Title : Closing the coverage gap: Expanding tetanus toxoid / tetanus and diphtheria (TT/Td) and human papillomavirus (HPV) immunization access in Tanzania through periodic intensification of routine immunization (PIRI) – a case study of Kagera and Njombe regions
Abstract:
Ensuring equitable vaccine access in low-resource settings remains a major challenge, particularly for underserved groups such as women of reproductive age and adolescent girls. In Tanzania, despite national and global efforts, coverage gaps persist, especially in rural regions. Routine immunization services often struggle to meet targets due to limited outreach, logistical barriers, and insufficient integration with other health services. Strengthening strategies such as Periodic Intensification of Routine Immunization (PIRI) combined with active community engagement, culturally tailored messaging, and robust monitoring can help close the coverage gap, improve equity, and advance the goal of universal access to life-saving vaccines. This was evident in Kagera and Njombe regions, where between April and June 2025, TT/Td and HPV vaccination coverage was way below expectation.
The Saving Lives and Livelihood’s Project data from April to July,2025 was analyzed alongside field visits to evaluate service delivery and confirm reported information. The results show that the project had a slow start between April and June 2025. In May, only 1,333 vaccinations were given, reaching 17% of the monthly goal, and in June, 1,465 vaccinations attributed to 19% of the target were administered. However, after implementing PIRI in July, coverage skyrocketed to 12,703 vaccinations, which is 166% of the monthly target for both women of reproductive age and adolescent girls getting Tetanus Toxoid/Tetanus and Diphtheria (TT/Td) and Human Papillomavirus (HPV) shots. This significant improvement resulted from better planning and the integration of routine immunization with other health services during PIRI. The method effectively bridges vaccine access gaps for underserved groups. When combined with community involvement and thorough data verification, it greatly enhances the reach of essential immunizations like HPV and Td/TT. These results highlight the need for systematic integrated outreach and strong monitoring to achieve equity in immunization coverage. By combining vaccination with other essential health services, leveraging community mobilization, and strengthening planning and monitoring, these outreaches addressed multiple barriers at once. They reduced missed opportunities, improved service efficiency, and expanded access to hard-to-reach populations.
