Learnings from routine child vaccination coverage for Covid policy and practice

Learnings from routine child vaccination coverage for Covid policy and practice


Around the world various interventions from lotteries to free beer to community influencers are being used to improve COVID vaccination coverage. However, what is the evidence on the effectiveness of interventions like these? This edition of the 3ie evidence dialogues focused on what we know about the state of evidence on increasing routine immunisation of children in low- and middle-income countries and reflect on its relevance and current practices in the context of Covid. The session included a brief presentation of findings from a new evidence gap map highlighting the volume and type of evidence available on effectiveness of interventions related to routine immunization of children and the major gaps in the evidence base. Followed by a panel discussion on the role and use of evidence in this sector as well as opportunities and challenges associated with evidence-informed decision making, especially in the context of the global push for increasing covid vaccination coverage.


  • Mark Engelbert, Evaluation Specialist, 3ie
  • Sohail Agha, Senior Program Officer, Bill and Melinda Gates Foundation
  • Harini Kannan, Research Scientist, J-PAL (TBC)

Chair: Sebastian Martinez, Director of Evaluation, 3ie

3ie #EvidenceDialogues webinar summary

Evidence Dialogues: A new Evidence Gap Map shows what we know, and what we don’t, about routine vaccinations

While the COVID pandemic may be what brought vaccinations to the forefront of global headlines, the public health community has been working for decades to make sure everyone gets the shots they need.

On Thursday, experts gathered for a 3ie Evidence Dialogues discussion to reflect on a new resource for those looking for evidence about how best to accomplish that aim: 3ie’s new Evidence Gap Map on routine childhood immunizations.

The map does not specifically address COVID vaccines – it is part of a research program on routine vaccinations which was launched years before the pandemic began. Nonetheless, the experts at our panel discussed its implications for the unique health challenges the world faces today.

“I think what is to me the most interesting is where evidence is missing, and there is quite a lot of areas where evidence is missing,” said Sohail Agha, a senior program officer at the Bill and Melinda Gates Foundation.

The Evidence Gap Map categorizes the studies it includes by outcome measure, grouped into three categories: barriers faced by caregivers and communities, effects on health systems, and final vaccination rates. The evidence mostly looks at barriers or final vaccination rates, said 3ie Evaluation Specialist Mark Engelbert.

“We basically have a great big hole in the middle, suggesting that we have very little evidence about outcomes that are related to health system capacity to deliver vaccination services,” Engelbert said.

That gap is also noteworthy because of the extra demands being placed on health systems during the pandemic.

There is a risk that requiring existing health infrastructure to deliver COVID vaccination campaigns will mean that other essential health services will get crowded out and neglected, said Harini Kannan, a research scientist at J-PAL South Asia.

“It’s very tempting to use this infrastructure, because it is a wonderful infrastructure, but somebody really needs to think through this,” Kannan said.

The absence of studies about health systems reflects a misplaced focus on an imagined lack of motivation as the primary barrier to vaccination, Agha said.

Citing survey data from Nigeria, he said that two thirds of adults in the country want a COVID vaccine – but only 38 percent feel that it is easy to access routine vaccination services.

Another evidence gap is the absence of evidence focused on disadvantaged groups, panelists said.

“Most of the research is just not designed to identify impacts on vulnerable communities,” Engelbert said. “It’s going to be the same groups that are going to be most affected by barriers to routine vaccination and to COVID vaccination.”

Solutions should aim to provide COVID vaccinations without impeding access to other services, panelists said.

“The more that we can identify ways to make routine vaccination and COVID vaccination efforts complementary rather than in competition for resources, that’s going to help,” Engelbert said.