Innovative webinar-based training to support evidence-to-recommendation decision-making by national immunization technical advisory groups: multi-country experience with hexavalent vaccines

Since endorsement of the Global Vaccine Action Plan, and continued emphasis under Immunization Agenda 2030, the number of functional National Immunization Technical Advisory Groups (NITAGs) has expanded rapidly, creating increased demand for training in evidence-informed decision making. To support timely national policy decisions relating to immunization, innovative and flexible training approaches are needed. This paper describes and evaluates a novel, webinar-based Evidence-to-Recommendation (EtR) training designed to support NITAGs in developing evidence-based recommendations for transitioning from pentavalent plus inactivated polio vaccine to combined hexavalent vaccines. Between January and June 2025, a five-part EtR webinar series focused on the hexavalent vaccine transition was delivered to countries, primarily within the WHO African Region, who qualify to receive financial and technical support from Gavi, the Vaccine Alliance, to help introduce new vaccines and strengthen their immunization systems. The series emphasized identification of evidence across EtR domains, and a cohort-based model to facilitate regional peer learning. Effectiveness of the webinar series was assessed through electronic post-webinar surveys and virtual key informant interviews. NITAGs from 32 countries participated in one or more webinars, including nine in three or more. Across participating countries, participants consistently rated the webinars as useful, particularly valuing country experiences and practical guidance on EtR domains. Qualitative feedback highlighted peer learning as the most valuable component of the webinar series, alongside practice guidance on EtR domains such as feasibility and resource considerations, and NITAGs showed strong interest in continued technical support, practical, peer-to-peer learning or "twinning", and operational guidance for hexavalent vaccine introduction.