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Choice Optimization for Immunization: Country Exercises in Sustainability (CHOICES)

The Challenge

With an evolving vaccine product landscape, countries—especially low- and middle-income countries— increasingly face complex decisions as they work to optimize their immunization programs and prioritize interventions, including:

  • Weighing new, existing, and anticipated vaccines
  • Adapting immunization programs and schedules to emerging evidence
  • Fielding market, financial, and programmatic pressures
  • Evaluating complementary disease prevention and control interventions

In addition, COVID-19 vaccines, as they become available, present countries with a new set of particular challenges.


“CHOICES is a partnership of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, the JSI Research and Training Institute, and the U.S. Centers for Disease Control and Prevention, with funding from the Bill & Melinda Gates Foundation

CHOICES aims to empower, equip, and support country immunization programs to develop and implement optimized, comprehensive communicable disease prevention and control programs, and to equip global partners with evidence-based resources, guidance, and frameworks to support countries in strengthening decision-making and sustainability.

CHOICES complements the efforts of Ministries of Health and key partners to:

  1. Optimize vaccination programs- CHOICES provides evidence and guidance on vaccine product profiles and alignment with country needs, supports countries in navigating and applying the CAPACITI decision support tool, and accompanies countries as they prepare for switches or introductions.
  2. Prioritize interventions- CHOICES provides technical assistance and guidance to review existing and planned immunization and communicable disease prevention and control programs, and supports decision-making on alignment with national disease prevention priorities.
  3. Navigate resources-CHOICES supports countries in navigating a catalog of tailored decision-making tools, best practices, guidance and frameworks, in partnership with CAPACITI (WHO).
  4. Strengthen capacity-CHOICES assists in strengthening capacity for monitoring and evaluation of implementation and impact.
  5. Implement decisions -For countries that decide to switch vaccine products, schedules, presentations, or uses, CHOICES can support planning and implementation

To support countries navigating COVID-19 vaccine introductions, CHOICES assists with reviewing emerging evidence for rapid decision-making on COVID-19 vaccine products (including interchangeability), schedules (including intervals and booster doses), rollout strategies, and more.”