National Immunization Technical Advisory Groups (NITAGs) serve as essential, country-owned platforms to guide vaccine policy through independent, evidence-informed recommendations. Since their early establishment in countries like the UK, US, and Canada in the 1960s, global momentum around NITAG development has grown significantly, particularly following the launch of Gavi-supported initiatives such as SIVAC and the 2012 Global Vaccine Action Plan (GVAP), which emphasized NITAG functionality as a global health priority.
12 Years of Global Progress: Coverage and Functionality
According to a 2025 global analysis of WHO/UNICEF Joint Reporting Form (JRF) data, 88% of countries had established NITAGs by 2023, up from 61% in 2012—covering 98% of the world’s population. Functionality has improved notably: 68% of NITAGs now meet WHO’s six process indicators (legal foundation, formal terms of reference, multidisciplinary expertise, regular meetings, agenda review mechanisms, and conflict of interest disclosure), compared to just 33% in 2012.
While low-income countries showed high NITAG coverage (94%) and the highest functionality rate (84%), policy adoption rates were not always aligned. In 2023, 87% of countries with NITAGs issued at least one vaccine policy recommendation, but adoption varied. Well-functioning NITAGs had a 91% adoption rate, compared to 62% among those not meeting core process standards.
Persistent Gaps: Staffing, Evidence Use, and Governance
Despite these gains, several structural and operational challenges persist. A study of NITAGs in the WHO European Region found that many lacked full-time secretariats or adequate human and financial resources. In most cases, staff held dual roles in national public health institutions or immunization programmes.
In terms of methodology, many NITAGs struggle to access full-text scientific literature or lack training in systematic evidence evaluation. Few apply structured “evidence-to-recommendation” (EtR) processes. Most rely on existing WHO SAGE reviews, systematic reviews from other NITAGs, or international policy briefs, highlighting a need for capacity-building in independent evidence appraisal.
Looking Ahead: From Tools to Institutionalization
Improving NITAG performance requires both short- and long-term strategies. In the short term, greater use of tools such as the NITAG Maturity Assessment Tool (NMAT), EtR framework training, and systematic review quality assessment (e.g., AMSTAR) can drive self-assessment and improvement. In the long term, dedicated secretariats, transparent governance, and sustainable funding will be essential to ensure NITAG independence and continuity. Cross-country collaboration and structural safeguards will be critical to support NITAGs in fragile settings and ensure their role as pillars of global immunization governance.
More can be found in these articles:
Henaff, L., Dumolard, L., Bura, V., Sume, G. E., Ndiaye, S., Sanwogou, J., Cho, H., Hombach, J., & Steffen, C. A. (2025). Strengthening National Immunization Technical Advisory Groups: Twelve Years of Progress (2012–2023). Vaccines, 13(1), 80. https://doi.org/10.3390/vaccines13010080
Külper-Schiek W, Mosina L, Jacques-Carroll LA, et al. (2025). Evaluation of National Immunization Technical Advisory Groups (NITAGs) of middle-income countries in the WHO European Region; a synopsis. Frontiers in public health, 13, 1464370. https://doi.org/10.3389/fpubh.2025.1464370
Content Editors: Rurong Li
Page Editor: Rurong Li
