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The Vaccine Confidence Project™ was founded in 2009 to monitor public confidence in immunisation programmes by building an information surveillance system for early detection of public concerns around vaccines; by applying a diagnostic tool to data collected to determine the risk level of public concerns in terms of their potential to disrupt vaccine programmes; and, finally, to provide analysis and guidance for early response and engagement with the public to ensure sustained confidence in vaccines and immunisation. This initiative also defines a Vaccine Confidence Index™ (VCI) as a tool for mapping confidence globally. Despite the historic success of immunisation in reducing the burden of childhood illness and death, episodes of public concerns and rumours around vaccines have occurred around the world, spreading quickly and sometimes seriously eroding public confidence in immunisation and ultimately leading to vaccine refusals and disease outbreaks. This project seeks to monitor public confidence in immunisation programs by listening for early signals of public distrust and questioning and providing risk analysis and guidance to engage the public early to pre-empt potential programme disruptions.