Child receives a vaccine at a health center in Ishaka Mberare, Uganda.


Strong routine immunization systems can stop the spread of preventable infectious diseases and support national security and economic prosperity.

Kate Holt/MCSP

Today, approximately 86% of children around the world receive basic immunizations, saving the lives of an estimated two to three million children each year.1

Immunization is one of the most cost-effective public health interventions available, providing savings from treating future illnesses with a $26 return for every $1 invested.2 Children who are fully immunized can thrive, stay in school, and contribute to the economic growth of their communities and countries.

Introducing and scaling up new vaccines for pneumococcal disease and rotavirus have had a profound impact on reducing childhood mortality and morbidity and freed up health care resources for other priorities in settings where resources are constrained.3 As the world nears the eradication of the wild poliovirus, further excitement about global immunization is rising with the potential development of new vaccines to prevent lethal respiratory virus infections, tuberculosis, malaria, HIV/AIDS, and several tropical diseases.

While low- and middle-income countries have made great strides over the past decade to increase the coverage and equity of immunization uptake, more work remains. In 2018, 20 million infants worldwide did not receive essential vaccines.4 Global progress has stalled over the last several years and, in some cases, declined. Outbreaks of previously controlled infectious diseases, like measles and diphtheria, are occurring in places where immunization coverage was once high.

In addition, disruptions in the delivery and uptake of immunization services caused by the COVID-19 pandemic further threaten vaccine coverage.5 Without dedicated attention to this growing challenge, the world risks losing the incredible progress made to date in expanding access to routine immunization.

Reaching Zero-Dose Children: Resources from MOMENTUM

Check out the latest resources from MOMENTUM on reaching zero-dose children with lifesaving vaccines when and where they need them, including research and analysis, country-specific resources, and interventions.

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MOMENTUM’s Approach

We strengthen country immunization programs as a central approach to reducing newborn and child deaths in USAID partner countries. We collaborate closely with ministries of health, global health leaders, and coordinating bodies—including Gavi, the Vaccine Alliance, the World Health Organization (WHO), the United Nations Children’s Fund, the U.S. Centers for Disease Control and Prevention, and the Bill & Melinda Gates Foundation—to amplify and complement their immunization investment in partner countries and advance global immunization policy priorities.

MOMENTUM focuses on:

  • Addressing obstacles that contribute to stagnating immunization among children who are unimmunized and underimmunized.
  • Adapting to an increasingly complex service delivery environment marked by new vaccines, more complicated vaccination schedules, and developing approaches to reach older populations.
  • Advancing country ownership and progress in achieving national goals for improving immunization coverage.
  • Contributing to the achievement of Gavi’s 2021-2025 vaccination strategy and the WHO Immunization Agenda 2030.

Build sustainable, routine immunization systems

MOMENTUM helps countries reinforce immunization as a critical pillar of primary health care that extends equitable access to life-saving vaccines. The approach to implementing routine immunization systems in each country varies by local need, but the goal is always to reach every child. We also help countries integrate immunization services with existing primary health care services, as studies demonstrate that the integration creates positive health outcomes.6

Raja brings her baby in for a measles vaccination.
Amy Folwer/USAID

Tailor immunization approaches based on context

MOMENTUM works closely with countries’ public health leaders, health and non-health stakeholders, and technical experts to review immunization and demographic data and use it to take action. Based on this analysis, countries can adapt their service delivery approaches to reach vulnerable children. These children include those who reside in rural areas or in growing, heavily populated, low-income urban neighborhoods or whose parents are seasonal laborers or members of a migratory population.

To expand the reach of the COVID-19 vaccine in the countries where we work, we are engaging country stakeholders in policy and service delivery to collaboratively create effective local solutions based on best practices. We support skills building in adaptive management to address barriers, mitigate their impact, and build country resiliency. To meet the unique needs of women and children in fragile settings who experience diminished access to primary health care, we work with countries to adapt their approaches, including conducting supplementary vaccination campaigns and responding to outbreaks of vaccine-preventable diseases.

Learn how MOMENTUM Routine Immunization Transformation and Equity has worked with local partners and governments to vaccinate people in seven countries against COVID-19.

Karen Kasmauski/MCSP

Contribute to global technical leadership and learning

MOMENTUM fosters policy dialogue and the sharing of best practices to increase equitable coverage of routine immunization and achieve global immunization goals. We plan to:

  • Provide technical input on developing evidence-based global policies, strategies, frameworks, and action plans; and collaborate closely with global, multilateral, and private sector organizations.
  • Generate new learning to address routine immunization knowledge gaps and apply it within and across countries.
  • Help shape global and regional dialogue around the most promising practices for immunization in different contexts.
  • Facilitate exchange and innovation to inform global policies.
A health worker prepares a vaccine in a health center in Igembe, Meru Kenya, 2016
Allan Gichigi/MCSP
Immunization in Focus Newsletter

Are you interested in receiving regular news, documents, and tools on routine immunization? MOMENTUM produces a quarterly immunization newsletter, Immunization in Focus, designed to keep busy public health professionals abreast of developments in the immunization world.

Sign Up here for the Immunization in Focus newsletter


  1. World Health Organization (WHO), “Children: Improving Survival and Well-Being,” Sept. 8, 2020,
  2. So Yoon Sim et al., “Return on Investment From Immunization Against 10 Pathogens in 94 Low- and Middle-Income Countries, 2011-30,” Health Affairs 39, no. 8 (2020),
  3. Frédéric Debellut et al., “Re-Evaluating the Potential Impact and Cost-Effectiveness of Rotavirus Vaccination in 73 Gavi Countries: A Modelling Study,” The Lancet Global Health 7, no. 12 (2019): e1664-74.
  4. WHO, “20 Million Children Miss Out on Lifesaving Measles, Diphtheria, and Tetanus Vaccines in 2018,” July 15, 2019,
  5. WHO, “WHO and UNICEF Warn of a Decline in Vaccinations During COVID-19,” July 15, 2020,
  6. HIP: Family Planning High Impact Practices,

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