Building capacity to improve the assessment of vaccine safety, effectiveness and uptake in Pakistan: An environmental scan to inform and plan future research

Vaccine-preventable diseases (VDPs) still account for a substantial proportion of deaths worldwide, especially in children living in low-and-middle-income countries (LMICs). In Pakistan, full coverage remains modest in children and varies by province from below 40% up to 80%, leading in turn to ongoing endemic transmission of certain VPDs, including poliomyelitis and measles. The risk posed to Canadians by the re-emergence and ongoing circulation of VPDs in parts of the world has been particularly evident in 2024, during which 80 cases of measles have been observed in Canada. The COVID-19 pandemic has highlighted the importance of having accurate and up-to-date monitoring of vaccine safety, effectiveness and uptake in the context of an emerging infectious disease threat. In Ontario and Canada, the established infrastructure has allowed for the accurate and timely assessment of COVID-19 vaccine safety, effectiveness and uptake through health administrative data and existing surveillance mechanisms. However, such platforms and the ability to monitor for vaccine effectiveness, safety and uptake remain limited in Pakistan, which may in turn contribute to further vaccine hesitancy in these settings. Building on work around the evaluation of vaccine safety and effectiveness that we have conducted in Canada and existing research networks, our team is planning to identify key challenges and local needs related to the evaluation of vaccine programmes in Pakistan through surveys and meetings with stakeholders and community partners. This project will allow for the implementation of an infrastructure that can be leveraged for long-term vaccine research and response to emerging and re-emerging infectious diseases threats in Pakistan.