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

Immunization

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.

The introduction and scale up of new vaccines for pneumococcal disease and rotavirus have had a profound impact on reducing childhood mortality and morbidity, as well as freeing up health care resources for other priorities in settings where resources are constrained.3 As the world nears eradication of the wild polio virus, 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 to be done. In 2018, 20 million infants worldwide did not receive essential vaccines.4 Global progress on immunization 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.

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 applies lessons learned and best practices from USAID’s 30-plus years of global leadership in strengthening routine immunization. USAID is a foundational supporter of Gavi’s work, including the introduction of new and underutilized vaccines and global polio eradication, among other achievements.

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.
Coverage

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
Access

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, such as those in rural areas or whose parents are seasonal laborers, members of a migratory population, or who reside in growing, heavily populated, low-income urban neighborhoods.

We plan to engage country stakeholders in policy and service delivery to collaboratively create effective local solutions based on best practices. We will support skills building in adaptive management to address emerging issues such as COVID-19, 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 will work with countries to adapt their approach to immunization, including conducting supplementary vaccination campaigns and responding to outbreaks of vaccine-preventable diseases.

Karen Kasmauski/MCSP
Leadership

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 the development of 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

References

  1. World Health Organization (WHO), “Children: Improving Survival and Well-Being,” Sept. 8, 2020, https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality.
  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),
    https://doi.org/10.1377/hlthaff.2020.00103.
  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, https://www.who.int/news-room/detail/15-07-2019-20-million-children-miss-out-on-lifesaving-measles-diphtheria-and-tetanus-vaccines-in-2018.
  5. WHO, “WHO and UNICEF Warn of a Decline in Vaccinations During COVID-19,” July 15, 2020, https://www.who.int/news-room/detail/15-07-2020-who-and-unicef-warn-of-a-decline-in-vaccinations-during-covid-19.
  6. HIP: Family Planning High Impact Practices, http://www.fphighimpactpractices.org/.

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