Table 1.

Summary of Strategic Approaches, Challenges, and Lessons Learned.

	Alliances	Contributions	Challenges Encountered	Lessons Learned
Colombia: Multi-level Partnerships for Pro-Equity Capacity Building	PAHO (regional), MOH and EPI (national), and Departmental EPI Directors (subnational)	-Capacity building and technical training for the measurement, analysis, and monitoring social inequalities impacting immunization -Innovative equity tools and resources	-Scarcity of adequately trained local-level personnel -Insufficient political commitment at the municipal and district-levels -Insufficient vaccination capacity in some areas, including inadequate provider networks, poor compliance, and a shortage of vaccinators	-Need for ensuring technical capacity and data use at the district and municipal levels through training activities and steady multi-level support -Importance of sensitizing subnational decision-makers and funders to the value of monitoring immunization inequalities to secure political commitment
	Departmental EPIs and community leaders and stakeholders	-Collaborative planning of vaccination activities and outreach brigades -Improved community vaccine sensitization and acceptance
Guyana: Intersectoral Collaboration and Community Partnerships to Strengthen Emergency Response	Inter-Agency Coordinating Committee on Immunization and Multi-Agency Coordinating Committee for Addressing the Influx of Migrants	-Integrated approach and coordinated response to addressing VPD risks and migrant needs -Intersectoral data sharing and streamlined knowledge database -Multi-level engagement with key stakeholders and potential collaborators	-Access and outreach to border communities and migrant points of entry as well as cold-chain maintenance were challenged by time-consuming travel, difficult-to-navigate terrain, and weather-related complications -Competing demands on limited healthcare personnel -Linguistic barriers associated with migrants and Amerindian populations	-Optimizing limited resources and effectively targeting vulnerable areas and high-risk populations requires data-driven decision-making, for which intersectoral data sharing is crucial -Integrating emergency response activities with the existing EPI structure leverages established data practices, distribution networks, outreach programming, and health care personnel -Intersectoral collaboration and community partnerships is crucial for comprehensive emergency response as public health impacts all sectors
	Border Personnel, including immigration officers, local law enforcement, army personnel, and port authority	-Standardization of migrant registration and immunization verification procedures -Establishment of migrant health referral practices -Verification of immunization status of high-risk border personnel
	Amerindian Village Councils and toshaos	-Data sharing, including local documentation of VPD-related symptoms and migrant entry patterns in their communities -Stakeholder-led vaccination promotion and sensitization -Collaborative coordination of mop-up visits, linguistic support, and help with vaccination follow-up
Bolivia: Promoting Vaccine Access and Uptake through Intersectoral Collaboration and Civil Society Participation	Education sector, including individual schools and personnel	-Survey of all active educational units -School-based student census data -Collaborative campaign planning, including coordination of parental orientation sessions -Identification and outreach to vaccine-eligible students absent on campaign days	-Determination of denominators for school-based vaccination with outdated, national census data -Growing misinformation about vaccine safety and effectiveness, especially on social media, generating confusion and vaccine hesitancy	-School-based campaigns reduce barriers to vaccination access and decrease vaccinator burden -Multi-level, intersectoral data sharing supports more accurate campaign planning and monitoring -Educating and empowering community leaders and stakeholders reinforce EPI efforts to inform the public, counter misinformation, and alleviate vaccine hesitancy
	School Board Association and other civil society organizations	-Collaborative campaign planning, including coordination of parental orientation sessions and social mobilization strategies -Peer-to-peer and community-based vaccine promotion and sensitization -Identification and outreach to vaccine-eligible individuals absent on campaign days and/or not enrolled in school
	Local media	-Expanded reach of EPI messaging -Publicization of immunization experts to notify the public regarding ESAVIs