Table 2 Summary of themes and sub-themes from data analysis

Decision-making process for policy development and implementation

- Problem identification

- Considerations for vaccine introduction

- Monopolized engagement of national level entities in vaccine policy recommendation

- Complexity of decision-making process

- Policy implementation process (systematic implementation)

- Policy evaluation

Effects of devolution on health care policies

- Policy adaptation to local needs

- Intra-governmental communication

- Delineation of responsibilities

- Resource provision within government

Resilience of policy to external influences

- Rumours

- Anti-vaccine campaigners

- Sociocultural influences

Recommendations for improving vaccine policy-making process

- Stakeholder engagement at all levels

- Improve intra-governmental communication