Evidence map›Paper›PMID 40803145›Full record

ArticleVaccine2025

Exploring off-label vaccine use: a survey of the global national immunization technical advisory group network.

Candace Roberts, Karina A Top, Louise Henaff, Matthew Tunis, Awnish Singh, Judith van Holten, Simona Ruta, Shalini Desai

Abstract read
In one paragraph

Article in Vaccine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Candace RobertsPublic Health Agency of Canada, 130 Colonnade Rd S, Nepean, Ontario K2E 1B6, Canada.
Karina A TopDepartment of Pediatrics, Faculty of Medicine and Dentistry and School of Public Health, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada.
Louise HenaffWorld Health Organization, Immunization, Vaccines and Biologicals Department, Avenue Appia 20, 1211, Geneva 27, Switzerland.
Matthew TunisPublic Health Agency of Canada, 130 Colonnade Rd S, Nepean, Ontario K2E 1B6, Canada.
Awnish SinghDepartment of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, United States of America.
Judith van HoltenWorld Health Organization, Immunization, Vaccines and Biologicals Department, Avenue Appia 20, 1211, Geneva 27, Switzerland.
Simona RutaCarol Davila University of Medicine and Pharmacy and Stefan S. Nicolau Institute of Virology, 285 Mihai Bravu, Bucharest 030304, Romania.
Shalini DesaiPublic Health Agency of Canada, 130 Colonnade Rd S, Nepean, Ontario K2E 1B6, Canada. Electronic address: shalini.desai@phac-aspc.gc.ca.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundNational Immunization Technical Advisory Groups (NITAGs) are crucial for enhancing vaccine use in immunization programs, particularly through off-label recommendations. This study sought to assess the adoption and trends of off-label vaccine recommendations made by NITAGs across low-, middle-, and high-income countries since the COVID-19 pandemic.

methodsAn online survey was distributed to NITAG representatives in World Health Organization (WHO) member states, asking questions related to off-label use of vaccines including policies, procedures, legislation, and regulations for NITAGs in participants' countries. Respondents across all six WHO regions were invited to participate.

resultsRespondents from 76 countries participated in the survey (55 %) were NITAG representatives, and 45 % were immunization program managers or from the NITAG secretariat). Most respondents 52 (68 %) reported their NITAG makes off-label recommendations, 18 (24 %) indicated their NITAG does not make off-label recommendations, and 6 (8 %) were unsure of their NITAG's role. There was a noticeable shift relating to off-label vaccine recommendations observed pre, during, and post-pandemic period. Prior to 2022, 25 (48 %) respondents indicated their country recommended off-label vaccines, 11 (21 %) specified off-label recommendations were limited to emergencies as temporary or conditional expansions, and 6 (12 %) were unsure. After 2022, 30 (58 %) respondents indicated their country recommended off-label vaccines, 4 (8 %) specified off-label recommendations were limited to emergencies as temporary or conditional expansions, 18 (35 %) selected no, and 0 (0%) were unsure. While most countries make off-label recommendations, few (15 %) have policies and procedures to support implementation.

conclusionsAlthough WHO broadly provides guidance on the mandate and core functions of NITAGs, globally, they have differing mandates and operational capacities related to off-label vaccine use. These findings suggest the need for increased awareness of off-label vaccine recommendations and strengthened dialogue around implementation of off-label recommendations.

Indexed as

COVID-19COVID-19 VaccinesImmunization ProgramsOff-Label UseVaccinationVaccinesAdvisory CommitteesGlobal HealthHumansSARS-CoV-2Surveys and QuestionnairesWorld Health OrganizationCOVID-19 VaccinesVaccinesImmunizationNational Immunization Technical Advisory GroupOff-label vaccinesVaccinationVaccine policy

Identifiers

PMID40803145
PMCPMC12447085

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.