The formal ability of countries to deliver high-quality vaccination services: Introducing the Country Vaccination Score (CVS)

Abstract

Despite the huge benefits of vaccination, vaccine uptake around the globe is surprisingly suboptimal in most places; explanations include vaccine hesitancy and increasingly well-organized anti-vaccine groups. In addition, WHO identified structural gaps in many countries for the delivery of vaccination services, specifically a lack of scientifically sound NITAGs of the highest integrity, as well as a lack of political will and implementation. Here country vaccination systems were evaluated using simple 4x2 managerial criteria (having goals, one plan, implementation, and evaluation), to look into the structural ability of selected countries to deliver appropriate vaccination services, expressed as the Country Vaccination Score (CVS). Based on the availability of expert vaccinologists, each selected country was described (basic demographic, economic, political, health care data) followed by CVS-scoring. All data were centrally reviewed and validated. To date, a total of 42 countries received a CVS, with scores between 1 and 8. Some Low-and Middle-Income Countries (LMICs) scored high, whereas some high income countries scored low. The strengths of the system include the crowdsourcing approach, and scoring based on written documentation followed by a strict central review process. The main weakness may be that "what is on paper may not be what happens in reality", i.e., overscoring may have happened. The ongoing project may help countries identifying structural gaps in delivering optimal vaccination services and take appropriate actions. Readers are invited to contribute with comments, additional data as well as by evaluating any of the more than 150 countries still missing.