title: Strengthening routine immunization systems to improve global vaccination coverage.
abstract: BACKGROUND
  Global coverage with the third dose of diphtheria-tetanus-pertussis vaccine among children under 1 year of age stagnated at ∼ 83-84% during 2008-13.
  
  
  METHODS
  Annual World Health Organization and UNICEF-derived national vaccination coverage estimates.
  
  
  RESULTS
  Incomplete vaccination is associated with poor socioeconomic status, lower education, non-use of maternal-child health services, living in conflict-affected areas, missed immunization opportunities and cancelled vaccination sessions.
  
  
  RESULTS
  Vaccination platforms must expand to include older ages including the second year of life. Immunization programmes, including eradication and elimination initiatives such as those for polio and measles, must integrate within the broader health system.
  
  
  CONCLUSIONS
  The Global Vaccine Action Plan (GVAP) 2011-20 is a framework for strengthening immunization systems, emphasizing country ownership, shared responsibility, equity, integration, sustainability and innovation.
  
  
  CONCLUSIONS
  Immunization programmes should identify, monitor and evaluate gaps and interventions within the GVAP framework.
authors: Global Immunization Division, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, MS A-04, Atlanta, GA 30333, USA ssodha@cdc.gov.
authors: S V
authors: SV
authors: Sodha
authors: Global Immunization Division, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, MS A-04, Atlanta, GA 30333, USA.
authors: V
authors: V
authors: Dietz
mesh_terms: D003906:Developing Countries; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000600:supply & distribution; D004522:Educational Status; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007223:Infant; D000068101:Maternal-Child Health Services / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D012959:Socioeconomic Factors; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine
keywords: Expanded Programme on Immunization; global health; immunization; routine immunization; vaccination; vaccination coverage
references: Rural Remote Health. 2009 Apr-Jun;9(2):1045
references: 19368489
references: East Mediterr Health J. 2011 Nov;17(11):804-12
references: 22276486
references: Vaccine. 2012 Mar 28;30(15):2551-5
references: 22326777
references: Bull World Health Organ. 2008 Mar;86(3):A-B
references: 18368190
references: Bull World Health Organ. 2009 Jul;87(7):535-41
references: 19649368
references: J Infect Dis. 2014 Nov 1;210 Suppl 1:S514-22
references: 25316875
references: J Public Health (Oxf). 2010 Mar;32(1):18-25
references: 19542268
references: Vaccine. 2014 Apr 17;32(19):2150-9
references: 24598724
references: Trop Med Int Health. 2009 Jan;14(1):11-9
references: 19017307
references: J Acquir Immune Defic Syndr. 2013 May 1;63(1):e9-e15
references: 23406977
references: Br Med Bull. 1998;54(2):445-61
references: 9830209
references: PLoS Med. 2013;10(5):e1001404
references: 23667334
references: Vaccine. 2011 Dec 30;29 Suppl 4:D74-9
references: 22486980
references: Trop Med Int Health. 2012 Jun;17(6):697-710
references: 22943300
references: Vaccine. 2011 Mar 21;29(14):2555-60
references: 21300101
references: Food Nutr Bull. 2010 Sep;31(3 Suppl):S248-63
references: 21049845
references: J Infect Dis. 2012 Mar;205 Suppl 1:S20-7
references: 22315382
references: J Infect Dis. 2014 Nov 1;210 Suppl 1:S5-15
references: 25316873
references: MMWR Morb Mortal Wkly Rep. 2014 Nov 21;63(46):1055-8
references: 25412062
references: J Acquir Immune Defic Syndr. 2014 May 1;66(1):e8-e14
references: 24326602
references: J Infect Dis. 2012 Mar;205 Suppl 1:S6-19
references: 22315388
references: BMC Int Health Hum Rights. 2009 Oct 14;9 Suppl 1:S2
references: 19828060
references: Lancet. 2014 May 17;383(9930):1697-8
references: 24835603
references: MMWR Morb Mortal Wkly Rep. 2014 Oct 3;63(39):867-72
references: 25275332
references: J Infect Dis. 2012 Mar;205 Suppl 1:S49-55
references: 22315386
references: N Engl J Med. 2014 Oct 16;371(16):1481-95
references: 25244186
references: Vaccine. 2011 Oct 26;29(46):8215-21
references: 21893149
references: J Infect Dis. 2012 Mar;205 Suppl 1:S65-76
references: 22315389
references: J Infect Dis. 2012 Mar;205 Suppl 1:S28-39
references: 22315383
references: Int J Health Serv. 1997;27(4):767-90
references: 9399118
references: Int Health. 2012 Dec;4(4):229-38
references: 24029668
references: J Infect Dis. 2014 Nov 1;210 Suppl 1:S498-503
references: 25316872