A missed opportunity for vaccination (MOV) refers to any contact with health services by a child or adult who is eligible for vaccination, which does not result in the person receiving one or more of the vaccine doses for which he or she is eligible. When countries observe that their vaccination coverage is decreasing or stagnating, they seek alternative strategies to explore the reasons and design tailored strategies to address them. The MOV strategy, which includes the 1) Planning Guide to Reduce Missed Opportunities for Vaccination, 2) Methodology for the Assessment of Missed Opportunities for Vaccination and 3) Intervention guidebook for implementing and monitoring activities to reduce Missed Opportunities for Vaccination, was designed to help decision-makers and national or subnational programme managers reduce MOV. The MOV strategy aims to increase immunization coverage by simply making better use of existing vaccination sites and promoting synergy between different maternal and child health programmes. The MOV strategy answers three important questions:
- How many opportunities were missed?
- Why are these opportunities being missed?
- What can be adjusted or done differently?
Once these questions have been addressed, the MOV strategy aims to link and translate the MOV findings into actionable solutions and interventions to reduce MOV, especially at the facility level where vaccination services are provided.
This page was created and is maintained by the WHO Expanded Programme on Immunization (EPI) and provides a list of resources related to MOV.
- MOV publications
- MOV training material
- Interventions to reduce MOV by addressing health worker knowledge, attitudes and practice
- Interventions to reduce MOV by addressing health systems issues
- Interventions to reduce MOV by addressing the demand-side (caregiver behaviours)
MOV publications
This collection contains technical and methodological publications on MOV
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017 | Bvudzai Priscilla Magadzire, Gabriel Joao, Graça Matsinhe, Ikechukwu Udo OGBUANU, Laura Nic Lochlainn, Ruth Bechtel | 2021 | Journal article | English |
| Missed opportunities for vaccination among children aged 0–23 months visiting health facilities in a southwest State of Nigeria, December 2019 | Fiona Braka, Laura Nic Lochlainn, Lassané Kaboré, Modupeola Dosumu, Elvis Isere, Itse Olaoye, Francis Adegoke Akanbiemu, Yetunde Olagbuji, Rosemary Onyibe, Kofi Boateng, Richard Banda, Akinola Ayoola Fatiregun | 2021 | Journal article | English |
| Assessment of missed opportunities for vaccination (MOV) in Burkina Faso using the World Health Organization’s revised MOV strategy: Findings and strategic considerations to improve routine childhood immunization coverage | Bertrand Meda, Colin Sanderson, Edouard Betsem, Ikechukwu Udo OGBUANU, Isaie Médah, Lassané Kaboré, Laura Nic Lochlainn, Mâ Ouattara, Stephanie Shendale, William M. F. Kaboré | 2020 | Journal article | English |
| Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016 | Anyie J. Li, Colin Sanderson, Collins TABU, Iheoma U. Onuekwusi, Ikechukwu Udo OGBUANU, Isaac K. Mugoya, Kibet Sergon, Peter O. Okoth, Stephanie Shendale, Zorodzai Machekanyanga | 2020 | Journal article | English |
| Studies of missed opportunities for immunization in developing and industrialized countries | H.A.F.M. Jansen, P. Evans, R.J. Kim-Farley, S.E. Robertson, S.S. Hutchins | 1993 | Journal article | English |
| Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities | Anyie J. Li, Collins TABU, Ephantus Maree, Iheoma U. Onuekwusi, Ikechukwu Udo OGBUANU, Isaac K. Mugoya, Kibet Sergon, Peter O. Okoth, Stephanie Shendale, Zorodzai Machekanyanga | 2020 | Journal article | English |
| Opportunities to improve vaccination coverage in a country with a fledgling health system: Findings from an assessment of missed opportunities for vaccination among health center attendees—Timor Leste, 2016 | Anyie J. Li, Colin Sanderson, Ikechukwu Udo OGBUANU, Laura Nic Lochlainn, Manuel Mausiry, Rosye Bela Joana Benevides Monizda Silva, Thelge Sudath Rohana Peiris | 2019 | Journal article | English |
| Can vaccination coverage be improved by reducing missed opportunities for vaccination? Findings from assessments in Chad and Malawi using the new WHO methodology | Anyie J. Li, Blanche-philomene Melanga Anya, Colin Sanderson, Dah Cheikh, Geoffrey Chirwa, Ikechukwu Udo OGBUANU, Joseph Okeibunor, Kwame W. Chiwaya, Mbaihol Tamadji, Mohamed El-Hafiz Djalal, Richard Mihigo, Zorodzai Machekanyanga | 2019 | Journal article | English |
| Increasing routine immunization coverage by reducing missed opportunities for vaccination | World Health Organization (WHO) | 2017 | Guidance | English, French |
| A systematic literature review of missed opportunities for immunization in low- and middle-income countries | Anaïs Colombini, Bradford D. Gessner, Elise Guillermet, Nadira Maleq, Shruti Sridhar | 2014 | Journal article | English |
| Reducing missed opportunities for vaccination in selected provinces of Mozambique: A study protocol | Ikechukwu Udo OGBUANU, Stephanie Shendale, Gabriel Joao, Bvudzai Priscilla Magadzire | 2017 | Journal article | English |
| Intervention guidebook for implementing and monitoring activities to reduce Missed Opportunities for Vaccination | World Health Organization (WHO) | 2019 | Guidance | English, French |
| Planning Guide to Reduce Missed Opportunities for Vaccination | World Health Organization (WHO) | 2017 | Guidance | English, French, Portuguese |
MOV training material
This collection contains tools and resources for training on MOV.
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| Identifying Interventions to Reduce MOV: Health Worker Issues | Immunization Academy, World Health Organization (WHO) | 2020 | Training | English |
| Identifying Interventions to Reduce MOV: Caregivers | Immunization Academy, World Health Organization (WHO) | 2020 | Training | English |
| Interventions to Reduce MOV: Health System Issues | Immunization Academy, World Health Organization (WHO) | 2020 | Training | English |
| Recognizing Common Reasons for Missed Opportunities for Vaccination | Immunization Academy, World Health Organization (WHO) | 2020 | Training | English |
| Missed Opportunities for Vaccination (MOV) and Their Impact on Immunization Coverage | Immunization Academy, World Health Organization (WHO) | 2020 | Training | English |
| Training slides and sample agenda | World Health Organization (WHO) | 2017 | Training | English |
Interventions to reduce MOV by addressing health worker knowledge, attitudes and practice
Country examples and/or resources to address health worker knowledge, attitudes and practice.
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| Assessment of vaccine wastage rates, missed opportunities, and related KAPs during introduction of a second dose of measles-containing vaccine into Cambodia’s national immunization program | Aaron S. Wallace, Danni Daniels, Eleanor Burnett, John Hustedt, Kong Krey, Margaret L. Watkins, Narin Choun, Richard Duncan, Sann Chan Soeung | 2018 | Journal article | English |
| Vaccination calendar from Thailand, including accelerated schedule | Ministry of Public Health, Thailand | 2017 | Report | Thai |
| Australian Measles vaccination catch-up guide | National Centre for Immunisation Research and Surveillance | 2019 | Guidance | English |
| Ministry of Health and Child Care Vaccination Calendar | Zimbabwe Ministry of Health and Child Care, UNICEF, World Health Organization (WHO), United States Agency for International Development (USAID), Maternal Child Health Integrated Program (MCHIP) | 2017 | Tool | English |
| Flow chart for integrated maternal and child health from Kenya | UNICEF | Tool | English | |
| Vaccination calendar from Thailand | Ministry of Public Health, Thailand | Tool | Thai | |
| Tool for catch-up vaccination from Malawi | Malawi Ministry of Health | 2017 | Tool | English |
| Working together: An integration resource guide for planning and strengthening immunization services throughout the life course | World Health Organization (WHO) | 2018 | Case study | English, French |
| MSF Vaccinometer - immunization wheel to determine eligibility for vaccination among children 0-8 years. | MSF - Médecins Sans Frontières | 2024 | Tool | English |
Interventions to reduce MOV by addressing health systems issues
Country examples and/or resources to address health systems issues.
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| Immunization flip-chart from Ghana | Ghana Health Service, UNICEF, Centers for Disease Control and Prevention (CDC) | 2022 | Guidance | English |
| Vaccination Programs: Standing Orders | The Community Guide | 2015 | Repository | English |
| Providing opportunistic immunisations for at-risk inpatients in a tertiary paediatric hospital | Fiona Newall, Kirsten Perrett, Sonja Elia | 2017 | Journal article | English |
| Annex 4: Illustrative example of job aid on screening for vaccine eligibility (2YL Guidance) | World Health Organization (WHO) | 2018 | Training | English |
| Data Quality Review (DQR) Toolkit | World Health Organization (WHO), Gavi, the Vaccine Alliance, The Global Fund, JSI, United States Agency for International Development (USAID), MEASURE Evaluation | 2020 | Repository | English |
| Working together: An integration resource guide for planning and strengthening immunization services throughout the life course | World Health Organization (WHO) | 2018 | Case study | English, French |
Interventions to reduce MOV by addressing the demand-side (caregiver behaviours)
Country examples and/or resources to address demand-side (caregiver behaviours).
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| Lao PDR vaccination sticker | Lao PDR Ministry of health, World Health Organization (WHO), Gavi, the Vaccine Alliance, UNICEF | 2012 | Tool | Lao |
| A picture speaks a thousand words: evaluation of a pictorial post-vaccination care resource in Australia | Hammad Ali, Holly Seale, Kirsten Ward, Nicholas Zwar | 2010 | Journal article | English |