Prioritizing the introduction of new vaccine in Tanzania (2026–2030): a multi-criteria decision analysis by the Tanzania immunization technical advisory group

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BACKGROUND: The growing need for availability of new vaccines, alongside constrained financial and health system resources, necessitates transparent and evidence-based prioritization. METHODS: A multi-criteria decision analysis (MCDA) approach was applied by the Tanzania Immunization Technical Advisory Group (TITAG) to prioritize new vaccine introductions for 2026-2030. The World Health Organization's New Vaccine Introduction Prioritization and Sequencing Tool (NVI-PST) was adapted to the Tanzanian context. From thirteen candidate vaccines, seven were shortlisted: hepatitis B birth dose, hepatitis B (adult), malaria, measles-mumps-rubella (MMR), meningococcal (Men5), maternal respiratory syncytial virus (RSV), and typhoid conjugate vaccine (TCV). Thirteen criteria across importance (n = 9) and feasibility (n = 4) domains were applied. Evidence was compiled and vaccines were scored through a structured, participatory process. RESULTS: Hepatitis B birth dose ranked highest (combined score 1.9), followed by hepatitis B (adult) vaccine (3.0). Malaria and maternal RSV vaccines were moderate priorities (4.2), while MMR (4.4), Men5 (4.5), and TCV (5.2) ranked lowest. Key system constraints identified included limited cold chain capacity, financing uncertainties, cost of a vaccine and gaps in local epidemiological and economic data. CONCLUSION: The application of MCDA through the NVI-PST provided a transparent, systematic, and context-specific framework for prioritizing new vaccine introductions in Tanzania. The findings support phased introduction of hepatitis B vaccines while highlighting the need for strengthened surveillance, sustainable financing, and health system capacity to enable future vaccine adoption. This approach offers a practical model for other resource-constrained settings seeking to optimize immunization decision-making.

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