Identifying characteristics that enable resilient immunisation programmes: a scoping review

Area of Science:

• Public Health
• Health Systems Research
• Epidemiology

Background:

• The COVID-19 pandemic exposed significant vulnerabilities in global immunization programs, resulting in decreased vaccination coverage and increased outbreaks of vaccine-preventable diseases.
• The need for robust and resilient immunization programs capable of functioning effectively during crises is paramount.
• Currently, no established framework exists for evaluating the resilience of immunization programs.

Purpose of the Study:

• To conduct a scoping review of immunization programs during crises to identify factors contributing to their resilience.
• To inform the development of an Immunisation Programme Resilience Tool.

Main Methods:

• A scoping review was conducted following the Arksey and O'Malley framework.
• Searches were performed across multiple databases (CINAHL, CENTRAL, Embase, Google Scholar, MEDLINE, PsycINFO, Web of Science) from January 2011 to September 2023.
• Thirty-seven empirical, peer-reviewed studies on immunization program resilience during crises were included and synthesized.

Main Results:

• Five core characteristics of resilient immunization programs were identified, drawing from the Health System Resilience Index: Integration, Awareness, Resource Availability and Access, Adaptiveness, and Self-regulation.
• The reviewed studies spanned six continents, with a notable concentration in Africa, Asia, and Europe.
• Several evidence gaps in the literature regarding immunization program resilience were identified.

Conclusions:

• No existing tool assesses immunization program resilience.
• The identified characteristics, derived from the Health System Resilience Index and empirical evidence, provide a foundation for developing a novel Immunisation Programme Resilience Tool.
• This tool could enhance the capacity of immunization programs to withstand and recover from various crises.