Closing the immunization gap by reaching zero-dose children through improved equitable and cost-effective vaccine delivery strategies

In spite of high immunization coverage in many countries, pockets of zero-dose (ZD) children still exist as well as communities neglected by current immunisation efforts. The Immunization Agenda 2030's goal of reducing the global count of ZD children by 50% remains unfulfilled and has faced setbacks due to the COVID-19 pandemic. The REACH-OUT project endeavours to contribute to this crucial goal by developing and testing enhanced strategies for the delivery of essential routine vaccines to ZD children in Kenya, Nigeria and Rwanda.

The project has delineated four specific objectives. First, we will gather and analyze survey data on vaccination behaviour factors to better comprehend ZD children. Also, advanced geospatial and epidemiological methods will enrich existing geographical information systems (GIS) and create precise risk maps for immunization support. Second, by employing a human-centered approach, we will design GIS-augmented vaccine delivery strategies tailored for ZD children. Innovative geospatial decision-support tools will optimize microplanning, implementation, and monitoring. Third, in each target country, we will conduct thorough implementation studies and scenario analyses via epidemiological models to assess the interventions' (cost-)effectiveness, financial sustainability, and equity impact. Fourth, we will strengthen the capabilities of in-country partners and stakeholders. We'll explore scalability to ensure sustainability beyond the project, fostering wider adoption. This endeavour will be taken forward by a robust consortium of eight partners, including five from the EU and three from sub-Saharan African countries, providing a multidisciplinary expertise in public health, health service research and health policy, medical science, epidemiology, statistics and health economics.