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The COVID-19 pandemic revealed weaknesses in vaccination programs, leading to reduced vaccination rates and disease outbreaks. This study identifies key characteristics of resilient immunization programs to inform the development of a new assessment tool.

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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.