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Vaccines
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Strategies and Innovations to Recover Post-Pandemic Losses in Routine Immunization...
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Strategies and Innovations to Recover Post-Pandemic Losses in Routine Immunization Coverage

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Vaccines and Public Health".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 3399

Special Issue Editor

Dr. Noha H. Farag

E-Mail
Guest Editor
1. U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
2. U.S. Centers for Disease Control and Prevention, Middle East and North Africa Regional Office, Muscat, Oman
Interests: polio; vaccine; vaccine preventable diseases prevention and response

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic disrupted routine immunization programs worldwide, leading to declines in vaccination coverage and an increased vulnerability to vaccine-preventable diseases. Post-pandemic efforts to improve coverage have progressed; however, we are still significantly below pre-pandemic vaccination levels. This Special Issue focuses on strategies and collaborative efforts to enhance routine immunization coverage. Our goal is to provide countries and stakeholders with evidence-based practices and lessons learned to prevent outbreaks of vaccine-preventable diseases and to meet immunization goals. We welcome original research articles and reviews for this Special Issue. Research areas may include (but are not limited to) the following:

  • Innovative approaches to catch-up vaccination;
  • Community engagement and communication strategies to increase vaccine demand and uptake;
  • Policy and funding mechanisms to support immunization recovery;
  • Technological innovations in vaccine delivery and monitoring.

Thank you for your continued commitment to improving immunization coverage.

We look forward to receiving your contributions.

Dr. Noha H. Farag
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccines
  • immunization
  • pandemic
  • vaccine preventable diseases
  • interventions

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

16 pages, 251 KB  
Article
A Scalable Polio-EPI Synergy Model for Urban Immunization: Coverage Gains Following Workforce Integration in Lahore, Pakistan
by Imtiaz Hussain, Naeem Majeed, Ali Jan Khan, Ahmad Khan, Muhammad Umer, Uzair Ansari, Zara Ansari, Hamza Fawad and Sajid Bashir Soofi
Vaccines 2026, 14(2), 167; https://doi.org/10.3390/vaccines14020167 - 11 Feb 2026
Viewed by 1500
Abstract
Background: Large urban centers in low- and middle-income countries (LMICs) often have persistent pockets of under-immunized children, despite higher overall vaccination coverage than rural areas. Lahore, a megacity in Pakistan, had the lowest rate of fully immunized children in Punjab province as of [...] Read more.
Background: Large urban centers in low- and middle-income countries (LMICs) often have persistent pockets of under-immunized children, despite higher overall vaccination coverage than rural areas. Lahore, a megacity in Pakistan, had the lowest rate of fully immunized children in Punjab province as of 2022 (70%), partly due to challenges in its urban slums. In 2023, an innovative intervention was implemented, utilizing Pakistan’s extensive polio eradication workforce to identify and reach children who were missing routine vaccinations. Objective: The objective was to assess changes in routine immunization coverage during a pre–post evaluation period in which polio campaign workers were engaged to support routine immunization among under-immunized urban populations in Lahore. Methods: A special outreach strategy engaged polio vaccination teams to conduct door-to-door visits of children aged 12–23 months, recording each child’s routine immunization status. These data were integrated into the electronic health system and provided to Expanded Programme on Immunization (EPI) staff for targeted follow-up. Two cross-sectional household surveys of caregivers of children aged 12–23 months were conducted: a 2022 baseline survey and a 2023 follow-up survey conducted six months after implementation. Both surveys used two-stage cluster sampling and WHO-standard immunization coverage methods, with vaccination status verified using cards or caregiver recall. Results: A total of 773 children were surveyed at baseline and 780 at endline. Full immunization coverage increased from 69.8% (CI: 64.13–74.98) to 85.1% (CI: 81.01–88.51). Partial immunization declined from 26.9% (CI: 22.37–31.92) to 14.5% (CI: 11.27–18.50), and the proportion of children not vaccinated at all dropped from 3.3% (CI: 1.92–5.60) to 0.3% (CI: 0.11–0.98). Penta-3 coverage improved from 83.2% (CI: 78.65–87.04) to 94.1% (CI: 91.15–96.07), and Measles 1 from 76.9% (CI: 71.80–81.40) % to 92.1% (CI: 88.71–94.56). Immunization card retention increased from 69.9% (CI: 64.15–75.16) to 84% (CI:81.19–86.94). Improvements were observed across all socio-demographic groups, with a higher impact in peri-urban clusters and low socio-economic groups, and all remained statistically significant. Conclusions: Our findings showed improvements in routine immunization coverage in urban Lahore between 2022 and 2023. This period coincided with district-wide implementation of a polio worker outreach strategy as well as the broader post-COVID-19 recovery of immunization services. This study lacked a control group; therefore, the findings indicate a temporal association occurring during the post COVID-19 recovery period, rather than definitive evidence of causal impact. Nonetheless, integrating the workforce of the polio program into routine immunization could be a promising programmatic strategy to close immunization gaps in urban areas. Full article
(This article belongs to the Special Issue Strategies and Innovations to Recover Post-Pandemic Losses in Routine Immunization Coverage)
17 pages, 356 KB  
Article
COVID-19 Vaccination Knowledge, Attitudes, Perception, and Practices Among Frontline Healthcare Workers in Tunisia, 2024
by Fatma Ben Youssef, Aicha Hechaichi, Hajer Letaief, Sonia Dhaouadi, Amenallah Zouaiti, Khouloud Talmoudi, Sami Fitouri, Ahlem Fourati, Rim Mhadhbi, Asma Sahli, Ghaida Nahdi, Khouloud Nouira, Ihab Basha, Eva Bazant, Chelsey Griffin, Katie Palmer and Nissaf Bouafif ep Ben Alaya
Vaccines 2026, 14(1), 74; https://doi.org/10.3390/vaccines14010074 - 9 Jan 2026
Viewed by 1111
Abstract
Background/Objectives: Healthcare workers (HCW) in primary care settings play a significant role in recommending vaccines to patients. We aimed to describe COVID-19 vaccination knowledge, attitudes, perception, and practices (KAPP) of HCWs in Tunisia and identify associated factors. Methods: We conducted a [...] Read more.
Background/Objectives: Healthcare workers (HCW) in primary care settings play a significant role in recommending vaccines to patients. We aimed to describe COVID-19 vaccination knowledge, attitudes, perception, and practices (KAPP) of HCWs in Tunisia and identify associated factors. Methods: We conducted a national cross-sectional survey (29 January to 3 February 2024) among HCWs in primary public healthcare centers using purposive sampling. Factors associated with good knowledge, positive attitude, and good practice, measured through Likert scales using face-to-face questionnaires, were identified using binary logistic regression. Results: We included 906 HCWs (mean age = 41.87 ± 8.89 years). In total, 37.75% (342/906) of HCWs had good knowledge and perception, 4.30% (39/906) had a positive attitude, and 24.9% (226/906) had good practices related to COVID-19 vaccination. Working in urban compared to rural areas was associated with good knowledge (aOR = 1.57, 95%CI = 1.12–2.21) and positive attitude (aOR = 4.94, 95%CI = 1.19–20.44) to COVID-19 vaccination. Physicians had better KAPP scores than other medical professionals. HCWs working in departments with high-risk patients were more likely to have good knowledge (aOR = 1.28, 95%CI = 1.00–1.72). Positive attitude was also associated with being male (aOR = 2.97, 95%CI = 1.75–5.07) and having at least one non-communicable disease (aOR = 1.92, 95%CI = 1.14–3.23). Being male (aOR = 1.97, 95%CI = 1.35–2.88) and having more years of professional experience (aOR = 1.81, 95%CI = 1.29–2.52) were associated with good practice. Conclusions: Just over a third of HCWs in primary healthcare clinics had good knowledge of COVID-19 vaccination, while positive attitudes and good practices were low. Targeted interventions, particularly for HCWs with less professional experience working in rural settings, are needed to increase good practices and improve COVID-19 vaccination coverage in Tunisia. Full article
(This article belongs to the Special Issue Strategies and Innovations to Recover Post-Pandemic Losses in Routine Immunization Coverage)
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