In August 2023, Economist Impact’s The Vaccine Ecosystem launched the Immunisation Readiness Index, which measures the enabling environment for equitable and sustainable immunisation of 30 countries. The tool assesses policies, strategies, and actions that facilitate routine and emergency vaccination programmes; 50 indicators are considered within 6 domains to consider both “readiness to respond” and ways to improve and maintain immunisation programmes. Here we look at some highlights from the report.

The Vaccine Ecosystem: a quick recap 

As we have previously explored, The Vaccine Ecosystem Initiative is an attempt to “promote a sustainable vaccine ecosystem” through an examination and reimagination of the “elements critical for vaccine development, deployment, and adoption”. It comprises 5 pillars: 

  • Research and Development 
  • Manufacturing 
  • Procurement, pricing, and financing 
  • Distribution, logistics, and supply chain management 
  • User acceptance and uptake 

When we spoke to David Humphreys at the Congress in April, he kindly explained a bit about the intention behind this initiative, which stems from a “really basic premise”. He suggested that during the pandemic, two opportunities arose: the first was the educative potential of the largest global rollout of vaccines in history, and the second a more forward-looking view. 

“How can we galvanise people across the ecosystem to drive vaccines for the future.”  

From this point, the Index comes with a key question: 

“What leverage do I have at my disposal to be able to immunise the people with the right type of vaccine at the right moment?” 
Immunisation Readiness: the report 

To see the full report, click here to download it from Economist Impact’s website.  

The report begins with a foreword by Professor Nigel Lightfoot, in which he describes vaccines as the “cornerstone of public health measures to prevent and control infectious diseases”.  

“[Vaccines] are unique in delivery health benefits to individuals, communities, populations, and society in general, and help provide a stable platform for economic development and prosperity.”  

Despite the success of various vaccination efforts in disease eradication and control, Professor Lightfoot recognises the drop in coverage over recent years. 

“No one will be safe until everyone is safe.”  

The Index presents several domains, and Professor Lightfoot states that “without successful implementation of the actions contained within these domains, vaccines will not be available to populations at a local level”. The first four domains consider the policies and processes involved in the development of a national approach to getting vaccinations to a country’s population. Domain 5 explores the importance of building public trust in vaccines and ensuring that all members of the population are reached. The final domain represents the governance and societal context, with insight offered to the other domains but not separately analysed in the report.  

  1. Planning 
  2. Regulation 
  3. Procurement 
  4. Delivery 
  5. Outreach 
  6. Society 
Readiness rankings and recommendations 

Of the 30 countries included, none made it into “Tier 1”, considered “most ready”, for the overall rankings. The Index “clearly” shows that the countries studied have “room to improve”. The report concludes with a summary of collective performance, highlighting that there were strengths as well as areas for development.  

All countries in the Index “recognised the importance of planning”, demonstrated by good performance in the first domain. However, national immunisation plans and strategies could be strengthened to address “routine endemic diseases” alongside emerging threats.  

“Mechanisms for coordinating, monitoring and evaluating vaccine availability and promoting population-wide immunisation must be part of the national approach, and planning and coordination must be equitable, far-sighted and regularly evaluated, and flexible enough to accommodate emerging needs.” 

For the second domain, regulation, all countries were found to have regulatory authorisation mechanisms to approve new vaccines, but streamlining data sharing would enhance the speed and accuracy of information dissemination and assessment. For domain three, “more can also be done” to prioritise mechanisms for vaccine procurement.  

“National immunisation plans and strategies often overlook the inclusion of forecasting and dedicated budgets, but good forecasting is critical for all downstream planning, budgeting, and operationalisation. No plan can be operation unless it has a dedicated source of funding.”  

The experts suggest that a 5-year forecast is the minimum time frame for adequate planning to protect public health from disease.  The fourth domain indicates that “better operationalisation of national immunisation strategies improves readiness” by ensuring a country’s physical and health infrastructure is resilient.  

“National plans for delivering immunisations are of little value unless they can be properly utilised and adapted to meet specific needs.”  

The need to prioritise investment in programmes and systems that “optimise public acceptance and uptake of vaccinations” by addressing health literacy, vaccine hesitancy, mistrust, or other concerns is considered in the fifth domain. Here, the importance of “culturally appropriate” outreach is emphasised, with the role of “trusted leadership” made clear.  

“Overall, the Index has highlighted the need to build stronger partnerships and involve a broader range of stakeholders, such as forging alliances between ministries of health and public health, finance, social services and education, health professionals, and cross-sector leaders at community, national, and international levels.” 

Where does your country rank in the Index if it was part of the analysis, and if not, how might it shape up? Do you think this provides a useful insight into immunisation readiness? For more on public health and immunisation strategies, don’t forget to subscribe to our weekly newsletter.