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The Expanded Program on Immunization (EPI) has still been found to offer services that do not comply with standards. The purpose of this paper is to ascertain competency in terms of the knowledge and skills of the EPI staff.

The research design was a mixed-methods approach. The quantitative method employed a questionnaire survey on the perceived competency of 382 EPI staffs from six regions in Thailand. This was paired alongside of the qualitative method, where four staffs were in-depth interviewed, and the performance of the EPI staffs was observed.

The overall perceived competency in the work of immunization was at a high level. A comparative analysis between the quantitative and qualitative data showed findings in three categories. First, the perception of competency was high, and performance conformed to standards in the preparation of the setting and equipment for providing the service; second, the perception of competency was high, but in the performance of their work the participants did not comply completely with standards for scheduling the immunization appointments or for vaccine storage; and third, the perception of competency was either moderate or low, and the performance of work was inadequate for vaccine estimations, registering reports, and dealing with adverse events following immunization.

The findings showed a gap between perception of knowledge-and-skill competency and actual practice in EPI service. Effective cooperation among involved organizations in order to improve the standard of performance in expanding the quality of EPI service provision in Thailand is suggested.

Child immunization is widely recognized as a cost-effective preventive medicine. Unfortunately, in India about 50% of the eligible children aged 12–23 months miss some essential vaccination. Though a positive association between maternal education and markers of child health like immunization has been long established, the literature has struggled to find a causal relationship, mainly because education is inextricably correlated with other socioeconomic variables like income. In this chapter, I propose a new instrument for women’s education in India using the following facts. First, due to lack of sanitary facilities in schools, particularly rural schools, large number of girls drop out of school once they reach puberty. Second, age at menarche is largely determined by biological factors and not social factors. Together, age at menarche can explain variations in schooling, yet be independent of outcome variables like child immunization. I find that additional years of maternal schooling (conditional on strictly positive years of schooling) do increase the probability of complete immunization of children.

Payment for healthcare services in the USA has shifted from fee for service to compensation based on value and quality. The indicators used for payments are a variety of clinical measures, including administration of vaccines to patients. The purpose of this paper is to describe the implementation of programs in health systems to improve vaccination rates and patient outcomes.

A search of the literature was conducted to find examples of vaccine programs in US health systems, and also to identify policies to improve immunization rates.

Successful programs for improving vaccination rates require advocacy and support of leadership, a systematic and multidisciplinary approach, and an evaluation of local resources and capacity. Numerous examples exist of medical, nursing, and pharmacy led programs that improve vaccination rates. The department in charge has relied on the support of other groups to ensure the success.

Mandatory vaccination of healthcare personnel (HCP) in the health system has been a growing trend in the USA. Although there has been some resistance to mandatory vaccinations for HCP, the standards and requirements have resulted in improved rates in health systems, which ultimately improve efficiency and protects patients.

This review describes considerations for implementing a successful vaccination program in a health system and provides examples of specific strategies. An overview of mandatory vaccinations for HCP is also described.

The purpose of this paper is to present a new immunization strategy for effectively solving the control of the spread of the virus.

Inspired by the idea of network partition, taking two optimization targets which are the scale of sub-network and the sum of the strengths of the sub-network's nodes into account at the same time, a new immunization strategy based on greedy algorithm in the scale-free network is presented. After specifying the number of nodes through the immunization, the network is divided into the scale of sub-network and the sum of the strength of the sub-network's nodes as small as possible.

The experimental results show that the proposed algorithm has the better performance than targeted immunization which is supposed to be highly efficient at present.

This paper proposes a new immunization strategy based on greedy algorithm in the scale-free network for effectively solving the control of the spread of the virus.

The purpose of this article is to assess important changes made to the vaccines used for childhood and adolescent immunisation in August 2004. These changes resulted in a number of patient safety incidents.

The changes are reviewed for the way that risk assessment and risk management were used in their development. An analysis of recent claims and complaints handled by the Medical Protection Society is then used to broaden the debate.

The August 2004 changes to the childhood vaccination programme contained unnecessary and avoidable risks of patient safety incidents, which could have been avoided if existing advice had been followed. Errors continue to be seen in the administration of childhood immunisation in primary care. These are driven both by systems and human factors.

This paper will be of use to those working in primary care who wish to ensure that childhood and adolescent immunisations are carried out correctly.

The paper highlights risk‐management issues that are relevant to childhood and adolescent immunisation.

The purpose of this paper is to outline the organization and governance of the US vaccine and immunization enterprise. It describes the major components of the US system including the various relationships between major federal government entities, stakeholders, and advisory committees that inform government policymaking at various points in the system.

The authors describe the complex interdependent network of partners that engage in a wide range of activities such as disease surveillance, research, vaccine development, regulatory licensure, practice recommendations, financing, service delivery, communications, and post-licensure monitoring.

The US system of governance is highly participatory and focuses on a transparent and open engagement, with input from a wide range of partners to inform decision-making. This collaborative framework allows many inputs to be heard and helps support the US vaccine and immunization system as it evolves to meet the continued public health needs in the USA through the optimal use of safe and effective vaccines.

This is an invited article on the US vaccine and immunization enterprise. The development and availability of vaccines in the USA has had profound impact on mortality and morbidity and public health (Centers for Disease Control and Prevention, 2011). The success of this enterprise is a result of a blended public and private sector system with partnerships at the federal, state, and local levels of government to optimize the use of safe and effective vaccines. Governance structures have been established to support the interaction and decision-making among the federal and non-federal actors toward the common goal of controlling and preventing infectious diseases.

The purpose of this paper is to identify the key performance indicators (KPIs) of vaccine supply chain of Universal Immunization Program (UIP) India, and measure their impact on vaccine supply chain performance improvement, so that results of this study can help the decision makers manage the activity and effectiveness of their resources in order to improve vaccine delivery performance and child immunization coverage.

The 41 KPIs in terms of four dimension of the balanced scorecard (BSC), i.e. financial, customer, internal process and learning and growth have been identified and validated from the literature and expert’s opinions. Further, the impact of internal process and learning and growth performance indicators on the vaccine supply chain performance improvement have been evaluated using two-way assessment. The rankings obtained using two-way assessment are then compared to DEMATEL approach to validate the results.

The results from the analysis reveal that “Enhancement in employee work satisfaction” (LG3=10.08 percent), “Enhancement in professional vaccine supply chain managers and leaders” (LG2 = 6.70 percent) “Improvement in planning and coordination in the supply chain” (LG9 = 6.57 percent) are the three critical performance indicators having maximum impact on vaccine supply chain performance improvement. The decision makers should give priority to these performance indicators to improve delivery performance and immunization coverage.

This study focuses on the improvement in vaccine delivery performance, therefore, analysis and findings can be useful to government immunization programs of India to other developing nations to improve child immunization coverage.

To our knowledge, this paper is first to attempt to provide a direction to improve immunization coverage through vaccine supply chain performance indicators.

Much of the discussion surrounding the antivaccine movement focuses on the decision of parents to not vaccinate their children and the resulting danger posed to others. However, the primary risk is borne by the child left unvaccinated. Although living in a developed country with high vaccination rates provides a certain amount of protection through population immunity, the unvaccinated child is still exposed to a considerably greater risk of preventable diseases than one who is vaccinated. I explore the tension between parental choice and the child’s right to be free of preventable diseases. The chapter’s goal is twofold: to advocate for moving from a dyadic framework – considering the interests of the parents against those of the state – to a triadic one, in which the interests of the child are given as much weight as those of the parent and the state; and to discuss which protections are available, and how they can be improved. Specific legal tools available to protect that child are examined, including tort liability of the parents to the child, whether and to what degree criminal law has a role, under what circumstances parental choice should be overridden, and the role of school immunization requirements in protecting the individual child.

Over the last decade there has been considerable debate about the merits of targets as a policy instrument. The purpose of this paper is to examine the implementation of two health targets that were cornerstones of New Zealand health policy between 2009 and 2012: immunisation rates for two-year-olds, and time to treatment, discharge or admission in hospital emergency departments.

For each policy target, the authors selected four case-study districts and conducted two waves of key-informant interviews (113 in total) with clinical and management staff involved in target implementation.

Despite almost identical levels of target achievement, the research reveals quite different mixes of positive and negative implementation consequences. The authors argue that the differences in implementation consequences are due to the characteristics of the performance measure; and the dynamics of the intra-organisational and inter-organisational implementation context.

The research is based on interviews with clinical and management staff involved in target implementation, and this approach does not address the issue of effort substitution.

While literature on health targets pays attention to the attributes of target measures, the paper suggests that policymakers considering the use of targets pay more attention to broader implementation contexts, including the possible impact of, and effects on related services, organisations and staff.

The research focuses specifically on implementation consequences, as distinct from target success and/or changes in clinical and health outcomes. The paper also adopts a comparative approach to the study of target implementation.

The purpose of this paper is to achieve effective governance of online rumors through the proposed rumor propagation model and immunization strategy.

The paper leverages the agent-based modeling (ABM) method to model individuals from two aspects, behavior and attitude. Based on the analysis and research of online data, we propose a rumor propagation model, namely the Untouched view transmit removed-Susceptible hesitate agree disagree (Unite-Shad), and devise an immunization strategy, namely the Gravity Immunization Strategy (GIS). A graph-based framework, namely Pregel, is used to carry out the rumor propagation simulation experiments. Through the experiments, the rationality of the Unite-Shad and the effectiveness of the GIS are verified.

The study discovers that the inconsistency between human behaviors and attitudes in rumor propagation can be explained by the Unite-shad model. Besides, the GIS, which shows better performance in small-world networks than in scale-free networks, can effectively suppress rumor propagation in the early stage.

This paper provides an effective immunization strategy for rumor governance. Specifically, the Unite-Shad model reveals the mechanism of rumor propagation, and the GIS provides an effective governance method for selecting immune nodes.

The inconsistency of human behaviors and attitudes in real scenes is modeled in the Unite-Shad model. Combined with the model, the definition of diffusion domain is proposed and a novel immunization strategy, namely GIS, is designed, which is significant for the social governance of rumor propagation.