The Americas
When past progress becomes present complacency
The Challenge
Can the Americas protect their immunisation gains before complacency and health system strain erode them?
The Context
The Americas helped lead global polio eradication and still boast some of the world’s highest immunisation rates. But success has created its own vulnerabilities. Diseases that have disappeared from living memory no longer feel like real threats. Rapid urbanisation and migration have broken the social networks that once made vaccination a community habit. And for caregivers who do choose to vaccinate, the system too often fails them: at health centers, they are met with long waits, empty shelves and cold boxes, and overstretched health workers who are forced to turn families away.
The Americas has historically been a global leader with its high vaccination rates.
Now, this progress is threatening to slide.
3 out of 25
children are left behind or under-vaccinated.
For every 25 children in the Region, two are completely left behind, and one has not received all the vaccines she needs.
The Quechuan language alone – spoken mainly in Peru and also in Bolivia, Ecuador, Colombia and Argentina – has 9 dialects – making generic vaccination messages challenging.
What We Heard
We listened to Ministry of Health staff from 8 countries tell us about their struggles to design behavioral solutions. Getting messages, health workers and vaccines to remote locations was the most frequently mentioned challenge. We heard that vaccination schedules are often confusing and inaccessible to parents, especially if they don’t perceive a threat of disease. Working parents struggle to find appointments outside of their working hours. Behaviour is not modelled in ways that are visible among people caregivers value.
Immunisation managers told us they need a better way to organise the long list of problems they face so they can see behavioral solutions more clearly.
Our Solution
We created a framework to help the region make sense of its shared challenges and identify the most urgent solutions. Because immunisation journeys vary significantly across countries, the framework gives immunisation managers a way to classify the barriers they face and match them to a relevant set of responses.
The framework addresses four core problem areas: reaching remote populations with reliable vaccine access; communicating vaccination benefits in ways that resonate culturally and linguistically; expanding facility opening hours to reduce access barriers; and defining success in ways that prioritise the most vulnerable, not just the easiest to reach.
- Improving Vaccine Hesitancy in The Americas (WHO)
- Mumps cases in Bolivia
- PAHO-WHO/UNICEF 2019 joint reporting form (JRF) on immunisation (2018 data)