITAG ACTIVITIES. THE BRIGHTON COLLABORATION TEAM WILL WORK TO STRENGTHEN GLOBAL IMMUNIZATION SAFETY MONITORING SYSTEMS. THE TASK FORCE?S IN-HOUSE TECHNICAL CAPACITY COMBINED WITH THE EXISTING PROGRAM AND FETP NETWORK RELATIONSHIPS ARE STRONG ASS
OpenAlex ID: W4410154997