Table 1.
Key Best Practices for New Vaccine Introductions (NVIs) Identified During Inactivated Polio Vaccine Introduction
| Key Step for NVI | Global | National | Best Practice Identified |
|---|---|---|---|
| Decision-making | X | Global policies on cofinancing and conditionality are effective tools to incentivize countries to introduce vaccines in alignment with global targets | |
| X | Sharing evidence globally from early NVI–adopting countries can reduce other countries’ concerns and facilitate NVI decision-making | ||
| Planning and project management of the introduction | X | Weekly NVI TWGs with clear terms of reference are critical in providing oversight, accountability, and momentum for NVI | |
| X | Robust project management systems should plan for front-loading of critical activities and include a weekly review of progress against project schedule | ||
| X | Strong coordination with subnational stakeholders can leverage innovative means of communication, such as WhatsApp and weekly teleconferences | ||
| Preparing the supply and cold chain | X | When faced with global antigen shortages, tiering of countries on the basis of risk allows for transparent, rational supply prioritization | |
| X | Notifying countries of likely supply delays before they are confirmed enables EPIs to build stronger contingency plans, minimizing costs and further delays | ||
| X | Prioritizing multiyear cold chain planning and building robust repair and maintenance systems averts the risk of vaccine damage | ||
| X | Partner coordination forums that link global and country levels are useful, to agree on mitigation activities when crises arise | ||
| Financing the introduction | X | The marginal impact of each NVI on operational costs (eg, HCW time and cold chain) needs to be carefully analyzed to avoid compromising the quality of service delivery | |
| X | MoHs should budget introduction funds such that the activities that need to happen early (eg, printing and national training) are not dependent on VIG release | ||
| X | Transparency on VIG delays allows countries to take mitigating action, such as seeking prefinancing from other partners | ||
| X | Countries need to smoothen the often lengthy in-country VIG release process or set a realistic launch date that factors usual national disbursement timelines | ||
| X | Communication of global partners’ policies should be enhanced so that EPIs are aware of all requirements related to fund use | ||
| Launching the vaccine and postintroduction tracking | X | NVI administration should not be held up because of official ceremonies | |
| X | Early postlaunch assessments (<2 months after vaccine rollout) allow EPIs to quickly identify and mitigate bottlenecks to vaccine uptake | ||
| X | Subnational operation rooms can allow each region to conduct regular spot-checks and coordinate corrective activities | ||
| X | Close monitoring of stock levels and enforcement of eligibility policies in-country ensure that the vaccine is available for the target cohort | ||
| X | Postintroduction tracking needs to continue until target coverage is reached, to ensure that the NVI is fully integrated into the RI system | ||
| Integrating the NVI within RI system | X | Countries should monitor the existing health system to ensure that there is no negative impact from NVIs and that opportunities for improvements through NVI activities are leveraged | |
| X | EPI teams should adapt good NVI program management practices (eg, creation of operation rooms) to accomplish other immunization goals |
Abbreviations: EPI, expanded program on immunization; HCW, healthcare worker; MoH, ministry of health; RI, routine immunization; TWG, technical working group; VIG, vaccine introduction grant.