In one remote district in the northeastern Indian state of Arunachal Pradesh, local vaccinators have managed to overcome huge challenges in order to vaccinate most adults. They have to drive on poor roads, walk hours into the jungle, and cross rickety bridges over rivers -- all the while struggling to keep the vaccines cool in insulated bags in the blistering jungle heat. In remote villages, education has encouraged vaccine skeptics to turn out, but so too have creative approaches. In one case, vaccinators combined their work with the district's day for delivering free rice rations, so villagers only had to miss one day of work in the fields. They also offered cash incentives to health centers whose workers administered the most doses.

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