Recent research reveals that overcoming complex barriers, from misinformation to logistical challenges, is crucial for boosting childhood immunisation coverage, with personalised strategies proving most effective across diverse settings.
Childhood immunisation remains one of the most effective public health tools, but new research suggests the reasons some children miss vaccines are far more complex than simple hesitancy. Meron Mengistu, a PhD candidate in health and rehabilitation sciences at Western University in Ontario, says barriers can range from transport problems and conflict to misinformation, understaffed clinics and pressure within households. Her work, published in Discover Public Health, argues that improving uptake requires interventions tailored to the local obstacles families face. The World Health Organization says vaccines remain a global health success story, while the CDC and the US Department of Health and Human Services say childhood immunisation protects both individual children and wider communities.
Mengistu’s review focuses on the third dose of diphtheria-tetanus-pertussis vaccine, known as DTP-3, which is widely used as a benchmark for routine childhood coverage. Based on the latest global estimates from 2025, about 85% of infants received all three doses, below the Immunization Agenda 2030 target of at least 90%. Mengistu also points to about 13.5 million children classified as zero-dose, meaning they had not received a first DTP-containing vaccine. She says that figure shows how far the world still is from universal protection.
The review groups vaccination strategies into four broad categories: demand-side approaches aimed at caregivers and communities, service-delivery changes, system-level policies and combinations of those methods. Demand-side examples included text reminders, educational sessions and cash incentives. Service-delivery measures ranged from mobile clinics to communication training for health workers. System-level approaches included policies tying vaccination status to child-care or kindergarten enrolment. Multi-level programmes combined tools such as phone reminders with digital scheduling systems for health staff.
The findings suggest that no single method works everywhere. In Saskatoon, telephone reminders were linked with an increase of about 7 percentage points in measles-mumps-rubella coverage, from 67.4% to 74%, while home visits also appeared helpful. Internationally, cash incentives produced small but steady gains, though the evidence came from only two lower-middle-income countries. Informational sessions also improved later-dose coverage, but results varied. Mengistu says the main lesson is not to copy one intervention wholesale, but to match the approach to the barriers facing a specific community. She says emerging tools such as rumour-tracking systems and community co-design may offer new ways to reach families, especially in places where misinformation and mobility complicate delivery.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
