Background: The World Health Organization (WHO) has a mandate to provide leadership on global policies, standards and norms and to support member countries in applying these to national programmes to improve health. In line with this mandate, the WHO Director General established the Strategic Advisory Group of Experts on Immunization (SAGE) as the principal advisory group to WHO for vaccines and immunisation.

Methods: SAGE is comprised of 15 independent experts who meet twice a year to develop recommendations on global vaccine policies and strategies for controlling vaccine-preventable diseases. Proceedings are open to partners as well as other observers, and are preceded by a comprehensive review of current scientific evidence.

Results: SAGE recommendations are evidence-based and provide the basis for WHO vaccine position papers, which inform country-level decision making and programme implementation. SAGE recommendations are also important for all immunisation stakeholders. The recommendations can be vaccine-specific or cross-cutting. SAGE has made recent recommendations regarding malaria and dengue vaccines; vaccine hesitancy and pain mitigation during vaccine delivery; etc. SAGE also provides annual Global Vaccine Action Plan (GVAPP) progress reports; and technical guidance to WHO and the Global Polio Eradication Initiative for the development and finalisation of the overall polio eradication 'endgame strategy’.

Conclusions: SAGE recommendations are having a clear and significant impact on the introduction and use of vaccines worldwide. SAGE continues to refine its operational processes with a focus on rapid dissemination of recommendations to WHO member countries and ensuring immunisation policies are coordinated within a wider framework of prevention.