Building on three decades of influenza vaccine use, Jordan is advancing efforts to establish a more structured national programme and generate the data needed to better understand coverage and address barriers to vaccination.
A 2025 burden of disease analysis by the Ministry of Health and World Health Organization (WHO), based on hospital surveillance data from 2015 to 2019, estimated that influenza was associated with an average of 1974 hospitalizations and 93 deaths over the study period, with more than half of hospitalizations among children under five years of age. While approximately 200 000 doses of influenza vaccine are distributed annually, the absence of detailed coverage data limited the ability to accurately assess uptake among vulnerable groups.
Understanding the barriers first
In 2024, the Ministry of Health, in collaboration with WHO, conducted a behavioural and social drivers (BeSD) study to better understand influenza vaccination practices among key population groups, including health workers, pregnant women and older people, and to identify the barriers influencing vaccine uptake and access. The study found a substantial gap between awareness of influenza vaccination and actual uptake. Although awareness of the influenza vaccine was high among health workers (95%), pregnant women (76%) and older people (70%), only 65%, 30% and 25%, respectively, reported having been vaccinated during the preceding two years. The findings also highlighted practical barriers to access, including inconsistent vaccine supply, distance and cost, as well as barriers to vaccine uptake, such as concerns about vaccine safety and low perceived risk of influenza. Recommendations from health workers and supportive family norms emerged as important enablers of vaccination. The findings underscored the need for a national seasonal influenza vaccination policy to support a more consistent and equitable vaccination programme.
A tool that produced Jordan's first coverage data
In response to these findings, the Ministry of Health worked with the Partnership for Influenza Vaccine Introduction (PIVI) and WHO to develop Jordan's first national influenza microplanning tool. Microplanning is the process of translating national health goals into detailed local plans for reaching target populations with health interventions. In this case, it helps health authorities estimate the number of people in priority groups, allocate vaccine supplies and plan delivery at the local level. The Excel-based tool combines WHO microplanning guidance, PIVI's forecasting methodology and the BeSD findings adapted to Jordan's context.
After being piloted in 2025 with two governorates, the tool was introduced across all fourteen health directorates. It produced Jordan's first national database of target-group estimates and its first reported public-sector influenza vaccination coverage data.
Of approximately 75 000 doses distributed in 2025, reported coverage was 69.3% among health workers, compared with 0.75% among pregnant women, 0.6% among children, 9.1% among older people and 12.5% among people with chronic conditions. Even within the best-covered group, coverage varied sharply by directorate, from 37% in Zarqa to more than 100% in Jarash, highlighting the value of local data visibility and ownership in identifying and addressing such gaps.
From data to national action
A national seasonal influenza vaccination policy informed by the BeSD findings and the tool's risk group coverage data has now been drafted and is awaiting endorsement by the Minister of Health. Jordan's 2026–2027 plan includes targeted campaigns delivered through antenatal care, chronic disease management and services for older people. It also proposes an expanded pharmacy channel, improved supply forecasting and digitalization of microplanning through the national Vaccine.jo platform.
“We saw stronger ownership and accountability at the directorate level,” said Nizar Maswadi, Community Medicine Specialist and EPI Manager at Jordan's Ministry of Health, of the decentralized planning process. “Once directorates could see their own numbers, they acted.”
Photo caption: Patient receiving influenza vaccine at Amman Comprehensive Center, Jordan, 2023
Photo credit: WHO