The impact of new vaccine introduction on immunization and health systems: A review of the published literature

Terri B. Hyde, Holly Dentz, Susan A. Wang, Helen E. Burchett, Sandra Mounier-Jack, Carsten F. Mantel, Jacqueline Gindler, Susan T. Goldstein, W. Scott Gordon, Logan Brenzel, Jessica C. Shearer, Michael Favin

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


We conducted a systematic review of the published literature to examine the impact of new vaccine introduction on countries' immunization and broader health systems. Six publication databases were searched using 104 vaccine and health system-related search terms. The search yielded 15,795 unique articles dating from December 31, 1911 to September 29, 2010. Based on review of the title and abstract, 654 (4%) of these articles were found to be potentially relevant and were referred for full review. After full review, 130 articles were found to be relevant and included in the analysis. These articles represented vaccines introduced to protect against 10 different diseases (hepatitis A, hepatitis B, Haemophilus influenzae type b disease, human papilloma virus infection, influenza, Japanese encephalitis, meningococcal meningitis, Streptococcus pneumoniae disease, rotavirus diarrhea and typhoid), in various formulations and combinations. Most reviewed articles (97 [75%]) reported experiences in high-income countries. New vaccine introduction was most efficient when the vaccine was introduced into an existing delivery platform and when introduced in combination with a vaccine already in the routine childhood immunization schedule (i.e., as a combination vaccine). New vaccine introduction did not impact coverage of vaccines already included in the routine childhood immunization schedule. The need for increased cold chain capacity was frequently reported. New vaccines facilitated the introduction and widespread use of auto-disable syringes into the immunization and the broader health systems. The importance of training and education for health care workers and social mobilization was frequently noted. There was evidence in high-income countries that new vaccine introduction was associated with reduced health-care costs. Future evaluations of new vaccine introductions should include the systematic and objective assessment of the impacts on a country's immunization system and broader health system, especially in lower-income countries.

Original languageEnglish (US)
Pages (from-to)6347-6358
Number of pages12
Issue number45
StatePublished - Oct 5 2012
Externally publishedYes


  • Health system
  • Immunization program
  • Introduction
  • New vaccines
  • Under-utilized vaccines

ASJC Scopus subject areas

  • General Immunology and Microbiology
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • General Veterinary
  • Molecular Medicine


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