Vaccine Delivery
QUICK FACTS ON IMMUNIZATION
Immunization improves lives and benefits communities—but not everyone can access it.
1.5 million
Universal immunization would save an additional 1.5 million lives around the world each year2
44x
Every dollar invested in immunization in low and lower-middle income countries yields $44 in benefits by preventing illness and increasing productivity3
86%
Worldwide, coverage rates for the essential diphtheria-tetanus-pertussis (DTP) vaccine—a global standard for measuring the effectiveness of an immunization system—have plateaued since 2010. In 2018, about 86% of infants received all three doses of the vaccine that they need before their first birthday1
Vaccine Delivery 101
Vaccine delivery is the process of getting vaccines to the people who need them. We measure success in vaccine delivery by monitoring vaccine coverage.
Vaccine coverage is the percentage of a vaccine’s target population that has been vaccinated. The target populations differ by vaccine, but they typically comprise those who are at greatest risk of contracting and transmitting a particular disease. Infants are vulnerable to more diseases than adults; consequently, they are typically the most important target population. To measure the effectiveness of an immunization system, coverage of the third dose of the DTP vaccine (DTP3) is often used. This DTP3 coverage is the percentage of infants in a community that receive all three recommended doses of the diphtheria, tetanus, and pertussis vaccine in their first year of life.)
As a community’s vaccine coverage rises, the risk for all members of the community, even those unable to be vaccinated, falls. And as infection rates decrease, the human and economic burden of disease is likewise reduced. This improves health and productivity for individuals and communities alike.
Vaccine coverage serves as an indicator of a health system’s ability to provide basic care to all. Looking more closely at coverage within communities can also reveal inequities in access to health services—due to wealth, education, or location, for instance. Since diseases continue to circulate among un- and under-vaccinated people and communities, these inequities have consequences for everyone.
Immunization is one of the most successful public health programs the world has ever seen: it reaches more children than any other intervention. And more children are being vaccinated each year than ever before. In 2018, 116 million infants received 3 doses of DTP, and 86% of children worldwide now receive the recommended three doses of DTP vaccine before their first birthday.1
But this is not enough. World Health Organization (WHO) member states have set a target of at least 90% DTP3 coverage in every country and at least 80% DTP3 coverage in every district. Still, one-third of all countries—mostly low- and lower middle–income ones—do not meet this national target. Even fewer countries meet the target for district-level DTP3 coverage. Only 35% of countries report reaching at least 80% of children in every district with three doses of DTP.1
These gaps mean that every year, nearly 20 million infants do not receive all three doses of DTP. The majority of these children live in Africa and Southeast Asia.
Furthermore, DTP is an important indicator, but it does not tell the whole story. Coverage with other, newer vaccines is increasing as more countries add them to their vaccination schedules and deliver them to their children—which means that more children worldwide are protected against more diseases than ever before .1
Nevertheless, these vaccines lag behind DTP in coverage, leaving millions of children unprotected against serious, often fatal diseases.
To achieve and sustain high vaccine coverage, countries and communities will need to make progress in multiple areas. These include:
- Building strong delivery systems
Health systems need the capacity to tailor delivery strategies to community needs and reach under-served populations. - Involving communities
Communities need to understand the value of vaccines and to see—and demand—them as an essential health service. - Sustaining coverage in spite of challenges and threats
Health systems must be resilient and adapt to changing contexts.
Vaccine delivery will continue to rely on the country investments and global enablers that have contributed to success to date. At the same time, increasing coverage rates and meeting national and global immunization targets will depend on innovation, learning, and knowledge sharing across the board.
Our Partners
The co-investigator team is drawn from the Emory University’s Rollins School of Public Health, School of Medicine, Goizueta School of Business, the Department of Political Science in the College of Arts & Sciences; Georgia Institute of Technology School of Industrial and Systems Engineering; University of Delaware School of Public Policy & Administration; and Yale University School of Medicine.
Learn More
ask an expert
Vaccine Delivery Exemplars
-
1
Global Vaccine Action Plan. Monitoring, evaluation & accountability 2019 report. Annex to the Global Vaccine Action Plan review and lessons learned report. Geneva: World Health Organization; 2019. https://www.who.int/immunization/global_vaccine_action_plan/GVAP_secretariat_report_2019.pdf?ua=1
-
2
Batson A, Bernson J, McIlvaine B, Digre P. Data innovations and insights: Novel approaches to using data to inform equity-related decision-making. Equity Reference Group for Immunization; 2018. https://drive.google.com/file/d/1gIuqmi2bOnQYDRM62F86aZ5ulg8lxjtL/view?usp=sharing
-
3
Ozawa S, Clark S, Portnoy A, Grewal S, Brenzel L, Walker DG. Return On Investment From Childhood Immunization In Low- And Middle-Income Countries, 2011-20. Health Aff (Millwood). 2016;35(2):199-207. DOI: 10.1377/hlthaff.2015.1086
-
4
World Health Organization. WHO recommendations for routine immunization - summary tables. https://www.who.int/immunization/policy/immunization_tables/en/
-
5
Vanderslott S, Dadonaite B, Roser M. Vaccination. Our World in Data Web site. https://ourworldindata.org/vaccination
-
6
Explorations of inequality: childhood immunization. Geneva: World Health Organization; 2018. https://apps.who.int/iris/bitstream/handle/10665/272864/9789241565615-eng.pdf?ua=1
-
7
Levine OS, Bloom DE, Cherian T, et al. The future of immunisation policy, implementation, and financing. Lancet. 2011;378(9789):439-448. DOI: 10.1016/S0140-6736(11)60406-6.
-
8
United Nations General Assembly. Transforming our world: the 2030 Agenda for Sustainable Development. Resolution adopted by the General Assembly on 25 September 2015. A/RES/70/12015. https://sustainabledevelopment.un.org/content/documents/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf
-
9
World Health Organization. Global Vaccine Action Plan 2011-2020. 2013. 978 92 4 150498 0. http://www.who.int/immunization/global_vaccine_action_plan/GVAP_doc_2011_2020/en/
-
10
World Health Organization. Immunization Agenda 2030: A Global Strategy to Leave No One Behind. https://www.who.int/immunization/immunization_agenda_2030/en/
-
11
Moeti M, Nandy R, Berkley S, Davis S, Levine O. No product, no program: The critical role of supply chains in closing the immunization gap. Vaccine. 2017;35(17):2101-2102. DOI: 10.1016/j.vaccine.2017.02.061.
-
12
Batson A, Bernson J, McIlvaine B, Digre P. Data innovations and insights: Novel approaches to using data to inform equity-related decision-making. Equity Reference Group for Immunization; 2018. https://drive.google.com/file/d/1gIuqmi2bOnQYDRM62F86aZ5ulg8lxjtL/view?usp=sharing [Accessed March 13, 2020].