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The Strategic Advisory Group of Experts on Immunization (SAGE) met from 22–25 September 2025, alongside the Malaria Policy Advisory Group (MPAG). The meeting reviewed global immunization progress and ongoing challenges.
What Happened
Experts noted that vaccination coverage has mostly returned to pre-pandemic levels. However, recovery remains uneven, especially in fragile and conflict-affected areas. Funding shortages, instability, and declining public trust continue to affect vaccine acceptance.
SAGE’s mid-term review of the Immunization Agenda 2030 (IA2030) reaffirmed its global goals. The group called for faster action and stronger partnerships to help countries integrate immunization into primary health care and improve data use.
Key Discussions
Members reviewed global COVID-19 trends. Experts noted that vaccination coverage has mostly returned to pre-pandemic levels. However, despite this progress, recovery remains uneven and inconsistent, especially in fragile and conflict-affected areas. Furthermore, many regions continue to struggle with limited resources and disrupted health systems, slowing down full recovery efforts.
On polio, SAGE urged swift action to stop wild poliovirus transmission in Pakistan and Afghanistan and to address ongoing cVDPV2 outbreaks. The group encouraged stronger strategies, wider use of nOPV2 and fractional-dose IPV, and political accountability.
Vaccine Innovation
SAGE expressed optimism about progress in vaccine research. Five new tuberculosis (TB) vaccines are in proof-of-concept stages, with hopes for the first adult and adolescent TB vaccine by 2028. The group also updated guidance on influenza A(H5) vaccines for high-risk groups and reaffirmed a four-dose malaria vaccine schedule. Experts encouraged the development of combination vaccines to simplify delivery and boost acceptance.
Looking Ahead
The G20 Health Ministers’ Meeting will take place in Limpopo, South Africa, from 4–7 November 2025. It will focus on building political support for global immunization. On 6 November, the TB Vaccine Accelerator Council, co-led by WHO, South Africa, and Gavi, will release a report on financing and access to new TB vaccines.
Conclusion
Experts agreed that this is a critical moment for global immunization. Urgent action and stronger cooperation are needed to protect progress, close equity gaps, and ensure every community benefits from life-saving vaccines.
