Critical issues in implementing a national integrated all-vaccine preventable disease surveillance system

•Disease surveillance systems are often fragmented and stand-alone.•Surveillance systems should be flexible and meet the needs of disease elimination and control goals.•A universal fully integrated surveillance system will not fit all diseases.•Many system components can be integrated, improving efficiency and optimizing limited resources.

In 2007, the World Health Organization published the Global Framework for Immunization Monitoring and Surveillance (GFIMS) outlining measures to enhance national surveillance for vaccine preventable diseases (VPDs). The GFIMS emphasized that VPD surveillance should be integrated and placed in a ‘unified framework’ building upon the strengths of existing surveillance systems to prevent duplication of activities common to all surveillance systems and to minimize human resource and supply expenditures. Unfortunately, there was little experience in actually developing integrated VPD surveillance. We describe the process of developing operational guidance for ministries of health to implement such an integrated surveillance system for multiple VPDs.