Successful national immunization programmes depend on up-to-date policies and effective implementation strategies to achieve and sustain their goals. Countries need to have strong mechanisms that enable informed decision-making about immunization priorities and the introduction of new vaccines, programme strategies, and technologies.

If all people are to access immunization services, vaccines need to be delivered to areas that are isolated geographically, culturally, socially or otherwise and to marginalized populations such as displaced people, migrants, and those affected by conflict, political instability and natural disasters. The causes of low vaccine coverage, including missed opportunities for vaccination, must be identified and addressed. Tailored strategies are needed, to understand and overcome obstacles to vaccination, particularly gender barriers affecting caregivers and health workers alike. New approaches are required to reach older age groups and to deliver people-centred immunization services, integrated with primary health care.