The need for sustainability and alignment of future support for National Immunization Technical Advisory Groups (NITAGs) in low and middle-income countries.

National Immunisation Technical Advisory Groups (NITAGs) provide independent guidance to health ministries to support evidence-based and nationally relevant immunisation decisions. We examined NITAGs' value, sustainability, and need for support in low and middle-income countries, drawing from a mixed-methods study including 130 global and national-level key informant interviews. NITAGs were particularly valued for providing independent and nationally owned evidence-based decision-making (EBDM), but needed to be integrated within national processes to effectively balance independence and influence. Participants agreed that most NITAGs, being relatively new, would need developmental and strengthening support for at least a decade. While national governments could support NITAG functioning, external support is likely needed for requisite capacity building. This might come from Gavi mechanisms and WHO, but would require alignment among stakeholders to be effective.