Protecting lives across the lifespan through vaccination in Bhutan

The Bhutan Immunization Programme, established in 1979, has consistently protected communities from vaccine-preventable diseases through strong routine immunization and outreach services. In recent years, the programme has expanded from a primary focus on childhood and selected adult vaccinations to comprehensive life-course vaccination guidelines, ensuring protection at every stage of life.

To address subnational coverage gaps and equity challenges, vaccination records of more than 2 500 children under 15 years of age from urban and highland communities were reviewed. Children who had missed vaccines were rapidly identified and provided with the required doses. These efforts focused on reaching hard-to-reach populations and ensuring that no child was left unprotected.

Innovation remains central to Bhutan's Immunization Programme. Alongside the introduction of life-course vaccination guidelines, the cold chain system has been digitalised, enabling real-time monitoring of cold chain equipment. Any temperature excursion now triggers an immediate SMS alert to health workers, allowing prompt corrective action. To further strengthen vaccine safety, solar direct-drive cold chain equipment has been installed in 18 health facilities affected by frequent power outages, ensuring uninterrupted vaccine storage and potency.

The WHO Country Office (WCO) played a facilitative and advisory role by providing technical guidance and policy support, coordinating closely with the Ministry of Health and partners, and linking national needs with regional and global expertise. Community trust was strengthened through targeted awareness programmes in districts with sub-optimal coverage, as well as capacity-building workshops for village health workers, who serve as trusted links between the health system and remote communities.

Bhutan has sustained high immunization performance, with coverage for Penta-3 and MMR-1 consistently above 95%. The National Health Survey 2023 reported basic vaccination coverage of 99.4% among children under two years of age, demonstrating strong protection against vaccine-preventable diseases. Ongoing research on the behavioural and social drivers of vaccine uptake will further inform targeted strategies to sustain high coverage across all population groups.

Voices from the field

Health worker: "Communication is a cornerstone of ensuring that people feel confident about vaccination and return for subsequent doses. I take time to clearly explain the benefits of vaccination and address any questions or concerns that families may have."

Community member: "Vaccines are one of the best ways to protect our children. Both of my children have received their vaccinations and are healthy and thriving. I encourage all parents to ensure their children are vaccinated on time for a safer future."

Bhutan's experience demonstrates that strong leadership, innovation and community engagement can effectively strengthen immunization programmes. Digital cold chain monitoring, solar-powered equipment and life-course vaccination guidelines ensure equitable access and vaccine safety.

By empowering village health workers and addressing subnational gaps, Bhutan shows that coordinated action and trust-building can protect people of all ages-demonstrating that for every generation, vaccines work.

Photo Credit: Cheten Zangmo, Program Officer, MoH, Bhutan