Peer-reviewed article
Why are missed opportunities for immunisation and immunisation defaulting among children indistinguishable?
Israel Oluwaseyidayo Idris, Gabriel Omoniyi Ayeni, Yusuff Adebayo Adebisi ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This paper examines confusion in global immunisation research between two concepts: Missed Opportunities for Immunisation (MOI) and immunisation defaulting, which are often used interchangeably despite being distinct. The author argues that this conceptual confusion has led to ineffective interventions and flawed policy recommendations, particularly hindering vaccination coverage in low- and middle-income countries. The paper calls for clearer definitions and better guidance to improve immunisation strategies and help countries achieve 80% vaccination coverage by 2030.
Key points
- MOI and immunisation defaulting are inappropriately used interchangeably in public health research and practice
- Flawed strategies based on biased evidence have been recommended and adopted in various settings
- Many opportunities to incorporate immunization coverage research into policy are being squandered
- Low- and middle-income countries struggle to vaccinate 80% of their children, partly due to these conceptual and strategic issues
- Current guidelines and information on both concepts are insufficient
Limitations
This is a conceptual/opinion paper that does not present new empirical data or evaluate specific interventions. It cannot tell us about actual vaccination coverage rates, the effectiveness of specific immunisation programmes, or quantitative evidence comparing different approaches.
Abstract
The two major global immunization agenda framings (Missed Opportunity for Immunisation (MOI) vs. Immunisation Defaulting) are interchangeably and inappropriately used in public health research and practice, with flawed or misleading strategies recommended and adopted in various settings around the world. This is demonstrated by the fact that many opportunities to incorporate findings from immunization coverage research into policy are squandered. The ineffectiveness of inappropriate interventions based on biased evidence can discourage and mislead policymakers to make radical decisions by discretion. This may explain why low- and middle-income countries are unable to vaccinate 80% of their children; it also poses a global health risk to capable countries. The current guidelines and information on MOI and immunization defaulting appear insufficient, and a little clarification would help immunisation forerunners achieve measurable progress in ensuring good coverage, particularly in low- and middle-income countries. The purpose of this paper is to provide appropriate recommendations to address this issue in immunization practice. Optimistically, this will stimulate further discussions, streamline differences, and gear global immunization governance on the subject to achieve the target coverage in low- and middle-income countries by 2030.