The intrinsic, instrumental, and symbolic values of sustaining childhood vaccination in conflict settings.

The World Health Organization's Decision Framework for Vaccination in Acute Humanitarian Emergencies remains the principal global guide for vaccination prioritization and decision-making in crisis settings. However, it gives insufficient attention to sustaining vaccination as a matter of justice, as a means of upholding established human rights norms and the values that vaccines provide in these contexts. We argue that, if children living in conflict settings are to enjoy the same fundamental rights to life and health as children elsewhere, vaccination must be recognized as more than an emergency‑response intervention. We therefore propose a broader perspective to support guiding decisions to sustaining vaccination services that enhance the medium- and long-term resilience of health systems, and justice in conflict settings. We categorize the benefits and values of vaccination in conflict settings into three types: intrinsic, instrumental, and symbolic. We contend that vaccines are valuable in all three ways during humanitarian emergencies, and that this overlapping value means global health actors should prioritize sustaining vaccine delivery for children during conflicts.