Immunization for All: Four Strategies That Make It Possible

A health care worker (left, in red) administers a vaccine to a child at a nursery school in Ashaiman, Ghana. Credit: JSI

The global community has made remarkable progress in immunization, but we have work to do to preserve and extend these advances. In honor of World Immunization Week 2025, we’re sharing key insights from JSI’s decades of highly successful immunization programs around the world. Here are four ways governments, organizations, and communities can advance global progress toward immunization for all.

Listen to communities

The most successful immunization initiatives share a fundamental approach: they begin by listening to what people say they need, and they’re designed with those needs at the forefront. Meaningful engagement with communities and local leaders is a key part of this process. In Nigeria, for instance, partnering with local clerics and community leaders has helped build community trust in the human papillomavirus (HPV) vaccination program and reach over 12 million girls with the HPV vaccine.

“One thing I’ve taken with me from working in routine immunization is what I gained from listening, observing, and taking notes and then looking at what the community is saying, what the state and the country wants, and using this to achieve what the global community wants,” said Paul Bassi Amos, country director of the HPV Vaccine Acceleration Program Partners Initiative (HAPPI) Consortium in Nigeria.

When programs proactively engage communities, they address real concerns. In Santa Clara County, California, JSI first conducted formative research with parents that led to the development of straightforward immunization messaging shared through a mix of advertising channels most likely to reach parents and caregivers.

“Most parents and caregivers want what is best for their children,” said Jessica Holli, senior communications advisor and campaign director. “By listening to people, answering their questions, and making vaccine services easy to access, people are more likely to let go of their vaccine hesitancy and make immunization a part of their family’s health care routine.”

Equip providers with resources

Health care providers can be trusted sources of immunization information for caregivers and communities, influencing decisions for vaccine uptake and use. Yet, many providers lack the necessary training and tools to discuss vaccination effectively with their communities across different life stages.

In India, when COVID-19 prevented in-person training for the pneumococcal conjugate vaccine launch, the new vaccine introduction team at JSI India developed animated training videos for health care workers in 14 languages. The files were small enough to download via the widely-used WhatsApp messaging app, even in areas with poor connectivity, and the dress and features of the animated characters were adapted to each region in India. This customization helped health care workers connect with the content, better preparing them to provide information and vaccination services.

“The customization may sound very trivial, but it makes a whole lot of difference,” said Arup Deb Roy, project director for New Vaccine Introduction, JSI India.

There is opportunity for health care providers to strengthen their roles in dispelling myths and misinformation. Providers also benefit from strengthened competencies in creating a mutually positive service experience. Equipping providers with resources for patient-centered conversations, which acknowledge concerns while providing accurate information, can increase uptake and use of immunization services.

Strengthen health systems

In many contexts, lower vaccination coverage stems from lack of available vaccines or inaccessible services rather than hesitancy. Government commitment is essential to financing vaccine programs, maintaining supply and distribution systems that support new and routine vaccinations, and making services accessible to everyone. Priorities should always evolve—for instance, in India and Nigeria, rural vaccination infrastructure is improving; however, urban and peri-urban areas also need more attention.

In Massachusetts during COVID-19 vaccine roll-out, travel, and ability to take time off to meet clinic hours posed barriers to getting vaccinated for many. Mass vaccination campaigns initially reached large numbers of people but data later revealed that some communities weren’t accessing vaccines.

“Very early on after the COVID vaccine was released in Massachusetts, we had these huge mass vaccination clinics which did a really good job getting a lot of people vaccinated in a very short period of time. But if you looked at the data of who got vaccinated, you would see that it was a very homogeneous group. So we had to reach people that couldn’t make the trip, and we did a really good job during COVID of bringing vaccines to people in their communities,” said Amy Sgueglia, project director for a Massachusetts project that focuses on mobile vaccination services.

Transform service delivery

While childhood vaccines within the first two years of life will always be critical, vaccination programs are expanding the focus beyond this age group to reach adolescents and adults. Gavi, the Vaccine Alliance aims to reach over 86 million girls with the HPV vaccine by the end of 2025. Progress toward this milestone has been accelerated by projects like the JSI-led HAPPI Consortium, which has provided technical assistance to 21 countries and helped vaccinate more than 22 million girls across Bangladesh, Indonesia, and Nigeria. Several factors contributed to make Gavi’s goal possible: accelerating introduction in multiple, large populations simultaneously, including dedicated financial and programmatic support; evidence-based policy changes enabling the switch from two- to single-dose schedules; and support for catch-up, multi-age cohort delivery of HPV vaccines for girls ages 9–18 years in selected countries.

The HPV vaccine is also changing the conversation around what routine immunization programs look like. Reaching adolescent girls requires different strategies than early childhood vaccination because girls access health care services differently and less frequently than young children. Vaccination services are often people’s main contact with primary health care services, creating valuable opportunities for ongoing engagement beyond childhood. Immunization must be considered essential preventative care throughout life, requiring appropriate infrastructure and sustainable funding at every age.

“With vaccine-preventable diseases, you are not safe until everybody is safe. It’s important to remind people of what immunization programs have achieved. There are some diseases which are eradicated, like smallpox, because of vaccines. We have polio, which we are about to eradicate. We have measles, which has been eliminated in many countries. All those achievements are because of vaccines. So I think we need to emphasize this while we are moving forward,” said Nassor Mohamed, project director for Choice Optimization for Immunization: Country Exercises in Sustainability (CHOICES) 2.0.

We’ve already shown what is humanly possible with vaccines. With meaningful conversations, well-resourced systems, and widely accessible services, we can ensure immunization is available for all.