As part of a Gavi-funded Hexa Switch Assessment Project, the Sabin Vaccine Institute – in collaboration with the Task Force for Global Health and WHO AFRO – developed this Hexavalent Switch Evidence-to-Recommendation (EtR) Framework to support countries considering a transition in 2026. The document provides a structured EtR framework using a PICO question to guide NITAG decision-making on switching from pentavalent + IPV to hexavalent vaccines in infants.
It outlines the policy rationale for the switch, including fewer injections, improved IPV coverage, support for polio eradication, and potential efficiencies for immunization programmes.
The framework organizes decision-making across seven key domains: problem/burden, benefits & harms, values & preferences, resource use, equity, acceptability, and feasibility.
It compiles key evidence types and data sources, drawing heavily on WHO guidance (e.g., position papers, SAGE, GACVS, WHO/UNICEF data) and relevant scientific literature.
Designed as a practical, adaptable tool, the framework supports country-specific analysis and can assist Gavi-eligible countries in making informed decisions about adopting hexavalent vaccines.
