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Vaccination coverage rates have stagnated in the past several years in many middle-income countries (MICs), especially in the UNICEF Middle East and North Africa region, with political and economic turmoil as contributing factors. This paper reviews country experiences with three under-utilized strategies aimed at increasing vaccination coverage and reducing disparities between socio-economic and geographic groups in MICs. These strategies include: (1) identifying and accounting for displaced, mobile and neglected populations; (2) assessing and addressing missed opportunities for vaccination, including by expanding immunization into the second year of life and beyond; and (3) engaging effectively with the private/nongovernmental health providers in the coordination, provision and reporting of immunization services. The examples focus primarily on quality data collection, analysis, use and reporting aspects of the strategies. While data are limited, there is evidence from MICs that each of these strategies can have a positive impact on vaccination coverage, especially among marginalized populations., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This supplement of Vaccine contains detailed descriptions of the experiences and processes of 15 well-established National Immunization Technical Advisory Committees from all regions of the world. All of these committees provide information to national governments that is used to make evidence-based decisions regarding vaccine and immunization policy. Nevertheless, many differences between committees exist including their legal basis, size and scope of committee membership, scope of work, role of the Ministry of Health on the committee, existence of conflict of interest policies, and ultimate role in the decision-making process. Individual country authors identified numerous areas for improvement and these are summarized here., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Face-to-face interviews and meetings with more than 160 policymakers and other influential professionals in seven large Asian countries (Bangladesh, China, India, Indonesia, Pakistan, Thailand and Vietnam) were conducted to survey opinions regarding the need for, and potential uses of new-generation vaccines against cholera, typhoid fever and shigellosis. Despite several barriers to their uptake--notably uncertainty of the burden of enteric diseases; preference for water, sanitation and other environmental improvements over vaccination for disease control; and high prices of the current vaccines relative to basic EPI vaccines, and their moderate protection levels--considerable interest was found in the targeted use of Vi typhoid vaccine in most countries, followed by (future) Shigella and oral cholera vaccines. The introduction of these vaccines in Asia could be greatly facilitated by country-specific evidence of disease burden, local or regional vaccine production, field studies demonstrating their safety and efficacy in local populations, evidence of potential economic savings from vaccination, and effective dissemination of research results to all those who make or influence immunization policy.

A survey of policymakers and other influential professionals in four southeast Asian countries (Cambodia, Indonesia, Philippines and Vietnam) was conducted to determine policymakers' views on the public health importance of dengue fever and dengue haemorrhagic fever (DHF), the need for a vaccine and the determinants influencing its potential introduction. The survey, which involved face-to-face interviews with policymakers, health programme managers, researchers, opinion leaders and other key informants, revealed an almost uniformly high level of concern about dengue fever/DHF and a high perceived need for a dengue vaccine. Several characteristics of the disease contribute to this high sense of priority, including its geographic spread, occurrence in outbreaks, the recurrent risk of infection each dengue season, its severity and the difficulty in diagnosis and management, its urban predominance, its burden on hospitals, and its economic toll on governments and families. Research felt to be key to future decision-making regarding dengue vaccine introduction include: disease surveillance studies, in-country vaccine trials or pilot projects, and studies on the economic burden of dengue and the cost-effectiveness of dengue vaccines. The results suggest favourable conditions for public and private sector markets for dengue vaccines and the need for creative financing strategies to ensure their accessibility to poor children in dengue-endemic countries.