Phased introduction

Nationwide implementation of a vaccine is usually preferred because of economies of scale, equity considerations, and the larger impact expected with a national introduction. However, in large countries, the complexities and potential lack of experience in providing vaccines to pregnant women may be a barrier to introducing influenza vaccine to this group. A phased introduction, in one or several districts with different characteristics (e.g. urban/rural, high/low coverage), can help to identify potential bottlenecks and facilitate the subsequent scale-up at national level.

A phased introduction delivering influenza vaccine on a small scale may be useful to:

  • test programmatic feasibility by determining the costs of vaccine introduction as well as the human and financial resources needed to support optimal delivery;
  • pilot and refine training and communication plans and materials to fit the local context;
  • determine and test strategies on how to best access pregnant women and monitor vaccination in this group;
  • provide a proof of concept for the proposed delivery strategies when current national capacities can support only a limited number of provinces or districts and demonstrating proof of concept may serve to secure external funding;
  • evaluate attitudes, acceptability and barriers in the community, pregnant women, and among health professionals – to help refine communication strategies.


Which of the following are potential benefits of a phased introduction for delivery of maternal influenza vaccine? Mark all that are true.

A. Test program feasibility by determining costs
B. Increase vaccine coverage across the country as quickly as possible
C. Evaluate attitudes to help refine communication strategies
D. Provide a proof of concept for the proposed delivery strategy


Answers A, C, D are correct.