![]() The purpose of this commentary is to assess whether the Social Ecological Model 14 is a useful theoretical framework to map existing interventions and identify areas in which technology may be leveraged to target undervaccination ( Figure 1). ![]() 13 Technology can also cut across the diverse vaccines, populations, and needs, and indeed the use of health information technology (IT) interventions for vaccinations is burgeoning. Similarly, the use of technology to directly impact the health of populations, as well as to provide access to important public health information, holds great promise that is emerging at the forefront of medical care and public health industries. Technological innovations have greatly improved the ability to access information, facilitate communication and improve efficiency in nearly all aspects of life. insurance status, remembering to get the vaccine) and health literacy (e.g. ![]() These categories of barriers include target population (child, adolescent, adult), schedule (one dose, series of doses, annual vaccination) logistic (e.g. In addition to general challenges for immunization programs, there is great heterogeneity to the recommended vaccine series requiring a variety of approaches to overcome vaccine-specific barriers. 11 A recent study from the CDC and its global partners found that between 291,000 and 646,000 people worldwide die from influenza-related respiratory illnesses each year, higher than previously estimated. 9, 10 The WHO reported 142,512 pertussis cases globally in 2015, with an estimated 89,000 deaths. where multi-state measles outbreaks regularly arise. For example, measles remains a significant problem across the globe, including in the U.S. Without coverage to attain population immunity, vaccine preventable disease outbreaks and significant burden of disease continue to occur. While countries have until 2020 to reach this goal, there has been no substantial increases in coverage rates for vaccines like MCV1 since 2010. 7 On a global level, while considerable progress in routine vaccination coverage has been made, 64 (33%) countries still have not reached the Global Vaccine Action Plan 2011–2020 (GVAP) target of ≥90% national coverage of a third dose of diphtheria and tetanus toxoids and pertussis–containing vaccine (DTP3), and 71 countries (37%) have yet to attain the 2012–2020 Global Measles and Rubella Strategic Plan target of ≥90% national measles-containing vaccine (MCV1) coverage. 5, 6 National influenza vaccination rates range from 38.8% to 43.6% for adults and 51.0 to 59.3% for children since the 2010–2011 season. Adolescent vaccine uptake differences are fewer, except for lower HPV vaccination coverage for those not living in urban areas. In the U.S, for most vaccines, coverage for young children is lower among non-Hispanic black children than among non-Hispanic white children, as well as for children living below the federal poverty level and those who are publically insured or uninsured. Yet, despite the demonstrated efficacy of vaccination for improving public health, problems still exist in translating even highly effective vaccines into vaccination coverage levels sufficient to achieve population immunity or to realize their full prevention potential. 2, 3 Similarly, a systematic review of HPV vaccination programs across 69 countries worldwide over the last ten years found approximate maximal reductions of 90% for HPV 6/11/16/18 strain infection, 90% for genital warts, 45% for low-grade cytological cervical abnormalities, and 85% for high-grade abnormalities. ![]() 1 Rotaviral diarrhea and pneumococcal pneumonia incidences are decreasing globally as vaccination coverage spreads. For example, polio grows closer to complete eradication, with no more new cases in India and Nigeria's last case in 2016, leaving Pakistan and Afghanistan as the sole remaining countries with circulating polio. Vaccination programs and policies have greatly reduced the burden of a number of diseases. Vaccinations are an important and effective cornerstone of preventive medical care with significant health benefits.
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