This newsletter edition is available in English, Portuguese, Spanish, and Russian.
Keep reading below for critical resources and to uncover key insights for addressing vaccine hesitancy and misinformation, successfully introducing the HPV vaccine, costing of interventions to reach zero-dose children, and more.
First, we have two newly published country case studies that center the importance and value of collaborative peer-to-peer learning interventions and illustrate how Linked has fostered innovations that strengthen national immunisation programs in Indonesia and Tunisia.
Get caught up with relevant Linked resources to strengthen your national immunisation program with our updated brief that features the 15 new resources produced in 2024. These resources include 4 practitioner perspective video interviews, 4 briefs,1 blog, and materials from 4 workshops and 2 webinars.
We’re also thrilled to share this new video that spotlights experiences from Linked countries. Please watch to learn more about how Linked has advanced country progress towards strong and sustainable national immunisation programs.
This newsletter edition also includes relevant and timely literature, guidance, case studies, and other tools to strengthen HPV vaccine introduction, engage the private sector, address vaccine hesitancy and misinformation, cost interventions and innovative strategies to reach zero-dose children, and more. Of particular interest is a special issue of Vaccine that focuses on innovations and challenges in introducing and implementing the introduction of the HPV vaccine with topics ranging from data-driven decision-making, health care worker communication, and workforce training.
Warm regards,
Elizabeth Ohadi, Program Director, Linked Immunisation Action Network
Network Updates
Linked Country Case Study: Strengthening Indonesia’s National Immunisation Program
Linked has supported Indonesia in addressing critical immunisation challenges through peer-to-peer learning and tailored interventions. Learning from Australia’s Electronic Immunisation Registry (EIR), Indonesia developed an e-notification system via WhatsApp and Satu Sehat mobile, enhancing data-driven targeting of zero-dose children. A subnational peer-learning network connected districts to share strategies, leading to innovations like cost-saving community workshops and improved data validation. These efforts underscore the value of adapting peer-tested strategies, integrating technology for real-time monitoring, and fostering decentralized collaboration to strengthen equity and sustainability.
Linked Country Case Study: Strengthening Tunisia’s HPV Vaccine Introduction
Linked played a pivotal role in supporting Tunisia’s HPV vaccine introduction by leveraging peer-to-peer learning and cross-regional collaboration. Tunisia joined the network in 2023 during critical preparations for its school-based HPV rollout targeting 12-year-old girls. Participation in workshops, including a learning engagement in Istanbul with peers like the Philippines and Mongolia, provided reassurance and practical insights into implementation strategies. Key refinements to Tunisia’s plan included integrating religious leaders into communication efforts to address hesitancy—a lesson drawn from Jordan and Uzbekistan’s experiences. Cross-regional engagements exposed Tunisia to diverse approaches, fostering innovation beyond regional norms and validating decisions like grade-based targeting over age-based cohorts.
Catch up on relevant Linked resources in updated brief that features 15 new resources
An updated brief of Linked resources, including those developed through the end of 2024, captures lessons learned and good practices identified through Linked learning engagements with topics ranging from increasing access to key missing vaccines, strengthening human resource capacity, and strengthening delivery of immunisation through PHC platforms, among others. We encourage immunisation stakeholders to draw upon these resources to learn about how other countries are addressing critical barriers and apply them to their own programs to work towards sustainable and equitable vaccine coverage.
New video spotlights Linked’s impact on country progress towards strong, sustainable immunisation programs
Curious to learn more about how Linked has advanced country progress towards strong and sustainable national immunisation programs? Our new video spotlights experiences from countries who have participated in collaborative peer-to-peer learning engagements and how they have applied the practical lessons and innovative strategies to improve immunisation program performance.
Featured News & Resources
HPV introduction and implementation: Case studies from Africa and South Asia
This special issue of Vaccine focuses on innovations and challenges in introducing and implementing the introduction of the HPV vaccine. Several articles highlight the importance of data-driven decision-making, health care worker communication, supply chain resilience, and workforce training to improve program efficiency. The issue also emphasizes the need for multi-sectoral collaboration and community engagement to sustain high vaccination coverage. Read it here.
Dynamics and triggers of misinformation on vaccines
A study published in PLOS ONE highlights the impact of community engagement on improving immunisation coverage in low- and middle-income countries (LMICs). The research emphasizes that involving local leaders, healthcare workers, and community members in vaccine awareness campaigns significantly increases vaccine uptake. The findings underscore the importance of integrating community-driven approaches into national immunisation programs to achieve equitable and sustainable coverage. Review the findings here.
Trust in scientists and their role in society across 68 countries
A study in Nature Human Behaviour explores the role of behavioral science in addressing vaccine hesitancy and improving immunisation rates. The research identifies key psychological and social factors influencing vaccine decisions, such as trust in institutions, risk perception, and social norms. It highlights the effectiveness of interventions like tailored messaging, nudges, and leveraging social influencers to encourage vaccine uptake. Examine the findings here.
Health and economic implications of adopting a 1-dose 9-valent human papillomavirus vaccination program in adolescents in LMICs: An analysis of Indonesia
A study in PLOS ONE evaluates the feasibility and impact of a single-dose 9-valent HPV vaccination program in Indonesia, focusing on its potential to reduce cervical cancer rates. The research highlights that a single-dose regimen is cost-effective, logistically simpler, and more accessible, particularly in low-resource settings. The findings suggest that adopting a single-dose strategy could accelerate HPV vaccine rollout and improve equity in immunisation programs. Explore the full study here.
Socioeconomic-related inequities in child immunisation: horizontal and vertical dimensions for policy insights
A study in Health Economics Review investigates the economic and equity impacts of expanding immunisation programs in low- and middle-income countries (LMICs), focusing on the cost-effectiveness of introducing new vaccines. The research highlights that while scaling up immunisation efforts requires significant investment, the long-term benefits—such as reduced disease burden, healthcare savings, and improved productivity—justify the costs. The study also emphasizes the importance of addressing equity gaps to ensure that vulnerable populations have access to vaccines. View the study here.
Private sector engagement for immunisation programs: a pragmatic scoping review of 25 years of evidence on good practice in low-income and middle-income countries
A study in BMJ Global Health explores the role of private sector engagement in strengthening immunisation programs in low- and middle-income countries (LMICs). The research highlights that partnerships with private healthcare providers, pharmacies, and businesses can expand vaccine access, improve service delivery, and increase coverage. Key strategies include leveraging private sector infrastructure, integrating public-private data systems, and fostering collaborative financing models. Discover more insights here.
Scoping Review of Current Costing Literature on Interventions to Reach Zero-Dose Children in Low- and Middle-Income Countries
A study in Vaccines analyzes the costs and effectiveness of interventions aimed at reaching zero-dose children—those who have not received any routine vaccinations—in low- and middle-income countries (LMICs). The research evaluates strategies such as mobile outreach, community engagement, and health system strengthening, highlighting their cost-effectiveness in improving immunisation coverage. The findings suggest that tailored, context-specific interventions are essential for reaching underserved populations and reducing inequities. Review all the findings here.
Zero-Dose Learning Hub: Key resources produced on advancing equity through evidence
In 2024, the Zero-Dose Learning Hub (ZDLH) published more than 40 resources to inform policy, guidance, and programming for achieving universal vaccine coverage and ensuring no child is left behind with life-saving vaccines. From practical toolkits designed to support researchers to in-depth political economy assessments that explore the barriers to immunisation to peer-reviewed journal articles, explore the ZDLH’s top publications from the year here.
Country Spotlights
New curriculum key to strengthening immunisation services in Azerbaijan
A new curriculum has been introduced in Azerbaijan to strengthen immunisation services by enhancing the skills and knowledge of healthcare workers. Developed with WHO support, the training focuses on vaccine safety, cold chain management, and communication strategies to address vaccine hesitancy. Explore more about this initiative that aims to improve immunisation coverage and ensure equitable access to vaccines here.
A family affair: Traversing the seas to bring vital immunisations to island communities
In Indonesia, healthcare workers are traveling by boat to deliver essential immunisations to remote island communities, ensuring no one is left behind. This initiative, supported by WHO, focuses on reaching underserved populations with vaccines and health education to combat preventable diseases. Read about the innovative strategies they’re using to achieve equitable immunisation coverage here.
External Events
Reaching Zero-Dose Children: Urban immunisation
Communities missed by immunisation in urban areas tend to be marginalized and often lack access to any other basic services. Although overall routine coverage is higher in urban environments, this percentage masks the high number of zero-dose children that may reside in a city but are not undocumented or unregistered with the health system. This webinar unpacked strategies used to reach underimmunised children in cities and discuss key challenges.
- The presentation slides of this webinar session are available here.
- The recording of this webinar session is also available in French.
Reaching Zero-Dose Children: Human Resources for missed communities
Well trained and motivated human resources for health (HRH) is fundamental for good quality immunisation services. Many countries struggle with HRH challenges including low pay, lack of incentives for staff to work in remote and insecure areas, weak supportive supervision, lack of career paths, and structural gender barriers in the health system. This webinar built an understanding of how health workers can be supported and motivated to reach zero-dose children and build stronger primary health care systems.
- The presentation slides of this webinar session are available here.
- The video recording of this webinar session is also available in French.
Digital transformation journey of the national immunisation information system in Viet Nam
Digital health innovations are changing the way health is delivered worldwide, improving the health equity and accessibility, and accelerating the overall global attainment of health. The Viet Nam National Immunisation Information System (NIIS) has proven to stand the test of time and adversity throughout the 12-year journey of digital transformation from the paper-based system. In this webinar, PATH shared experiences and lessons learned on EIR implementation in Viet Nam focusing on the phases of nationwide scale-up and paperless transition. The presentation slides of this webinar session are available here.