Table 2.

Cross-comparison of significant factors of immunization (stakeholder-wise).

Stakeholders →	Grass rootworkers (Asha, VHN, ANM, etc.)	Health Officers (CHO, MO, DHO, etc.)	Admins (DDM, Establishment Officer, State Coordinator, etc.)	Partners and Community Leaders (NGO, Sarpanch, Gram Sevak, etc.)
Factor ↓
Top-level management	The administrative support was satisfactorily provided, including timely assistance and guidance. There was legal and technical assistance and training, including guidelines to access and manage data in the CoWIN portal.	Health officers were prompt enough to monitor, supervise and evaluate the program. They also identified and selected the regions for the vaccination program. They also ensured a regular supply of the required vaccines and other medical equipment.	Administrative support was adequately available to facilitate the vaccination program. The required clearances were fast-tracked, and necessary approvals were timely made. All the procurements were done under NHM (National Health Mission).	NGOs and community leaders actively mobilized the beneficiaries for participation in the immunization program. They had a more significant impact on the local population.
Coordination, Planning, & Execution	Their main task was to identify regions and sites for conducting vaccination programs. The grass root workers also prepared the list of beneficiaries. The other essential task was to enter the data and make registrations. Daily reporting of the number of vaccinated people was another important objective.	A typical communication platform (WhatsApp and Phone calls) seamlessly transferred knowledge. Teams were formed, keeping the strength of the beneficiaries in mind. The sessions were planned and scheduled according to the availability of the beneficiaries. Session planning and scheduling There were regular reviews of the status of vaccination campaigns. A review of vaccination coverage was also conducted simultaneously.	The initiation of the campaign in select regions based on vaccination coverage was well-planned and coordinated. Assigning of the blocks and respective health officers for vaccination through MMUs was also conducted. Facilitated the immunization program diligently.	NGOs like ‘Give India’ ensured there was enough funding for the execution of the vaccination program effectively. NGOs supported the mobilization of the beneficiaries. There was the active involvement of the NGOs in community engagement. They helped in motivating the local population to get themselves vaccinated.
Challenges	The major challenge revolved around vaccine hesitancy. Immobilization was highly prevalent. Health illiteracy among the local population was also one of the critical reasons for the lower vaccination rate initially. Rumors regarding the ill effects of the vaccination were considered one of the significant reasons. Since the transportation service in the local areas could be more robust, leading to a lower vaccination rate.	There were issues related to the infrastructure. One of the major issues revolved around the technical glitch. At times there was a lack of assessing the vaccination program. Sometimes it was observed that there needed to be more appropriate preparation for IEC.	Specific infrastructural issues acted as a significant challenge during the vaccination program. However, most challenges were handled diligently, and due arrangements were made to combat the infrastructural challenge. For example- the supply chain and logistics were well coordinated.	The crucial challenges revolved around the immobilization of the beneficiaries. There were substantial efforts to eradicate the rumors about the side effects of vaccination. Especially in rural areas, such rumors were widespread because the decision to get vaccinated was delayed.
Impact	The grass root workers significantly impacted the reachability of the vaccination program. Since they knew the local demographics, it helped in reaching the beneficiaries.	The health officers significantly impact greater reachability, a higher vaccine uptake, and broader immunization coverage.	It immensely impacted reachability, and they ensured that the unreachable was reached. The immunization coverage was increased, leading to a successful vaccination program.	The vaccine uptake was increased with the involvement of the community as the local population was more comfortable with them. Overall, community engagement was increased, and a higher number of people were vaccinated.
Strategic views	As the vaccination program grows, more support is required in terms of the number of support staff and MMUs, especially for the coverage of school-going children. With the aid of ASHA and ANM workers, vaccination programs can have greater penetration in the interiors.	The program can be replicated in other states with similar actions but requires thorough training before moving to primary healthcare. Primary healthcare requires a higher level of expertise since children are involved.	The model can also be scaled up by engaging MMUs in other states. This program can be replicated according to the demographics of the concerned states. Regarding routine immunization, already a standard system is well in place. Therefore no primary need is felt for another program to be executed.	It will benefit a more extensive set of populations if implemented nationwide. The model has the potential to conduct primary healthcare as well. As it was observed that health workers during the vaccination program were reaching the door-step, if a similar door-to-door primary healthcare is conducted, more children will be vaccinated.