Vaccinating more children: which strategies really work?

By Ana Espino | Published on September 1st, 2025 | 4 min read

#Vaccination #VaccineCoverage #Immunization #Prevention  


Childhood vaccination is one of the most effective tools in public health, playing a key role in preventing serious infectious diseases such as measles, pertussis, and poliomyelitis. It has drastically reduced morbidity and mortality linked to these conditions, saving millions of lives each year. Yet, despite generally high vaccination rates, many countries still fail to reach the WHO-recommended coverage thresholds.  

Current challenges stem from the resurgence of under-vaccinated clusters, growing vaccine hesitancy, organizational barriers such as limited access to primary care or vaccination services, and socioeconomic as well as territorial inequalities that hinder both adherence and universal access. The major challenge, therefore, is to determine which public policies and concrete interventions effectively improve vaccine coverage, while accounting for cultural, economic, and health system diversity. The aim of this study was precisely to analyze and compare initiatives implemented across different countries, in order to assess their relevance, potential effectiveness, and transferability to other public health contexts.  

Mandate, incentivize, or convince: which path works best?

In total, 22 countries from Europe, North America, and Israel were included to provide a comparative overview of vaccination policies implemented between 2014 and 2019. Data were collected from official sources and public policy analyses, ensuring consistency in classifying the interventions identified. 

Findings revealed a wide variety of strategies. Some initiatives involved restrictive measures such as mandatory vaccination, school exclusion of unvaccinated children, or financial penalties. While these approaches proved effective in certain contexts, they raised ethical and political debates, particularly regarding individual freedom and social acceptability.

Other measures included financial incentives, mainly directed at healthcare professionals to strengthen vaccine recommendations, though available data on their effectiveness remained limited and sometimes contradictory. Countries also invested in improving logistical access to vaccination by offering it in schools, pharmacies, or via mobile units, while implementing automated reminder systems for parents and regular feedback mechanisms for providers.  

Finally, significant emphasis was placed on promotional and communication campaigns targeting parents, children, and professionals, ranging from continuous training to the involvement of respected community figures.  

Overall, most countries favored educational and communicative approaches, considered more acceptable and sustainable. However, a key limitation observed was the lack of robust evaluations to measure the real impact of these initiatives on improving vaccine coverage.  

Reinventing vaccination policies to protect all children

Childhood vaccination remains a global priority, yet the policies implemented show considerable diversity. A major challenge lies in developing interventions adapted to cultural and organizational contexts while grounded in evidence of effectiveness. The study confirms that communication and knowledge reinforcement are the most widely used strategies, but their impact remains uncertain due to insufficient rigorous evaluations.  

Future research must rigorously test the effectiveness of interventions, integrate new communication technologies, and explore the transferability of best practices across countries. These efforts are essential to achieve and sustain adequate vaccine coverage and ensure lasting herd immunity.   

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