The agenda on improving vaccine uptake is not new. Yet, persistent and emerging challenges threaten the significant public health gains that vaccination has made over decades. Spikes in vaccine hesitancy often coincide with new policies, procedures, information and risk perception. Much of the literature on vaccine hesitancy and vaccine uptake draws from cognitive models of individual-level drivers; there are few examples of studies grounded in mesoand macro-level interactions between individuals and systemic factors.

To create opportunities to respond to these challenges, the Alliance for Health Policy and Systems Research (the Alliance), with the support of the National Institute for Health and Care Research (NIHR) at the Department of Health and Social Care (DHSC) of the United Kingdom of Great Britain and Northern Ireland, is undertaking a new programme of health policy and systems research to improve vaccine uptake in low- and middle-income countries (LMICs). The objectives of this programme are to improve understanding of low vaccine uptake using health policy and systems research methods (multi-level, multi-stakeholder), and to support efforts to develop and implement appropriate strategies to address low vaccine uptake.