The Big Catch-Up (BCU) is a global initiative launched in 2023 by the WHO, the United Nations Children’s Fund (UNICEF), Gavi, the Vaccine Alliance and partners to help countries recover immunization coverage lost during the COVID-19 pandemic and to strengthen the long-term ability of health systems to identify and vaccinate zerodose and underimmunized children. This report synthesizes the findings of in-depth mixed-methods case studies conducted in Cameroon, Nigeria (Bauchi and Rivers States), Pakistan (Punjab and Sindh Provinces), the United Republic of Tanzania and Yemen – diverse settings that reflect the geographic, epidemiological and operational variation among Immunization Agenda 2030 (IA2030) priority countries. The case studies examined how countries planned and implemented BCU efforts, what facilitated or hindered progress, and how early gains can be institutionalized into routine immunization and primary health care systems.

Across the case study settings, the BCU was implemented during a time of significant global health transition, marked by funding contractions, competing emergencies, humanitarian challenges and constrained health workforce capacity. Despite this complexity, the initiative catalysed meaningful progress in identifying missed children, reaching high-risk communities, adapting service delivery modalities, updating policies, strengthening data systems and shifting practices toward sustainable catch-up approaches.

Catch-up reports and briefs

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• Le Grand Rattrapage

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