The Knowledge Hub

What is the Knowledge Hub?

Explore the VoICE Knowledge Hub—a searchable database featuring the latest peer-reviewed research on immunization benefits, especially in low- and middle-income countries. Browse the Knowledge Hub using a variety of different filters to find vaccine evidence based on country, region, topic, or disease. Click on a tag to find more evidence on a specific area, such as the return on investment of vaccines or impacts of infectious disease outbreaks.


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Fear of Ebola in West Africa caused financial losses and staff shortages in Nigerian hospitals

Fear of Ebola during the 2014-2016 epidemic in 3 West African countries had a major impact on the health sector in neighboring Nigeria, where hospitals some hospitals also turned away febrile patients to prevent being associated with Ebola while staff in other hospitals abandoned their posts.

Bali S, Stewart KA, Pate MA. 2016. Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria. BMJ Global Health. 1(3).

Adding hepatitis B vaccine to routine immunization for refugees in Africa reduces transmission and improves global health security

Adding a birth dose of hepatitis B vaccine to routine immunization of refugees in Africa — who have particularly high infection rates — is a highly cost-effective means of reducing transmission of the infection thus strengthening the overall global health security among these mobile, vulnerable populations.

Reardon JM, O'Connor SM, Njau JD et al.. 2019. Cost-effectiveness of birth-dose hepatitis B vaccination among refugee populations in the African region: a series of case studies. Conflict and Health. 13(5).

Meningitis epidemics in Burkina Faso caused major disruptions in healthcare services and increased misdiagnoses

Meningococcal meningitis epidemics in Burkina Faso “… disrupted all health services from national to operational levels,…” according to a 2011 study. Impacts included a shortage of available hospital beds and medicines, a reduction or delay in routine lab analyses for other diseases, longer wait times, and an increase in misdiagnoses by overtaxed health workers.

Colombini A, Badolo O, Gessner BD et al.. 2011. Cost and impact of meningitis epidemics for the public health system in Burkina Faso. Vaccine. 29.

Correctional facilities can provide access to health services for incarcerated adolescents at risk of hepatitis B

Studies have indicated that the prevalence of risky behaviors associated with Sexually Transmitted Infections (STIs) and HIV is high among incarcerated adolescents. In the US, most adolescents sentenced to serve time in correctional facilities are offered preventive vaccination against hepatitis B. Medical clinics in correctional facilities provide an ideal environment for adolescents in high risk settings to obtain access to preventive health services. In certain cases, these facilities even overcome barriers such as parental consent by making these adolescents wards of the state and followed by which preventive services are obtained by the state providing consent.

Tedeschi, S.K., Bonney, L.E., Manalo, R., et al.. 2007. Vaccination in juvenile correctional facilities: state practices, hepatitis B, and the impact on anticipated sexually transmitted infection vaccines. Public Health Rep. 122(1).

A strong national immunization program can be leveraged during health emergencies

The Government of Nigeria used the Incident Management System (IMS) to establish a national Emergency Operations Center (EOC) as part of a new national emergency plan for the global polio eradication initiative. The use of IMS through the EOC changed the operational tempo, accountability measures, and programmatic success of the polio program. This existing infrastructure was in place and leveraged to contain the outbreak of Ebola.

Shuaib, F., Gunnala, R., Musa, E.O., et al. 2014. Ebola virus disease outbreak – Nigeria, July-September 2014. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. 63(39).

Immunization infrastructure, personnel, and expertise from polio eradication programs allow countries to quickly respond to other diseases

In the Americas, a platform built to secure polio eradication has been expanded to help track, control, prevent, and monitor immunization impact for measles and rubella. In India, highly trained polio health workers have become the basis for a trained workforce working towards the elimination of measles and rubella and helping ensure India’s certification by WHO for having eliminated maternal and neonatal tetanus.

Andrus, J.K., Cochi, S.L., Cooper, L.Z., et al. 2016. Combining global elimination of measles and rubella with strengthening of health systems in developing countries. Health Affairs. 35(2).

Immunization provides a key opportunity to control disease outbreaks globally

The latest International Health Regulations (IHR) of the World Health Organization updated in 2005 contained several major changes compared to earlier versions. However, the need to report cases of cholera and yellow fever has remained along with an expansion of the concerned disease list. These diseases continue to be critical threats to national and international health security, making immunization against them a vital disease control approach.

Andrus, J.K., Aguilera, X., Oliva, O., et al. 2010. Global health security and the International Health Regulations. BMC Public Health. 10(1).