News In this issue

News

Actions to control Measles

in Peru

PAHO supports free

healthcare campaign in Peru

Improving the cold chain

process in Peru

Modeling used to help im-prove vaccine supply chains in the Democratic Republic

of Congo and Zambia

2

3 3

4

Obituary

4

Past meetings / workshops

5-14

Resources 14

Calendar 15

Links 16

Global Immunization News (GIN) October 2017

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World Polio Day celebration in the Americas Ana Elena Chevez, Eduardo Rivero, Elizabeth Thrush, PAHO

October 24th was World Polio Day and PAHO used this day

as an opportunity to highlight the world's progress towards

eradication, to call on governments to renew their commit-

ment to the Polio Eradication and Endgame Strategic Plan,

and invite families to maintain collective efforts to eradicate

the wild virus and the vaccine-derived poliovirus.

The recent resolution CSP29.R16 of the 29th Pan American

Sanitary Conference included a mandate for PAHO/WHO to

continue to support Member States in the use of the fraction-

al dose of the inactivated

poliovirus vaccine (IPV)

and, through the Revolving

Fund, ensure the availability of the vaccine in the countries. The

Comprehensive Family Immunization Unit and the Revolving

Fund are actively involved in preparing the implementation of

the fractional doses of IPV; currently eight Central American,

South American and Caribbean countries are preparing for the

change to fractional doses of IPV, implying a different dose of

the vaccine and a different route of administration.

Global polio eradication is

within our reach, the dream

of thousands of workers and health workers, who for decades

contributed with dedication to this achievement, is about to be

realized. Together, as a global effort, we can do it!

PAHO/WHO developed the following infographics to be

shared widely on social media in celebration of World Polio

Day 2017. Read more at this link.

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Page 2

Global Immunization News (GIN) October 2017

Actions to control Measles in Peru Renee Hernandez, Doris Peña, Maria Ticona Zegarra and Vilma Vargas, Ministry of Health, Peru; Luis Ordoñez and

Pablo Renjifo, National Center for Epidemiology, Disease Control and Prevention – CDC Peru; Samia Samad Abdul,

immunization consultant for PAHO

The last case of endemic measles in Peru was presented during epidemiological week 13 in the year 2000, and it was

from the Ventanilla District’s Pachacutec human settlements (AA HH [Asentamientos Humanos]) in Callao. During

the last 16 years, the country has reported two outbreaks associated with imported cases, controlled by efforts

from health teams (2008 and 2015).

In recent years, however, Peru has received more than 3.5 million foreign tourists and more than two million Peruvi-

ans have exited the country. The point of entry for a tourist in the country mainly takes place at the Jorge Chavez

International Airport, located in the Callao constitutional province, receiving more than 1.8 million tourists per year;

similarly, the motivation for tourism to the country’s inner regions creates a risk of outbreaks related to imported

cases.

There is an effort from the Ministry of Health in Peru through surveillance and vaccination to maintain measles and

rubella elimination in the country. The objective is strengthening the health personnel’s technical competencies and

surveillance activities to respond to possible imported cases and outbreaks of vaccine-preventable diseases in a time-

ly way, generating evidence for the sustainability of measles and rubella elimination.

PAHO/WHO has alerted Member States on the risk of outbreaks occurring from imported measles cases, as well as

on the possibility of re-introducing the disease in areas with low vaccination coverage.

It is necessary that all Member States ensure high quality epidemiological surveillance and reach adequate measles

vaccination coverage with the aim of avoiding dissemination of the virus from imported cases. Quickly detecting and

researching suspected cases, as well as implementing control measures, are key to avoid dispersion.

The regions of Alto Amazonas, Ayacucho, Cajamarca, Huacho, Huánuco, Junín, Lima, Loreto, Madre de Dios, Puno

and San Martin, will soon be trained. They will also conduct active searches in hospitals to guarantee that surveil-

lance is attentive and that no imported case has been detected. Approximately 1,000 health professionals are are

participating in training to replicate the courses and coordinate surveillance and vaccination. These are integrated

courses on surveillance, evaluation of the immunization situation, laboratory activities and cold chain to guarantee

quality vaccines.

The immunization team elaborated and executed a Contingency Plan to increase vaccination coverage in the entire

country, considering that vaccination is the activity with the highest cost-benefit and cost-effectiveness. However in

recent years, vaccination coverage has decreased progressively without reaching optimal coverages of ≥95%, with

incomplete vaccination schedules in the 16 regions of the country, indicating an urgent need for follow-up and moni-

toring of vaccination activities.

It is important to combine efforts to increase vaccination access to the entire Peruvian population and to enforce

that the population respond to the call to action from health teams to vaccinate, update vaccination cards in order

to reduce any delay in completing the vaccination schedule, and guarantee protection from vaccine-preventable dis-

eases.

At 12 months, all children should receive the first dose of the measles and rubella vaccine and at 18 months, the

second dose. Adults should also be vaccinated and protect themselves against these diseases. The vaccine is available

in all of Peru’s immunization centers.

Global Immunization News (GIN) October 2017

Page 3

PAHO supports free healthcare campaign in Peru Immunization Directorate in the Ministry of Health, Peru; Comas District Municipality, with leaders from Fuerza Venezo-

lana en Acción; Samia Samad Abdul, immunization consultant for PAHO

The District Municipality, in conjunction with Peru’s Ministry of Health and the Region-

al Health Directorate (DIRESA) of North Lima and the Immunization Directorate,

leaders from Venezuelan Strength in Action (Fuerza Venezolana en Acción), Environ-

mental Health and non-governmental organization MALLQUI, held a healthcare cam-

paign on 14 October 2017 in the Plaza de Armas de Cormas in Lima, with a focus on

environmental promotion and with support from PAHO-Peru’s immunization unit.

During this campaign, various healthcare services were offered to the population, with

deferential attention given to Venezuelan residents in the District who still do not have

access to security services in the country.

Each healthcare group had its own site to attend to those seeking care or information

on vaccination; nursing; general medicine; laboratory exams; ultrasounds; ophthalmolo-

gy; cancer screenings; family planning; prevention of sexually-transmitted infections

(STIs) and HIV/AIDS; dengue, Zika and Chikungunya prevention; the Ministry of the Environment’s waste separation pro-

gramme; noise control; massage therapy; podiatry and haircuts. Every service was offered free of charge.

Vaccination was offered for individuals of all ages, completing the vaccination schedules of children and adults alike,

strengthening measles, rubella, tetanus, pertussis and diphtheria prevention with the slogan “WITH ALL VACCINES,

THE GOAL CAN BE REACHED WITH STRENGTH AND HEALTH.” The population heeded the call to action and

sought necessary attention from the healthcare teams.

Improving the cold chain process in Peru Renee Hernandez, Cayo García Tuanama, Doris Peña, Maria Ticona Zegarra and Vilma Vargas, Immunization Directorate

in the Ministry of Health, Peru; Samia Samad Abdul, immunization consultant for PAHO

In early September 2017, the Executive Directorate of Immunization in Peru’s Ministry of Health conducted a workshop

with support from PAHO/WHO on training to manage and programme the temperature control tool throughout the

cold chain process and on complying with PAHO/WHO’s recommended vaccine safety rules for the country. Immuniza-

tion technical experts from Peru and PAHO participated in the training, which was ministered by Cayo Garcia Tuanama,

a technical expert from the San Martin region.

The cold chain ensures vaccine quality beyond coverage. Using electronic control thermometers and other monitoring

devices, temperatures are registered across all of the cold chain processes at the national level, from transportation,

storage and handling of the vaccines, until they are applied at the operational level. Intramural (vaccine application at the

health establishment’s vaccination center) and extramural vaccination (vaccination shifts, house-to-house follow-up, vac-

cination sweeps and AISPED brigades) are considered at this operational level.

It was demonstrated that the temperature control tool Data Logger should be utilized to monitor the cold chain at all

levels, during transportation, storage, handling of the vaccine in the vaccination center and field activities. The tool has

the benefit of not requiring additional costs, for example, to pay the people traveling with the vaccines during transporta-

tion, chauffeurs, gasoline, time, specialized personnel, or paying for arrival to all sites, accompanying the vaccine for 24

hours with a precise report, to guarantee that the vaccines are preserved with certified quality.

The immunization team is planning to execute the following with this tool: verifying how a refrigerator’s temperature or

calibration behaves, evaluating how to adequately prepare cold packages for vaccine preservation in the vaccine thermos-

es for extramural and intramural vaccination, transporting or applying the Contingency Plan, precisely registering and

evaluating breaks in the cold chain, accrediting health establishments that comply with maintaining standards of excel-

lence for adequate vaccine preservation, according to the Ministry of Health, as well as certifying the personnel responsi-

ble for accrediting the health establishments.

Flyer of the free healthcare cam-

paign held in Lima, Peru, 14 Oc-

tober 2017.

Obituary

Page 4

Global Immunization News (GIN) October 2017

Modeling used to help improve vaccine supply chains in the Democratic Republic of

Congo and Zambia Manahil Siddiqi and Melissa West, VillageReach

A strong immunization supply chain can ensure the availability of safe, effective and

reliable vaccines. Modeling is one tool that can help countries begin the process of

improving the performance and agility of their immunization supply chains. Modeling

uses data analysis software to create a representation of a country’s existing supply

chain. This model then can be manipulated to test potential changes to the supply

chain and find the optimal mix of cost, performance and risk based on a country’s

context and priorities.

In Zambia, the Ministry of Health and the Centre for Infectious Disease Research in

Zambia have used modeling to evaluate the current supply chain and inform future changes. One key finding is that

health facility staff are spending more than 100,000 hours annually from other health activities just to pick up vac-

cines. Modeling results point to several opportunities to optimise the current immunization supply chain, including

implementing multi-stop routes with delivery from the province directly to health facilities, eliminating point-to-point

routes.

In Equateur, one of the Democratic Republic of Congo’s most remote provinces, modeling results have led to imple-

mentation of recommendations including lengthening resupply intervals in hard-to-reach areas and resource sharing

with other public health supply chains. Additionally, groundwork is being laid for future changes that will, over time,

contribute to the increased availability of vaccines in difficult-to-reach health zones across the country.

Using modeling to actively design supply chains can help ensure vaccines are available where they are needed most,

bringing the lifesaving benefits of vaccines to all children.

Read more about modeling and modeling results in Zambia.

A health worker delivers vac-

cines to a health center.

Credit: Paul Joseph Brown for

VillageReach.

Dr Fernando Muñoz Porras, former manager of Chile’s National Immunization

Programme, dies Octavia Silva, PAHO

Earlier this month, Dr Fernando Muñoz Porras passed away from cancer, a short time after

he had been chosen as the recipient for 2017’s PAHO Immunization Award, which was

given to him at the Pan American Health Organization’s XXIV Meeting of the Technical

Advisory Group on Vaccine-preventable Diseases (TAG) in Panama City, Panama. Due to

his deteriorating health, Dr Muñoz could not physically receive the award at the meeting,

but was able to receive it in Chile, accompanied by the Minister of Health, Dr Carmen Cas-

tillo; Sub-secretary of public health, Jaime Burrows and PAHO/WHO Representative in

Chile, Paloma Cuchi.

As part of acknowledging the award, Sub-secretary Burrows stated that Dr Muñoz was

deserving of the recognition “for being a complete professional, technically and as a human,

as well as for being devoted to the development of public health in the country.” Dr Muñoz Porras, a medical sur-

geon, had worked as manager of Chile’s National Immunization Programme in the Ministry of Health, professor at

the Universidad de la Frontera, adjunct professor at the Universidad de Chile and the Universidad de la Frontera, director

of Araucania Health Services, Sub-secretary of Health in Chile, aggregate for the United Nations on health in the

mission for Chile, and as a consultant for PAHO/WHO, GTZ, IDB, USAID and the World Bank Group in matters of

public health, among many others.

Sub-secretary Burrows also stated that “support from Dr Muñoz was essential, from the technical and communica-

tions point-of-view, for the incorporation of the human papilloma virus vaccine [into Chile’s national immunization

programme]. Dr Muñoz highlighted the importance of this new vaccine that was being incorporated into the pro-

gramme.”

Dr Fernando Muñoz

Porras.

Global Immunization News (GIN) October 2017

Page 5

Past Meetings/Workshops Training of trainers on expanded programme on immunization (EPI) mid-level

management (MLM)

Ambendet A., Diallo B.F., Mourou Moyoka A., Ndinga E., Ndziessi G., Ngossaki H.D and Ondon W., WHO Coun-

try Office, Congo

Location: Brazzaville/Pointe Noire/

Owando

Date: May, July, August 2017

Participants 6 facilitators and 99 trainers

from the Ministry of Health,

the Faculty of Health Scienc-

es, the Paramedic Training

School, UNICEF and WHO.

Purpose: Train the trainers using MLM

modules

Participants at the training of trainers on EPI mid-level management

Details: The Ministry of Health and Population has requested WHO support for the organization of MLM

courses for the training of EPI management trainers. The first course session trained a pool of national trainers. Subsequently, the pool of trained trainers

would be responsible for organizing cascade training at the departmental level of Brazzaville, Pointe

Noire and Owando. The following topics were covered: participants' expectations, the regional strategic plan for immun-

ization, immunization system environments, the Reaching Every Community strategy, the problem-

solving approach, the role of the EPI manager, communication, planning, increasing immunization cov-

erage, cold chain and vaccine management, immunization safety, surveillance monitoring, data man-

agement including analysis through the data quality self-assessment tool, formative supervision and

evaluation. During these sessions, - 6 facilitators and 99 national and departmental trainers were trained. - Participants and facilitators were provided with the following basic reference documents: Global

and Regional Strategic Plans, Reach Every District Guide, Immunization in Practice, and revised

MLM / AFRO drafts. Training will continue with practical vaccination training for staff at the health center level.

Global Immunization News (GIN) October 2017

Page 6

Over 130 participants successfully complete a training on vaccination coverage sur-

vey design and sample size calculation

Carolina Danovaro, WHO HQ, Reda Sadki, Learning Strategies International (LSi)

Location: Distance learning, globally

Date: Module A1-28 August to 8 October 2017

Participants: 174 participants from Ministries of Health, academic

and research institutions, independent consultants, US

Centers for Disease Control and Prevention (CDC),

John Snow Inc. (JSI), Agence Medicine Preventive

(AMP), World Health Organization (WHO) and

UNICEF staff from all over the world. Training facilita-

tors are epidemiologists and statisticians from WHO,

CDC, UNICEF, and consultants for WHO and the Bill

& Melinda Gates Foundation.

Purpose: To train immunization practitioners, epidemiologists

and statisticians interested in leading or supporting

high-quality and statistically robust vaccination cover-

age surveys, based on the 2015 WHO Vaccination

Details: Two parts are envisioned for this Survey Scholar initiative, a distance-based portion in 2017, and a

practicum (residential and field-based) portion in 2018. The practicum will be offered to selected par-

ticipants among those who successfully complete all three distance learning modules. The distance-based portion of this training initiative, Modules A from August to December 2017, is

divided in three modules: Designing a vaccination coverage survey, with a focus on objectives, scope and sample size calcula-

tion Reviewing a protocol for a vaccination coverage survey, with a focus on sampling Data analysis for vaccination coverage surveys

Scholar Module A1 lasted 6 weeks and over 131 participants from all over the world successfully

completed this Module. Participants engaged in weekly web-based sessions, self-study, three weekly

assignments and the development of a survey concept note. Their draft concept note was reviewed by

peers, and by facilitators as needed, and the final project was to produce a revised survey concept

note with the feedback received. 144 participants are currently working on Module A2. Participants’ evaluations for Module A1 were extremely positive and a network of peers is being built. The WHO’s Survey Scholar initiative not only supports the development of technical skills, but also

leadership and critical thinking competencies. It is grounded in evidence-based adult-learning method-

ologies for digital learning, and follows the successful use of the same platform and approach for train-

ing and country-specific action planning and capacity building as the Global Routine Immunization

Strategies and Practices (GRISP) guide in 2016 and 2017 (currently ongoing).

Global Immunization News (GIN) October 2017

Page 7

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2017 Measles & Rubella Initiative (M&RI) Partners’ Meeting: “Are We Listening?”

James Noe, American Red Cross

Location: Washington, Dc

Date: 7-8 September 2017

Participants: 124 participants representing 42 organiza-

tions actively working towards the elimina-

tion of measles and rubella globally. Organ-

izations represented included M&RI found-

ing partners -- American Red Cross, the

Centers for Disease Control and Preven-

tion, the United Nations Foundation,

UNICEF, World Health Organization – and

others such organizations as Gavi the Vac-

cine Alliance, LDS Charities of the Church

of Jesus Christ of Latter Day Saints, Lions

Club International, and PATH.

Participants at the 2017 Measles & Rubella Initiative (M&RI)

Partners’ Meeting

Purpose: The 2017 Measles & Rubella Initiative Partners Meeting focused on progress and challenges towards

meeting the elimination goals set forth in the GVAP and highlighted discussions on the implementation

of the course correcting recommendations from the 2016 midterm review.

Details: The meeting was hosted by the American Red Cross at National Headquarters in Washington, DC,

USA. Day one began with a panel discussion by the leadership from the five founding partners and

Gavi. The panel members shared their perspectives, demonstrating and renewing their commitment to

protecting children against measles and rubella. Other highlights of the day included a keynote address

by Dr Alan Hinman which traced the history of proposals to embark on measles eradication and noted

the remarkable progress achieved in reducing disease burden over the past four+ decades since EPI

began, and a report by the Government of India on the first two Phases of the nationwide MR catch-up

campaign and improvements in MR surveillance. The day concluded with a hands-on demonstration

and progress report by Dr Mark Prausnitz from the Georgia Institute of Technology on the develop-

ment of microneedle vaccine patches. Highlights of the second day included an opening address by Dr Suresh Jadhav of the Serum Institute of

India. A presentation by Dr Kim Thompson of Kid Risk on the economics of measles elimination,

which concluded that “high control” of measles from an economic standpoint is not optimal if eradica-

tion is feasible, as well as a participatory session on innovative ways to strengthen routine immuniza-

tion services in the context of measles-rubella elimination activities. The meeting concluded with a call

to action stating that we can celebrate our sustained successes, but at the same time we must redou-

ble our efforts to achieve a world without measles, rubella, and congenital rubella syndrome.

The presentations from both days have been posted on the Measles & Rubella Initiative website, and

can be found at this link.

Page 8

Global Immunization News (GIN) October 2017

Installation and training workshop on vaccination supplies stock management

(VSSM) and assessment of cold chain operations

Janice Change and Laura Lynn Jackson, Ministry of Health, Bermuda; Karen Lewis Bell and Nora Lucia Rodriguez,

PAHO/WHO; Victor Gomez Bravo and Messrs Mojtaba Haghgou, PAHO/WHO Consultants

Location: Hamilton, Bermuda

Date: 11-12 September 2017

Participants 47 participants representing the

Department of Health, Bermuda

Hospitals Board, private sector

health providers, nursing homes

and the Information and Digital

Technologies Department (IDT)

of the Bermuda Government.

Participants at the VSSM installation and training workshop in Bermu-

da, September 2017.

Purpose: The objectives of the VSSM workshop were to evaluate the application of VSSM software to sup-

port the cold chain supply operations and logistics; train key users in the installation of the VSSM

software’s 4.8 version; sensitize private healthcare partners to the web-based version of the soft-

ware (wVSSM); The objectives of the Cold Chain Operations Assessment were to strengthen technical skills for

vaccine storage, handling, transportation, temperature control, equipment handling and mainte-

nance and to develop an implementation plan.

Details: Bermuda requested assistance from PAHO to strengthen aspects of the cold chain system to ac-

commodate new and expanding vaccines in the child and adult immunization schedules. An assess-

ment of the cold chain in the public and private sector was done, followed by two workshops in-

volving key participants in the Expanded Programme on Immunization (EPI). The cold chain assessment was a valuable exercise for stakeholders in the EPI. Whilst the country

capacity is currently adequate, investment in a cold room for sustainability was recommended.

Short-term recommendations for improvement include the implementation of a 24-hour tempera-

ture monitoring alarm system for central stores and strengthening the use of approved vaccine

carriers and ice packs. As a consequence, the training focused on storage conditions for vaccines and supplies, vaccine

carriers and complementary supplies for storage and distribution, as well as cold chain manage-

ment. Presentations were followed by interactive discussions and shared experiences. Return

demonstrations on packing vaccine carriers was used to assess learning outcomes. Resource mate-

rials were disseminated to agencies represented. The VSSM training consisted of presentations followed by interactive exercises in small groups us-

ing version 4.8 of the software, a stand-alone system. Group work included hands on simulation

exercises for receiving and dispatching vaccines from central stores. Participants were then sensi-

tized to the wVSSM version. Input from the private sector was elicited to determine the feasibility

of adopting the wVSSM. Their information suggests consideration may be needed to operate VSSM

and electronic medical record (EMR) systems simultaneously. However, the IDT has begun prepar-

atory work to facilitate the wVSSM for Bermuda, benefitting the public sector. In the interim, ver-

sion 4.8 will be utilized.

Global Immunization News (GIN) October 2017

Page 9

Third bi-regional cross-border meeting on Measles, Rubella, Polio and other vaccine-

preventable diseases

Sudhir Khanal, WHO Regional Officer for South East Asia

Location: Jakarta, Indonesia

Date: 18-20 September 2017

Participants A total of 58 participants from

16 countries, WHO, UNICEF

and US CDC attended the meet-

ing. The countries represented

were Bangladesh, Bhutan, Cam-

bodia, China, DPR Korea, India,

Indonesia, Lao PDR, Malaysia,

Myanmar, Nepal, Papua New

Guinea, Philippines, Thailand,

Timor-Leste, and Vietnam

Purpose: To strengthen capacity to collab-

orate, coordinate and share in-

formation about cases of mea-

sles, rubella, polio and other

vaccine-preventable diseases

(VPDs) as part of the VPD sur-

veillance programme across the

countries of WHO South East

Asia and Western Pacific Region,

and ensure early and compre-

hensive response to outbreaks

that extend or threaten to ex-

tend across national borders and

Regions.

Participants at third bi-regional cross-border meeting on Measles, Rubel-

la, Polio and other VPDs.

Details: The meeting was jointly organized by WHO Regional offices for South East Asia and Western Pacific

Region. Global and Regional updates on the status of cross-border collaboration for vaccine-

preventable diseases (VPDs). All countries presented updates on their status of VPD surveillance,

IHR core capacities, progress towards the recommendation from the previous meetings and the

current issues, challenges and lessons-learnt from the cross-border collaboration on vaccine-

preventable diseases surveillance, reporting, and outbreak response. Group work was conducted for in-depth discussions on cross-border collaboration and the actions

required in the next two years. All countries identified and documented their high-risk populations, high-risk border areas for mea-

sles, rubella, and other VPDs, and emphasized the need for wide sharing of this information across

borders. Countries emphasized the need to better coordinate at local levels and to “cut the red

tape” and make optimal use of the IHR mechanisms. Countries pointed out that sub-regional bilat-

eral and multi-lateral formal mechanisms exist across countries for cross-reporting cases, but have

not been optimally utilized by the EPI programme. Details from the country presentations and the

conclusions of the working groups will be published shortly.

Global Immunization News (GIN) October 2017

Page 10

Middle East and North Africa (MENA) regional workshop on equity-informed micro-

planning

Nahad Sadr-Azodi and Kamel Senouci, UNICEF MENA Regional Office, Jordan

Location: Dead Sea, Jordan

Date: 25-27 September 2017

Participants: US CDC, JSI, WHO, EM-

PHNET, GAVI, Djibouti,

Egypt, Iraq, Jordan, Lebanon,

Libya, Sudan and Syria.

Purpose: To improve the capacity of

participants to analyze im-

munization data with an eq-

uity lens, learn about existing

methodologies, tools and

Information and Communi-

cation Technology applica-

tions and exchange ideas and

best practices on how to

account for special popula-

tions such as transient, con-

flict-affected, and urban

slums, the non-public sector,

immunization during the

second year of life, missed

opportunities and equity-

informed microplanning.

Participants at the MENA Regional workshop on Equity-informed microplan-

ning.

Details: In MENA, immunization programmes have set increasingly ambitious goals, for instance to reach the

populations that are the hardest to reach and improve coverage across geographic, socio-economic

and demographic groups. Yet, current data systems in many countries are not designed with the

goals of universal health coverage and equity in mind and often focus on populations already reached

by programmes. Consequently, there is often a lack of information about those who are never vaccinated, do not

complete their vaccinations or those who opt out. Moreover, in many countries microplans are up-

dated or developed without particular focus on equity and where the private and civil society sec-

tors have a major role in providing services, there is a lack of coordination and communication, and

the data do not often get reported, recorded and incorporated as part of the country’s planning pro-

cess. Finally existing plans and tools for registering, recording and reporting coverage do not always

take into account immunization during the second year of life (2YL) and the missed opportunities for

vaccination (MOV). The Equity-Informed Microplanning workshop was organized in response to these ongoing challeng-

es of estimating and planning for special populations, accounting for the non-public sector contribu-

tions, 2YL and MOV.

Global Immunization News (GIN) October 2017

Page 11

Course on improving the quality of immunization and surveillance data

Ambendet A.; Diallo F.B.; Ndinga E.; Ondon W.; Elenga F., WHO Inter-Country Support Team, Brazzaville, Congo

Location: Owando, Congo

Date: 1-2 October 2017

Participants: Three facilitators and 26

agents including depart-

mental directors, supervi-

sors and district health

team members, surveillance

and EPI focal points.

Purpose: To train health district

teams on the use of the

DQS tool, including the

development of a correc-

tion plan

Participants in Course on improving the quality of immunization and surveillance

data

Details: Obtaining reliable, regular and quality immunization data remains one of the major goals of any im-

munization programme and partners. It is in this perspective that the Ministry of Health and Popula-

tion has requested the support of WHO for the organization of a specific course on the evaluation of

data quality. The training course for health district teams on data quality self-assessment took place in Owando, in

the department of Cuvette. This workshop was attended by 26 people from the departments of Cu-

vette, Cuvette-Ouest, Plateaux and Sangha and three facilitators. The training session covered the following topics: participant expectations, immunization monitoring,

data management, DQS analysis and formative supervision. During this two-day session, participants were trained to use the DQS, followed by application in two

health districts. The verification factor and the quality index were calculated; the correction plan was

also developed.

Page 12

Global Immunization News (GIN) October 2017

Capacity building workshop on immunization information systems, and data quality

assessments and improvement planning for potential national consultants

Jethro Chakauya, Aboubacar Ndiaye, Bernard Ntsama and Alain Poy, WHO Regional Office for Africa

Location: Kigali, Rwanda

Date: 10-13 October 2017 for Anglophone

countries and 17 au 20 October for

Francophone countries

Group at the Lemigo hotel,

Kigali Rwanda October 2017

Participants: 76 participants and facilitators drawn among Officers from national Statistic Offices, professors/ lectur-

ers /scientists from Universities and Public health schools from Eritrea, Ethiopia, Gambia, Ghana, Liberia,

Malawi, Mozambique, Rwanda, Sierra Leone, South Sudan, Tanzania, Uganda, Zambia and Zimbabwe for

Anglophones group and Angola, Benin, Burkina Faso, Cameroun, Central African Republic, Chad, Congo,

Côte d’Ivoire, Madagascar, Mauritania, Rwanda, São Tome and Príncipe, Senegal, and Togo for the Fran-

cophone group. Facilitators were from WHO AFRO and the 3 Inter-country Support Teams (ISTs), GA-

VI, CDC ATLANTA, PATH-BID, JSI and WAHO (West African health Organization). A total of 27 coun-

tries were represented.

Purpose: Brief participants on EPI programme, data elements, tools and indicators Reinforce the participants’ capacity to conduct data quality reviews, information system assessments

and to develop data quality improvement plans with clear monitoring and evaluation mechanisms Present data quality review (DQR) metrics and the methodology through tracer indicators across dif-

ferent programmes, including immunization and demonstrate the links between the new WHO guide-

lines and tools on immunization data quality review and the integrated DQR. Brainstorm and learn from countries about what processes and practices can promote harmonization

and/or alignment of data quality assessments and improvement efforts. Agree with participants on roles and expectations after the training, for all participants

Details: Participants were briefed on the EPI programme, EPI data elements, EPI data collection and data man-

agement tools and key immunization and VPD surveillance indicators Participants were trained on data quality reviews, information system assessments, field visits and im-

provement planning using the recently developed WHO EPI methodology. They were also briefed on

the integrated DQR method Participants conducted system assessments and data desk reviews using immunization and case study

data prepared by WHO AFRO, with analysis looking at completeness and timeliness, internal con-

sistency, external consistency and trend analysis. In addition, participants conducted SWOT analyses based on the case study for each of the six infor-

mation system components for national level and for the three sub-national levels; namely region, dis-

trict and health facility. Participants developed a comprehensive document highlighting data quality and system issues and root

cause analyses, and proposed concrete potential solutions. Participants appreciated the training and confirmed to be ready to support data improvement efforts

for immunization and other programmes, and to be part of their national data quality/improvement

teams. The following action points were adopted: All participants to debrief with WHO EPI focal points on the training and how to facilitate the link

with EPI and HMIS groups once back in countries All participants to link with their in-country EPI and HMIS teams in order to have an update on the

status of the data quality teams and progress of in-depth assessment and data quality improvement plan

(DQIP) development All participants to conduct a debriefing on the workshop outcomes to their own organizations, as well

as to the national authorities / technical ICC or similar body once back in the country All participants should be ready to assist the national team when needed in the efforts to improve data

quality. This includes being part of national data quality teams as well as international consultancies When taken as consultant, it will be mandatory for participants to comply with WHO consultancy

rules and requirements as provided by the WHO country offices when needed

So far between November 2016 and October 2017, EPI, HIMS and partners from 46 countries and 54

potential consultants from national organization in 27 countries in the African region have been

trained.

Global Immunization News (GIN) October 2017

Page 13

National training on the change to fractional doses of the inactivated poliovirus

vaccine (fIPV) in Ecuador

PAHO-Ecuador

Location: Quito, Ecuador

Date: 19-20 October 2017

Participants: EPI coordinators from each of the nine health

zones in Ecuador National Health Authorities and representatives

from the national EPI programme Dr Gina Tambini, PAHO-Ecuador Representa-

tive Representatives from PAHO-Headquarters

Participants at the Ecuador fIPV workshop. Credit:

Elizabeth Thrush, PAHO/WHO.

Purpose: To train the departmental immunization coordina-

tors from each zone on the background, rationale

andadministration technique for fractional doses of

the inactivated poliovirus vaccine (fIPV) in the rou-

tine immunization programme.

Interactive session on proper technique for fIPV ad-

ministration. Credit: Elizabeth Thrush, PAHO/WHO.

Details: In total, there were 58 people participating in this meeting. An update on global polio eradication pro-

gress was given, as well as background on the global and regional supply shortage of IPV, scientific evi-

dence on the immunogenicity of fIPV, open vial policy regulations and communication strategies. There was a hands-on workshop where participants practiced the administration technique and admin-

istrative procedures of fIPV vaccination. There was plenty of time for questions and discussion. This

was a crucial aspect of the training, as it was of utmost importance that each person in attendance

understood every aspect of the training, so that they can replicate the training in their respective

zones. Between now and the end of the year, Ecuador will do a cascade-style training on fIPV down to

the service level. Ecuador plans to implement the new schedule as of January 2018. 2018 Polio Vaccination Schedule in Ecuador

Page 14

Global Immunization News (GIN) October 2017

Resources New subnational immunization coverage data now available Laure Dumolard and Stephanie Mariat, WHO HQ

In 2017 and for the first time worldwide, WHO has collected and is publishing subnational immunization coverage

data reported by its member states.

Member states were asked to report for the first and third dose of DTP-containing vaccines (DTP1, DTP3) and

measles containing vaccine (MCV1) from their second subnational administrative level. The data collection is done

for the period of January to December 2016 through the WHO/UNICEF joint annual collection process.

140 member states have shared their subnational data, either from their first or second subnational administrative

level for DTP1, DTP3 and/or MCV1. Data has been shared for over 20,000 subnational entities, and represents

about two-third of the total number of surviving infants worldwide. Of note is that the size of the target popula-

tion (in the case of DTP3, the number of infants surviving at 12 months of age) of reporting districts varies signifi-

cantly from a district to another. Indeed the median number of surviving infants in all reported districts is 400,

ranging from a population of surviving infants of 1 in the smallest districts to more than 485,000 in the largest

(Karachi, Pakistan). Visit the website to learn more about the data and some of its limitations.

National coverage data often conceals large inequalities in coverage and access within the country that can be dis-

covered through subnational monitoring. Targeting specific subnational areas with focused interventions will help

countries achieve high and equitable coverage and meet their GVAP targets.

For more information, contact: vpdata@who.int (please use subnational data in the subject line).

Global Immunization News (GIN) October 2017

Page 15

Calendar 2017

November

10-24 Joint EURO MR Surveillance & Lab Network Meeting Belgrade, Serbia

13-17 Global Rotavirus and IB-VPD Surveillance Network Meetings Geneva, Switzerland

14-16 23rd Meeting of the Regional Commission for the Certification of Poliomye-

litis Eradication in WPR

Vientiane, Lao People’s

Democratic Republic

21-23 AFRO E&S Regional Working Group Addis Ababa, Ethiopia

December

5-7 AFRO Regional Immunization Technical Advisory Group (RITAG) meeting Johannesburg, South Afri-

ca

10-13 30th Intercountry Meeting of National Managers of the Expanded Pro-

gramme on Immunization and 17th Intercountry Meeting on Measles/ Rubel-

la Control and Elimination

Muscat, Oman

11-12 WHO Blueprint - Evaluating Therapeutics during Public Health Emergencies Utrecht, Netherlands

14 EMRO Regional Technical Advisory Group on Immunization (RTAG) Muscat, Oman

15-16 EMRO Regional Working Group meeting Muscat, Oman

2018

January

22-27 27th Executive Board Geneva, Switzerland

March

20-22 Global Vaccine and Immunization Research Forum (GVIRF) Bangkok, Thailand

April

17-19 Strategic Advisory Group of Experts (SAGE) on Immunization Geneva, Switzerland

17-19 Third Meeting of the South-East Asia Regional Verification Commission for

Measles Elimination and Rubella/CRS Control (SEA-RVC)

Kathmandu, Nepal

May

21-26 71st World Health Assembly Geneva, Switzerland

June

26-28 Global Immunization Meeting (GIM) TBD

Page 16

WHO Regional Websites Routine Immunization and New Vaccines (AFRO)

Immunization (PAHO)

Vaccine-preventable diseases and immunization (EMRO)

Vaccines and immunization (EURO)

Immunization (SEARO)

Immunization (WPRO)

Newsletters Immunization Monthly update in the African Region (AFRO) Immunization Newsletter (PAHO) The Civil Society Dose (GAVI CSO Constituency) TechNet Digest RotaFlash (PATH) Vaccine Delivery Research Digest (Uni of Washington) Gavi Programme Bulletin (Gavi) The Pneumonia Newsletter (Johns Hopkins Bloomberg School of Public Health)

Organizations and Initiatives American Red Cross Child Survival Agence de Médecine Préventive Africhol EpiVacPlus LOGIVAC Project National Immunization Technical Advisory Groups Resource Center SIVAC Centers for Disease Control and Prevention Polio Global Vaccines and Immunization Johns Hopkins International Vaccine Access Center VIEW-hub JSI IMMUNIZATIONbasics Immunization Center Maternal and Child Health Integrated Program (MCHIP) Publications and Resources Universal Immunization through Improving Family Health Ser-vices (UI-FHS) Project in Ethiopia PAHO ProVac Initiative PATH Better Immunization Data (BID) Initiative

Center for Vaccine Innovation and Access

Defeat Diarrheal Disease Initiative Vaccine Resource Library Malaria Vaccine Initiative RHO Cervical Cancer

Sabin Vaccine Institute Sustainable Immunization Financing UNICEF Immunization Supplies and Logistics USAID Maternal and Child Health Integrated Program WHO Department of Immunization, Vaccines & Biologicals New and Under-utilized Vaccines Implementation ICO Information Centre on HPV and Cancer Immunization financing Immunization service delivery Immunization surveillance, assessment and monitoring SIGN Alliance Other Coalition Against Typhoid Confederation of Meningitis Organisations Dengue Vaccine Initiative European Vaccine Initiative Gardasil Access Program Gavi the Vaccine Alliance International Association of Public Health Logisticians International Vaccine Institute Measles & Rubella Initiative Multinational Influenza Seasonal Mortality Study Network for Education and Support in Immunisation (NESI) TechNet-21 Vaccine Safety Net Vaccines Today

UNICEF Regional Websites Immunization (Central and Eastern Europe)

Immunization (Eastern and Southern Africa)

Immunization (South Asia)

Immunization (West and Central Africa)

Child survival (Middle East and Northern Africa)

Health and nutrition (East Asia and Pacific)

Health and nutrition (Americas)

Links

Global Immunization News (GIN) October 2017