In the mid-1990s, when I started working with the World Health Organization (and at that time, the Children’s Vaccine Initiative, a pre-cursor to the current GAVI Alliance) on trying to accelerate the uptake of the Hib meningitis vaccine, there were a
lot of barriers and concerns. Often, we heard that the existing immunization system was a “house of cards” and that introducing a new vaccine would risk pulling down the whole system. On the other hand, proponents of moving faster (like me) wondered whether
the introduction of a new vaccine might, rather than adding strain, actually energize the system and increase coverage. As it turns out, both of the groups debating the impact of new vaccine introduction on health systems in the 1990s were wrong. In a paper
released by a WHO working group last year, Jessica Shearer and colleagues conducted a rigorous statistical analysis of all available data, and concluded that the introduction of new vaccines did not result in a pronounced effect on routine immunization coverage.
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