Expert explainer: Strategies to improve childhood vaccination uptake

Protecting children is a shared responsibility, according to Meron Mengistu, a Ph.D. candidate in health and rehabilitation sciences. As a researcher at the University of Western Ontario, her work focuses on enhancing global childhood vaccination rates. Despite vaccine hesitancy and anti-vaccination movements, Mengistu's research, published in Discover Public Health, identifies multiple reasons why children may not receive vaccinations.

These include transportation issues, conflict zones, misinformation, and more. Childhood vaccination is crucial as it reduces disease spread and protects vulnerable individuals, such as those under 5 years old whose immune systems are still developing. Global coverage of the diphtheria-tetanus-pertussis (DTP-3) vaccine, a benchmark for childhood vaccination, stands at around 85% for infants aged 1 year.

However, 13.5 million children remain unvaccinated. Reasons for non-vaccination are varied and often interconnected. At the household level, caregivers may struggle with accessing services due to distance, costs, or work responsibilities. Community-level barriers include vaccine safety concerns, misinformation, and mistrust. Health facility-level issues may involve stockouts or understaffing, while broader health system factors like limited funding and underdeveloped infrastructure can also hinder vaccination efforts.

Strategies to improve vaccination uptake can be categorized into demand-level, service delivery-level, and system-level approaches. Demand-level strategies aim to influence caregivers and communities, while service delivery-level strategies focus on how and where vaccination services are provided. System-level strategies address broader health system factors, such as funding and infrastructure.

A successful multi-level strategy in Saskatoon involved telephone reminders and home-based MMR vaccination, resulting in a 7 percentage point increase in MMR immunization coverage.