Sustaining gains in vaccine-preventable diseases: WHO supports review of Mongolia’s national immunization programme

Mongolia has achieved substantial progress in controlling vaccine‑preventable diseases, with high routine immunization coverage and the elimination of diseases such as polio. However, recurrent outbreaks of measles continue to highlight immunity gaps, particularly among mobile and underserved populations in urban areas. At the same time, Mongolia carries a significant burden of infections with long-term consequences, such as hepatitis B, underscoring the importance of sustaining high-quality immunization services across the life course.

Although the national immunization programme remains strong, challenges persist in ensuring equitable coverage, strengthening surveillance systems, and maintaining population immunity across all age groups. Addressing these gaps through targeted immunization strategies, enhanced surveillance, and strengthened community engagement will be critical to sustaining disease control and advancing towards elimination goals.

The introduction of HPV vaccination represents a major milestone and an important expansion of the immunization programme beyond early childhood. Given Mongolia’s high burden of cervical cancer, HPV vaccination is a critical public health intervention. However, its successful implementation and scale-up depend on the strength of the broader EPI system, including effective delivery platforms for adolescents, strong community acceptance, well-designed communication strategies, and robust monitoring systems.

Therefore, the Expanded Programme on Immunization (EPI) Review, integrated with the Human Papillomavirus (HPV) vaccine Post-Introduction Evaluation (PIE) is essential to comprehensively assess the performance of the immunization programme in light of the current VPD epidemiology and the recent introduction of HPV vaccination. The review will help identify key gaps and bottlenecks in both routine immunization and HPV delivery, and inform strategic actions to strengthen the programme, close immunity gaps, and ensure effective and sustainable implementation of HPV vaccination.

National and international experts, health officials and partners participating in Mongolia’s Expanded Programme on Immunization (EPI) review and HPV vaccine Post-Introduction Evaluation (PIE), a nationwide effort to strengthen immunization systems and protect communities from vaccine-preventable diseases. © WHO Mongolia

Led by the Ministry of Health and the National Center for Communicable Diseases (NCCD), with support from the World Health Organization (WHO) Mongolia, UNICEF, Gavi and other partners, the review assesses every major component of Mongolia’s immunization programme, from vaccine delivery and cold chain systems to disease surveillance, and community engagement, following the WHO EPI Review framework and PIE tool. The review also examines programme performance at national, provincial, district, and service-delivery levels.

This review comes at a pivotal moment as the country reviews its Communicable Diseases Action Plan for 2026-2029, including updates to the comprehensive multi-year plan. Commending the efforts of the Government of Mongolia, health workers, and partners in advancing equitable access to vaccines and strengthening the immunization system, WHO Representative to Mongolia Dr Socorro Escalante notes, “The EPI review integrated with PIE highlights Mongolia’s strong commitment to protecting the health and future of its children and adolescents through immunization.  The findings and recommendations from this review provide an important opportunity to accelerate progress towards Mongolia’s public health goals and further reduce the risk of deaths from vaccine-preventable diseases.”

Bringing together perspectives from across the country

Over several weeks, multidisciplinary review teams conduct desk reviews, technical consultations, online sessions and field visits across provinces and districts, including urban, rural and remote areas.

Field teams visit health facilities, schools and local health departments to observe vaccination sessions, assess cold chain systems, review data quality and speak directly with health workers, teachers, caregivers and communities. The approach allows review teams to better understand how national policies translate into realities at local level, and where gaps and inequities continue to affect service delivery.

“Through close collaboration with national counterparts and field teams, we aim to understand not only what is working well, but also where operational gaps and inequities persist. By engaging directly with health workers, local authorities and service delivery points, the review ensures that the voices and experiences from the field inform practical and prioritized recommendations. Ultimately, this process helps strengthen programme performance, enhance the quality and reach of immunization services, and support Mongolia in advancing towards more equitable and resilient vaccination systems.”

Learning from the HPV vaccine introduction

A major focus of the review is Mongolia’s HPV vaccine rollout, which has already reached almost 49 000 children (61%) by 11 May 2026 through school- and community-based vaccination efforts.

© WHO Mongolia

The introduction of HPV vaccine required coordination between Mongolia’s health and education sectors on an unprecedented scale. Healthcare workers including the vaccinators from soum and family health centers, alongside teachers and school staff were trained nationwide, while local governments, schools and community leaders supported outreach and awareness activities.

The review examines both what works well and what challenges remain. Early lessons show that strong local leadership, face-to-face engagement with parents, tailored microplanning and trusted local voices play a key role in improving vaccine uptake in several provinces.

At the same time, the HPV vaccine rollout took place alongside Mongolia’s large measles outbreak response in 2025, placing additional pressure on frontline health workers and health systems nationwide. Widespread misinformation on social media also contributes to vaccine hesitancy and increases demand for risk communication and community engagement efforts.

Strengthening systems beyond immunization

The review also generates broader lessons for Mongolia’s health security and disease prevention efforts. Recent experiences responding to the 2025 measles outbreak have highlighted the importance of strong surveillance systems, emergency preparedness, coordinated communication, and resilient frontline services.

Review teams therefore examine how immunization systems can better support outbreak preparedness, improve data systems, strengthen risk communication and ensure equitable access to vaccines across all regions.

Particular attention is given to reaching underserved populations, strengthening local-level planning and ensuring lessons from HPV introduction can support future adolescent immunization programmes.

Emphasizing the long-term importance of the review, Dr S. Enkhbold, Director of the NCCD says: “This integrated EPI and HPV PIE review reflects Mongolia’s strong commitment to continuously strengthening its national immunization programme. By bringing together national leadership, technical partners and frontline health workers, the review enables a comprehensive assessment of programme performance, from policy and system governance at the national level to service delivery in provinces and districts.

“The active engagement of local health staff and stakeholders ensures that the findings are grounded in real-world implementation, allowing us to identify both achievements and areas requiring improvement. The outcomes of this review will play a critical role in guiding evidence-based decision-making, enhancing programme quality and ensuring equitable access to vaccines for all populations across Mongolia.”

Turning findings into action

The review concludes with a comprehensive report outlining strengths, weaknesses and priority recommendations across the immunization programme.

The findings will contribute directly to Mongolia’s updated Communicable Diseases Action Plan 2026-2029, the next comprehensive multi-year immunization plan and future partner support frameworks.

For Mongolia, the process is about more than reviewing performance. It is about strengthening the systems that protect communities from preventable diseases and ensuring that life-saving vaccines continue reaching every child and adolescent, everywhere.