Immunization against disease is among the most successful global health efforts of the modern era, and substantial gains in vaccination coverage rates have been achieved worldwide. However, that progress has stagnated in recent years, leaving an estimated 20 million children worldwide either undervaccinated or completely unvaccinated. The determinants of vaccination uptake are complex, mutable, and context specific. A primary driver is vaccine hesitancy - defined as a "delay in acceptance or refusal of vaccines despite availability of vaccination services". The majority of vaccine-hesitant people fall somewhere on a spectrum from vaccine acceptance to vaccine denial. Vaccine uptake is also hampered by socioeconomic or structural barriers to access. On August 17-20, 2020, the Forum on Microbial Threats at the National Academies of Sciences, Engineering, and Medicine held a 4-day virtual workshop titled The Critical Public Health Value of Vaccines: Tackling Issues of Access and Hesitancy. The workshop focused on two main areas (vaccine access and vaccine confidence) and gave particular consideration to health systems, research opportunities, communication strategies, and policies that could be considered to address access, perception, attitudes, and behaviors toward vaccination. This publication summarizes the presentations and discussion of the workshop.

Vaccines are among the most safe and effective public health interventions to prevent serious disease and death. Because of the success of vaccines, most Americans today have no firsthand experience with such devastating illnesses as polio or diphtheria. Health care providers who vaccinate young children follow a schedule prepared by the U.S. Advisory Committee on Immunization Practices. Under the current schedule, children younger than six may receive as many as 24 immunizations by their second birthday. New vaccines undergo rigorous testing prior to receiving FDA approval; however, like all medicines and medical interventions, vaccines carry some risk. Driven largely by concerns about potential side effects, there has been a shift in some parents' attitudes toward the child immunization schedule. The Childhood Immunization Schedule and Safety identifies research approaches, methodologies, and study designs that could address questions about the safety of the current schedule. This report is the most comprehensive examination of the immunization schedule to date. The IOM authoring committee uncovered no evidence of major safety concerns associated with adherence to the childhood immunization schedule. Should signals arise that there may be need for investigation, however, the report offers a framework for conducting safety research using existing or new data collection systems.

Vaccine reluctance and refusal are no longer limited to the margins of society. Debates around vaccines' necessity -- along with quesitons around their side effects -- have gone mainstream, blending with geopolitical conflicts, political campaigns, celebrity causes, and "natural" lifestyles to win a growing number of hearts and minds. Today's anti-vaccine positions find audiences where they've never existed previously. Stuck examines how the issues surrounding vaccine hesitancy are, more than anything, about people feeling left out of the conversation. A new dialogue is long overdue, one that addresses the many types of vaccine hesitancy and the social factors that perpetuate them. To do this, Stuck provides a clear-eyed examination of the social vectors that transmit vaccine rumors, their manifestations around the globe, and how these individual threads are all connected.

Written by leading experts in the field, this book examines the current state of research of all the most important and modern vaccine delivery systems available to date. The immunological principles upon which these systems are based, their potential applications and current clinical status are detailed. Topics covered include: bacterial polysaccharide conjugate vaccines, virosomes and liposomes, bacterial ghosts, attenuated Salmonella and Shigella vaccines, vaccines against tumors, edible vaccines and much more. An essential text for all vaccinologists, microbiologists, health professionals, biotechnologists, and pharmaceutial companies.

This practical guide contains seven modules targeted at district and health facility staff. It intends to meet the demands to improve immunization services so as to reach more infants in a sustainable way, building upon the experiences of polio eradication. It includes materials adapted from polio on planning, monitoring and use of data to improve the service, that can be used at any level. Revising the manual has been a team exercise. There are contributions from a large number of experts, organizations and institutions. This new edition has seven modules. Several new vaccines that have become more readily available and used in recent years have been added. Also the section on integration with other health interventions has been expanded as exciting opportunities and experiences have become evident in the years following the previous edition. Module 1: Target diseases and vaccines Module 2: The vaccine cold chain Module 3: Ensuring safe injections Module 4: Microplanning for reaching every community Module 5: Managing an immunization session Module 6: Monitoring and surveillance Module 7: Partnering with communities.

This collection of policies and articles addresses vaccine schedules, the safety of vaccines, and methods for addressing vaccine hesitancy. Vaccine delivery is a substantive portion of pediatric practice, and addressing vaccine hesitancy is time-consuming. This collection of articles will assist providers by providing vaccine information and policy statements in a single, easily accessible platform. We hope to support vaccine confidence and increase immunization of infants and children.