News In this issue

News

European Member States unanimously

adopt new plan to combat vaccine-preventable diseases

AMP-WHO LOGIVAC project marks the end of the second edition of the health logistics bachelor’s degree

Updates related to the intro of IPV

Chile introduces the HPV in its Nation-

al Immunization Programme

Comprehensive Costing of Brazil’s

National Immunization Programme

Use of Android application in conduct-

ing EVM assessment in Bihar, India

2

2

3

4

4

5

Upcoming Meetings 6-7

Meetings / workshops

Meeting on the introduction of IPV in

routine immunization programmes

Annual meeting of the European lab

networks for measles/rubella and polio

Training on Conventional and Real Time PCR in Streptococcus pneumoni-ae serotype determination for National

Reference Lab in Latin America

Fifth Meeting of the SEAR - ITAG

WHO workshop on Defining Disease

Burden and Decision-making for Sea-sonal Influenza Vaccination

Peer review of GAVI applications for IPV introduction

8 9

10

11

12

13

Resources 14

Calendar 15-

16

Links 17

Child mortality rates falling faster than ever Hayatee Hasan, WHO Headquarters

New data released on 18 September 2014 by the United Nations show that under-five

mortality rates have dropped by 49% be-

tween 1990 and 2013 thanks to evidence-

based interventions against the leading

infectious diseases such as immunization.

The average annual reduction has acceler-

ated – in some countries it has even tri-

pled – but overall progress is still short of

meeting the global target of a two-thirds

decrease in under-five mortality by 2015.

New estimates in Levels and Trends in Child

Mortality 2014 show that in 2013, 6.3 mil-

lion children under five died from mostly

preventable causes, around 200 000 fewer

than in 2012, but still equal to nearly 17 000 child deaths each day. Overall progress is still

short of meeting the global target of a two-thirds decrease in under five mortality by

2015.

“The global community is poised to end preventable maternal, newborn and child deaths

within a generation,” said Dr Flavia Bustreo, WHO Assistant Director-General. “We

know what to do and we know how to do it. The challenge now is to move from plan to

action – we are pleased to see countries like India beginning to lead the way.”

The Levels and Trends in Child Mortality 2014 report is developed annually by the United

Nations Inter-Agency Group for Child Mortality Estimation, which is led by UNICEF and

includes the World Health Organization, the World Bank Group and the United Nations

Population Division of the Department of Economic and Social Affairs.

Read the joint news release on falling child mortality rates.

Global Immunization News (GIN) September 2014

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A mother and her baby being vaccinated.

Credit : WHO/P. Virot

Page 2

Global Immunization News (GIN) September 2014

AMP-WHO LOGIVAC project marks the end of the second edition of the health

logistics bachelor’s degree Philippe Jaillard, Agence de Médecine Préventive (AMP)

Twenty-four newly trained health supply chain managers will now be contributing their expertise to health sys-

tems throughout sub-Saharan Africa, following their successful completion of the LOGIVAC-supported training

programme in health logistics.

Students received a bachelor's degree from the University of Abomey-Calavi during a ceremony held at the Re-

gional Institute of Public Health (IRSP) in Ouidah, Benin on 19 September 2014.

The French-language training programme, now in its second year, is the first of its kind in Africa and includes class-

room training (held at IRSP), distance learning, and an internship.

Among the 24 successful students this year were all 22 from the second class as well as two from the first class;

they are from nine Francophone African countries.

During the graduation ceremony, the director of IRSP expressed satisfaction with students’ academic perfor-

mance, given their relatively high average marks. The valedictorian, Faustin Sègla, acknowledged the relevance of

the degree course and the quality of teaching. All graduates thanked training programme partners including the

two LOGIVAC implementing institutions: the Agence de Médecine Préventive (AMP) and WHO.

The next challenge will be to provide professional opportunities to this new cohort of skilled supply chain manag-

ers. This is partly due to a lack of recognition in many sub-Saharan African countries of the profession’s vital im-

portance for the proper and effective functioning of the immunization supply chain. This is being addressed

through advocacy efforts supported by LOGIVAC and other health and immunization partners.

Registration for the third edition of the training programme is now open. To download the form (in French), click

here.

European Member States unanimously adopt new plan to combat vaccine-

preventable diseases Catharina de Kat-Reynen, WHO Europe

An ambitious roadmap to ensure equitable and optimal protection of Europe’s

population from vaccine-preventable diseases was adopted on 17 September

2014 by the 64th session of the WHO Regional Committee for Europe.

While significant progress has been made in controlling vaccine-preventable dis-

eases in the European Region, more must be done to reach underserved popu-

lation groups, ensure sustained demand for vaccines, as well as to expand access

to newly available vaccines. Through adoption of the European Vaccine Action

Plan (EVAP), Member States have pledged to step up their efforts and political

commitment to:

• sustain polio-free status;

• eliminate measles and rubella;

• control hepatitis B infection;

• meet regional vaccination coverage targets at all administrative levels throughout the Region;

• make evidence-based decisions about the introduction of new vaccines;

• achieve financial sustainability of national immunization programmes.

EVAP outlines a path to achieve these goals in the form of defined objectives, priority action areas and a frame-

work to evaluate and monitor progress. WHO/Europe will provide technical support to Member States to ensure

the full implementation of the Plan.

EVAP is a regional interpretation of the Global Vaccine Action Plan that addresses the specific needs and challeng-

es related to immunization in the WHO European Region. It is aligned with Health 2020 and other key regional

health strategies and policies, and was formulated through a consultative process involving Member States, part-

ners and the European Technical Advisory Group of Experts on Immunization before submission to the 64th ses-

sion of the Regional Committee for Europe.

The European Vaccine Action

Plan poster. Credit: WHO

Page 3

Global Immunization News (GIN) September 2014

Updates related to the introduction of Inactivated Polio Vaccine (IPV) Lisa Menning, WHO Headquarters

IPV introduction in Nepal

In a step to accelerate the global eradication of polio and help prevent a resur-

gence of the disease, Nepal introduced IPV on 18 September 2014 into its routine

immunization programme. Nepal was the first country in South Asia, and the first

GAVI-eligible country, to launch IPV as part of the global roll out of the vaccine.

IPV is administered to children at 14 weeks of age by intramuscular injection by a

trained health worker at established health facilities or immunization sessions. In

advance of the launch, the Ministry of Health and Population successfully conduct-

ed training for all heath workers in all 75 districts on IPV administration.

To share a selection of communication materials used to support the IPV introduction in Nepal, a package is available

on the IPV website with the following: technical guidelines for health workers, a brochure for caregivers, a fact sheet,

poster and job aid. (Credits: the Government of Nepal, WHO Nepal, and UNICEF Nepal.) We hope these are a use-

ful level example of final communication and training materials and help to complement the general global guidance.

Training materials for health workers on IPV

To support countries preparing to introduce IPV, a suite of training materials for health workers on IPV and related

aspects of vaccine administration and interpersonal communication are now available on the ‘Planning’ page of the IPV

website.

The modules cover a range of topics specific to IPV and across all aspects of service delivery, including eligibility, ad-

ministration, recording and monitoring data, adverse events monitoring, and communication with caregivers. Also

included are key messages and frequently asked questions to support a strong understanding by health workers of the

rationale for IPV introduction, IPV safety, timing of administration, as well as how to respond to common questions

from caregivers.

Developed by UNICEF, a training curriculum for increasing interpersonal communication (IPC) skills for the introduc-

tion of IPV is also available. The curriculum was developed to facilitate group health education with the help of visual

aids, flip charts, flash cards and posters, and includes an important emphasis on participatory and learn-by-doing exer-

cises.

All training materials are designed so that regional and/or country offices can adapt the content according to local

needs and norms. French versions will also be available soon.

UNICEF Nepal. The first child

being vaccinated with IPV in

Nepal.

Page 4

Global Immunization News (GIN) September 2014

Chile introduces the Human Papillomavirus Vaccine (HPV) in its National

Immunization Programme Fernando Muñoz, Ministry of Health, Chile; Marta Prieto and Andrea Vicari, PAHO/WHO

On 2 September 2014, Chile’s President Dr Michelle Bachelet

launched the vaccine against human papillomavirus (HPV). This year,

the Ministry of Health plans to vaccinate 125,000 girls aged nine to

10 years. The quadrivalent vaccine is being administered in a two-

dose immunization schedule with a 12-month interval between dos-

es.

Health workers will administer the HPV vaccine at public and private

schools. The vaccine introduction was jointly planned with the edu-

cation sector, and a manual specifically directed at teachers was pre-

pared and distributed. Additional information and videos are availa-

ble online.

Every year, 587 women die in Chile of cervical cancer (equivalent to a 5.7 age-adjusted mortality rate per 100,000

women). The introduction of the HPV vaccine is the outcome of the joint work among the National Programme for

the Control of Cervical Cancer, the National Immunization Programme, education and health experts, economists,

political leaders and civil society representatives.

In Chile, the HPV vaccine has been available in the private health sector since 2006. The inclusion in the national

immunization schedule thus achieves universal access to this vaccine throughout the target age cohorts, included for

vulnerable population groups. The annual public investment for HPV immunization will amount to US$ 2.5 million.

In the Americas, 22 countries (in addition to Chile) including Argentina, Antigua, Barbados, Brazil, Bermuda, Canada,

the Cayman Islands, Colombia, Ecuador, Guyana, Mexico, Panama, Paraguay, Peru, Puerto Rico, Saba, Sint Maarten,

Suriname, Trinidad and Tobago, the United States of America, and Uruguay—now offer the HPV vaccine in their

publicly funded immunization programmes. Each year, 6.5 million adolescent girls (85% of a typical birth cohort of

the Americas) have a guaranteed access to HPV vaccine in the Western Hemisphere.

Comprehensive Costing of Brazil’s National Immunization Programme Gabriela Felix, Cara Janusz and Samia Samad, PAHO

The Pan American Health Organization’s ProVac Initiative is working closely with

the Brazilian Universidade Federal de Goiás in a Ministry-sponsored costing of the

Brazilian National Immunization Programme (NIP). Brazil’s NIP recently celebrated

its fortieth anniversary. It has been a pioneer in new vaccine introduction and has

one of the most complete immunization schedules in the region. However, not

much is known about the full costs of the programme.

The ProVac Initiative is providing technical assistance for the study around its expe-

riences developing and implementing a PAHO immunization programme costing

tool [COSTVAC]. During the week of 15-19 September 2014, the PAHO ProVac

team and researchers from the Universidade Federal de Goiás trained a data collection team on survey administra-

tion for all administrative and operational levels of the programme. Data collector teams were sent to the field and

expected to complete data collection by the end of October 2014.

Data on resource use and costs of the programme (vaccines and supplies, personnel, infrastructure, cold chain, oth-

er equipment, among others) will be collected from the national, state, municipal administrative offices and service

delivery sites at immunization posts. Data collectors will visit all 27 states; 330 health facilities from 40 municipalities

across the country were probabilistically sampled. This health facility-based survey of costs is one of the largest of its

kind. Results will be available in 2015.

Chile’s President Michelle Bachelet (center) and

Health Minister Dr Helia Molina (second from

left) at the launch of national HPV vaccination.

Credit: MoH, Chile.

Data collection field training in

Brasilia.

Global Immunization News (GIN) September 2014

Page 5

Use of Android application in conducting Effective Vaccine Management (EVM)

assessment in Bihar, India Ghanashyam Sethy, Syed Hubbe Ali, UNICEF Bihar (India)

The effective vaccine management (EVM) assessment is an initiative to help

countries to improve the quality of their vaccine and cold chain management

from the time the vaccine arrives in country to the service delivery point. How-

ever, the data collection and analysis processes were time consuming and lim-

ited in outreach, as the data collection process was paper based and dissemina-

tion was primarily done through static worksheets that presented the aggregat-

ed results.

UNICEF Bihar (India) along with the government of Bihar developed and piloted a mobile application to collect data

based on the globally agreed EVM parameters. The application is free to download and can be installed on android

based mobile systems. The application includes smart forms that incorporate features such as capturing the GPS co-

ordinates, images of the facility, calculators to estimate volume, and has skip patterns embedded so that data collec-

tion is efficient. Once data is collected, it can be submitted to a central server using mobile internet or through a Wi-

Fi network as depicted in the schematic diagram.

The data is then collated in the server using an aggregation engine to compute the scores both at the aggregate level

and facility level. The computed scores are for the nine criteria; and seven category parameters are then visualized on

a dashboard which shows the location of the vaccine stores on a google map as well as the score obtained. The data

is disseminated via the DevInfo platform (a UNICEF led database technology initiative) which allows users to query

and combine criteria or category parameters and generate charts and thematic maps. The dashboard and the DevInfo

platform are accessible via the EVM portal which provides additional information on standard operating procedures,

tools and other useful resources pertaining to the EVM initiative.

The dashboard and custom query features

offer 24X7 data accessibility and add value to

the decision makers in the field as well as

senior policy makers.

Global Immunization News (GIN) September 2014

Page 6

Upcoming Meetings

Advanced Vaccinology Course

Institute of Tropical Medicine and International Health, Charité – Universitätsmedizin, Berlin

Location: Berlin, Germany

Date: 12 – 23 January 2015 (Deadline for application, 20

October 2014)

Participants: Charité - Universitätsmedizin, Berlin and University

of Antwerp, Belgium

Group photo from the participants in the course

in 2014

Purpose: The course covers state-of-the-art updates on recent global developments in the field of vaccinol-

ogy. It is run in partnership between the Institute of Tropical Medicine and International Health,

Charité – Universitätsmedizin Berlin, and the University of Antwerp, Belgium. A wide range of

lecturers contribute to the course teaching: these come from various institutions, from academia

as well as the pharmaceutical industry, with specialists from a wide array of regional and thematic

expertise.

Details: An introduction of new vaccines, new financing initiatives and related policy issues will be provid-

ed. Basic epidemiological, ethical and regulatory issues related to the assessment of vaccine efficacy

and effectiveness in different regions will be compared, while appraising issues of public confidence

in vaccination programmes. The course also provides an overview of economic aspects of vaccina-

tion programmes and ways in which health professionals may be assisted in designing, planning, and

implementing immunization programmes (with a strong focus on developing countries).

Global Immunization News (GIN) September 2014

Page 7

Global Advisory Committee on Vaccine Safety (GACVS) meeting

Patrick Zuber, WHO HQ

Location: Geneva, Switzerland

Date: 3-4 December 2014

Participants: Vaccine safety experts – WHO personnel

Purpose: The WHO Global Advisory Committee on Vaccine Safety (GACVS) is a technical advisory

body to WHO which aims to provide a reliable and independent scientific assessment of

vaccine safety issues through: • rigorous reviews of the latest knowledge, in all fields ranging from basic sciences to epide-

miology, concerning any aspect of vaccine safety of global or national interest; • determination of causal relationships between vaccines and/or their components and ad-

verse events attributed to them; • creation, where necessary, of ad hoc task forces with a mandate to commission, monitor

and evaluate research on any purported association of specific vaccines/components and

adverse events. The committee reports to Director, EMP. The Committee meets twice a year and on an additional ad hoc basis depending on the

emergence of vaccine safety situations.

Global Vaccine Safety Initiative (GVSI) meeting

Christine Maure, WHO HQ

Location: Tianjin, China

Date: 13-14 October 2014

Participants: Country representatives and major stakeholders in vaccine safety

Purpose: For countries and partners to interact and exchange information on progress with imple-

mentation of national and global vaccine pharmacovigilance activities and define plans for

further development.

Details: The Global Vaccine Safety Initiative (GVSI) implements the Global Vaccine Safety Blue-

print, a strategy to ensure vaccine safety in the Decade of Vaccines - Global Vaccine Ac-

tion Plan. Country representatives from the Global Network for Post Marketing Surveil-

lance and major stakeholders in vaccine safety are invited for a 2-day meeting to discuss

progress with implementation of national and global vaccine pharmacovigilance activities

and define plans for further development. Specific objectives are to develop an overview

of current and planned activities in global vaccine safety, identify needs and opportunities

to support countries in implementing an effective vaccine pharmacovigilance system, ex-

plore possible synergies between stakeholders and partners and avoid duplication of ef-

forts and update.

Global Immunization News (GIN) September 2014

Page 8

Meetings/Workshops

Meeting on the introduction of inactivated polio vaccine (IPV) in routine

immunization programmes

Catharina de Kat-Reynen, WHO Europe

Location: Istanbul, Turkey

Date: 13-15 August 2014

Participants: WHO Headquarters, WHO Regional

Office for Europe, UNICEF Supply Divi-

sion, GAVI Secretariat, representatives

of Armenia, Azerbaijan, Georgia, Kyrgyz-

stan, Republic of Moldova, Tajikistan, the

former Yugoslav Republic of Macedonia,

Turkmenistan and Uzbekistan

Purpose: To review the IPV introduction process,

assist Member States in developing and

refining detailed IPV introduction plans

and, for Member States eligible for GAVI

support, provide guidance on applications

for the mid-September 2014 deadline.

Group photo of the participants in the meeting on

the introduction of IPV in RI

Details: WHO/Europe provides ongoing support for the introduction of inactivated polio vaccine (IPV)

in Member States that currently use oral polio vaccine (OPV) only. During the meeting, partici-

pants also had the opportunity to discuss other key issues for IPV introduction, including com-

munication and cold chain needs. To assist Member States further, WHO/Europe has developed a resource package on IPV in-

troduction that includes a large range of operational and technical manuals, communication sup-

port, presentations, Frequently Asked Questions and much more. The package is available in

hard copy in English and Russian and can be ordered through this email address.

Global Immunization News (GIN) September 2014

Page 9

Annual meeting of the European laboratory networks for measles/rubella and polio

Catharina de Kat-Reynen, WHO Europe

Location: Hammamet, Tunisia

Date: 8-12 September 2014

Participants: Virologists from Azerbaijan, Belarus, Georgia, Kazakh-

stan, Kyrgyzstan, Republic of Moldova, Russian Feder-

ation, Turkmenistan and Ukraine, WHO EURO and

WHO EMRO

Group photo from the Annual meeting of the

European Laboratory networks for polio

Purpose: To conduct a joint review of the networks’ perfor-

mance in 2013–2014 and to define future priorities

and to further strengthen collaboration with sister

networks in the WHO Eastern Mediterranean Region.

The networks continue to work closely as part of the

WHO response to recent polio and measles out-

breaks in the Middle East.

Group photo from the Annual meeting of the

European Laboratory networks for Measles/

Rubella

Details: Within the European Region, WHO coordinates a Measles/Rubella Laboratory Network and a Polio

Laboratory Network to facilitate high-quality laboratory investigation of suspected cases of these dis-

eases. In addition to early detection of a potential outbreak, data provided by the laboratories are

critical to understanding the impact of a country’s vaccination programme on the prevalence and

spread of disease. All of the European networks’ laboratories passed the annual WHO external quality assurance testing

in the past year and were fully accredited. While both networks continue to maintain a high standard

of work, challenges related to insufficient staff and government funding present a real threat to their

performance. More should be done by the national governments in the respective countries and throughout the

European Region to ensure uninterrupted work of this essential component of the public health sys-

tem. In the context of the measles and rubella elimination target for the Region, Member States are

expected to also scale up case-based surveillance and optimize the linkage between epidemiological

and laboratory data. More information: European Polio Laboratory Network

European Measles and Rubella Laboratory Network

Eastern Mediterranean Region Polio Laboratory Network

Eastern Mediterranean Measles/Rubella Laboratory Network

Elimination and eradication efforts in the European Region

Global Immunization News (GIN) September 2014

Page 10

Training on Conventional and Real Time Polymerase Chain Reaction (PCR) in

Streptococcus pneumoniae serotype determination for National Reference

Laboratories in Latin America

Ana Belen Ibarz and Gloria Rey-Benito, PAHO

Location: Sao Paulo, Brazil

Date: 18-29 August 2014

Participants: Professionals from National Reference Laboratories

from Argentina, Chile, Mexico, Panama, Paraguay

and Peru attended the training in the Bacteriology

Lab of the Adolfo Lutz Institute.

Purpose: The purpose of this activity was to train National

Reference Laboratory professionals on the Poly-

merase Chain Reaction (PCR) technique for sero-

typing Streptococcus pneumoniae and to ensure that

this activity is implemented and remains installed in

the participating laboratories.

Participants from Latin American countries,

Adolfo Lutz Institute and CDC. Workshop

training on the conventional and real time

PCR for Streptococcus pneumoniae sero-

type determination. Adolfo Lutz Institute,

Sao Paulo, Brazil. Photo courtesy of Dr.

Maria Cristina Brandileone, Adolfo Lutz

Institute.

Details: This training was conducted as part of the activities aimed at improving invasive bacterial disease

surveillance in Latin America. It focused specifically on obtaining information on circulating S. pneu-

moniae serotypes following the introduction of pneumococcal conjugate vaccines (PCV) in most

Latin American countries. The training was organized by the Immunizations Unit of the Pan American Health Organization

and conducted by Dr Gloria Carvalho, from the Streptococcus laboratory of the United States

Centers for Disease Control and Prevention (CDC), and Dr Samanta Almeida, from the Bacteri-

ology laboratory at the Adolfo Lutz Institute in Sao Paulo, Brazil. For two weeks, participants participated in classroom lectures and hands-on practical activities on

the methodology: from sample manipulation, transport and conservation to DNA extraction,

PCR, interpretation of the results and problem-solving. All participants stressed the high technical knowledge of the trainers and the personnel at the

Adolfo Lutz Institute, the warm reception by the host institution, and the technical support they

were offered once they returned to their countries. They all felt confident they would be able to

install the S. pneumoniae PCR capacity in their home countries and contribute to improving pneu-

mococcal disease knowledge in Latin America.

Global Immunization News (GIN) September 2014

Page 11

Fifth Meeting of the South-East Asia Regional Technical Advisory Group on

Immunization (SEAR - ITAG)

Virginia Swezy, WHO SEARO

Location: New Delhi, India

Date: 25-29 August 2014

Participants: SEAR-ITAG members, members of National Com-

mittees for Immunization Practices (NCIP) of Mem-

ber States, SAGE members representing the Re-

gion, national EPI programme managers and national

surveillance focal points from all 11 countries, rep-

resentatives from WHO Headquarters, the Re-

gional Office for South-East Asia and WHO country

offices immunization focal points, UNICEF head-

quarters, the South Asia and the Eastern Asia and

Pacific Regional offices, country offices and a num-

ber of other local and global partners and stake-

holders.

Participants from the SEARO ITAG

Purpose: To review the status of performance of national EPI programmes in relation to disease eradication/

elimination/control targets; to address and seek guidance on ways to effectively address five issues of

importance to this Region, i.e. data quality and strengthening routine immunization to achieve and

sustain high immunization coverage; sentinel surveillance for congenital rubella syndrome (CRS);

applying lessons learned from implementation of health systems strengthening (HSS) activities and

ways to optimize GAVI HSS implementation to strengthen immunization service delivery; identifying

ways to strengthen effective vaccine management in countries; bilateral/horizontal collaborative

mechanisms between countries on group procurement to obtain better pricing and assured supply

of vaccines.

Details: While moving forward with its immunization agenda, a number of key challenges confront the coun-

tries in this Region. Most notable is that Regional DTP3 coverage estimates have remained stagnant

for the past five years at 77%, with India and Indonesia accounting for more than 90% of the Region’s

unimmunized infants. Other challenges are that Regional MCV1 and MCV2 coverage will need to hit

95% to eliminate measles by the goal of 2020, and can only do so if India and Indonesia accelerate

their efforts, and countries that have not conducted a wide age-range nationwide catch-up campaign,

do so. The Region will also need to ensure that the three countries yet to introduce routine MCV2

dose do so, and a special effort is made by the five countries that have yet to introduce a rubella

containing vaccine. To this end, the SEAR-ITAG concluded and made recommendations in a number of categories in-

cluding: Quality of Immunization Data, Polio and IPV Introduction, Measles and rubella surveillance

and immunization, CRS Sentinel Surveillance, Japanese Encephalitis, Maternal and Neonatal Tetanus

Elimination, Influenza Prevention and Control, Effective Vaccine Management, Pooled procurement,

and Adverse Events Following, Immunization.

Global Immunization News (GIN) September 2014

Page 12

WHO workshop on Defining Disease Burden and Decision-making for Seasonal

Influenza Vaccination

Pernille Jorgensen, Diane K. Gross, and Liudmila Mosina, WHO Regional Office for Europe; Philipp Lambach,

WHO Geneva

Location: Tbilisi, Georgia

Date: 25-29 August, 2014

Participants: National surveillance and immunization programme

managers and representatives of national immuniza-

tion technical advisory groups (NITAG) from seven

countries (Albania, Armenia, Belarus, Georgia, Ka-

zakhstan, Moldova and Ukraine), the Royal Tropical

Institute (Netherlands), Centers for Disease Control

and Prevention (United States), World Health Or-

ganization (WHO) Regional Office for Europe and

WHO headquarters. Total participants: 52

Participants at the workshop “Defining Influ-

enza Disease Burden”, Tbilisi, Georgia Credit: WHO

Purpose: To train national surveillance and immunization officers in methods for estimating seasonal influ-

enza disease burden; discuss the process of evidence based decision-making on seasonal influenza

vaccination policy; discuss the feasibility of introducing influenza vaccine; and share best practices

in making evidence-based decisions and implementation of seasonal influenza vaccination.

Details: The first half of the workshop focused on using the WHO Manual for Estimating Disease Burden

Associated with Seasonal Influenza. During the training, participants used national influenza sur-

veillance data from hospitals and outpatient clinics to develop preliminary burden estimates. Limi-

tations of surveillance data for burden calculations and quality issues were also discussed. The second part concentrated on principles and key criteria to be considered for making evi-

dence-based recommendations on seasonal vaccination policy, tools available to collect evidence,

and recent influenza vaccination developments. Approaches to develop evidence-based recom-

mendations on influenza vaccination considering disease burden, vaccine safety and efficacy, cost-

effectiveness of vaccination, programmatic aspects, and economic evaluations, etc. were discussed

in country groups. Challenges in establishing country NITAGs were also addressed including the

criteria required to become compliant with WHO recommendations. Although monitoring of influenza is strong in the WHO European Region, surveillance data have

not been widely translated into estimates of morbidity and economic burden of influenza. This

was the first workshop organized by WHO Regional Office for Europe and WHO headquarters

on estimating burden of influenza in the European Region anticipating to improve evidence-based

decision-making on influenza immunization and prioritize target groups in countries with limited

vaccines.

Global Immunization News (GIN) September 2014

Page 13

Peer review of GAVI applications for IPV introduction

L. N. AKA & J. N’GANTCHOU, Consultants WHO IST central, O. N’GANGA, D. Cheikh and A. Ambendet, WHO

IST central

Location: N’djamena, Chad

Date: 26-28 August 2014

Participants: Delegants consisted of EPI coordinators, EPI logis-

ticians, WHO and UNICEF focal points from An-

gola, Burundi, Chad (plus its Communication offi-

cer), the Central African Republic (CAR), the Con-

go, Gabon, and Sao Tomé and Principe. The team

of facilitators was composed of experts from

WHO (IST Central, Cameroon and two consul-

tants), and UNICEF/WCAR experts. Equatorial Guinea could not come but its case was

studied at the workshop.

Purpose: Mainly to review the quality of introduction plans

of the Inactivated Polio Vaccine (IPV), and GAVI

applications for this vaccine.

Participants from the Peer review of GAVI applica-

tions for IPV introduction

Details: In November 2013, the Strategic Advisory Group of Experts on Immunization (SAGE) adopted a

number of key recommendations on the use of inactivated polio vaccine (IPV) in national immuniza-

tion programmes. One recommendation relates to the fact that endemic and all other countries that

remain at high risk of polio importation must introduce at least one dose of IPV in their routine im-

munization programme before the end of 2015. To this effect, these countries should develop natio-

nal plans in 2014 for the introduction of IPV. In the context of the accelerated introduction of IPV, WHO IST Central in collaboration with AFRO

and UNICEF provided technical support to countries in preparing drafts of IPV introduction plans and

GAVI applications. Subsequently, WHO IST Central, in collaboration with UNICEF and other part-

ners, organized the workshop. It was also an opportunity to strengthen the capacity of national lea-

ders in the field of the introduction of IPV. The working methodology consisted primarily of presentations followed by working groups, which

focused on the review of documents (plans for the introduction of IPV and other related documents)

followed by feedback sessions from peers. This was the analysis of documents based on a predetermi-

ned template. During the plenary sessions, guidance and direction were provided. The workshop con-

cluded with the development of a timetable for completion by each country to enable it to send the

application on time.

Resources

Updated WHO fact sheets Hayatee Hasan, WHO Headquarters

Immunization coverage: Immunization averts an estimated 2 to 3 million deaths every year from diphtheria,

tetanus, pertussis (whooping cough), and measles. Global vaccination coverage—the proportion of the world’s

children who receive recommended vaccines—has remained steady for the past few years. During 2013, about

84% (112 million) of infants worldwide received 3 doses of diphtheria-tetanus-pertussis (DTP3) vaccine, protect-

ing them against infectious diseases that can cause serious illness and disability or be fatal. By 2013, 129 countries

had reached at least 90% coverage of DTP3 vaccine. Read the updated fact sheet

Children - reducing mortality: From the end of the neonatal period and through the first five years of life, the

main causes of death are pneumonia, diarrhoea and malaria. Overall, substantial progress has been made towards

achieving Millennium Development Goal (MDG) 4. Since 1990 the global under-five mortality rate has dropped

from 90 deaths per 1000 live births in 1990 to 46 in 2013. But the rate of this reduction in under-five mortality is

still insufficient to reach the MDG target of a two-thirds reduction of 1990 mortality levels by the year 2015. Read

the updated fact sheet

Global Immunization News (GIN) September 2014

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Global Immunization News (GIN) September 2014

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Calendar 2014

October

2-3 AFRO West and Central Sub-Regional Workshop Group meeting Ouagadougou, Burkina Faso

7-8 GAVI Programme and Policy Committee (PPC) meeting Geneva, Switzerland

8-9 14th Meeting of the European Technical Advisory Group of Experts on

Immunization (ETAGE)

Copenhagen, Denmark

13-14 Global Vaccine Safety Initiative (GVSI) meeting Tianjin, China

13-17 65th Session of the WHO Regional Committee for the Western Pacific Manila, Philippines

13-17 Regional workshop on surveillance for new vaccine-preventable diseases Manila, Philippines

14-15 AFRO East & South GAVI Sub-Regional Workshop group meeting Antananarivo, Madagascar

19-22 61st Session of the Regional Committee for the Eastern Mediterranean Tunisia

21-23 Meeting of the Strategic Advisory Group of Experts (SAGE) on Immun-

ization

Geneva, Switzerland

25-26 JTEG Malaria vaccine meeting Geneva, Switzerland

27-29 DCVMN (Developing Countries Vaccine Manufacturers) 15th Annual

General Meeting

New Delhi, India

27-31 Measles Rubella Laboratory Network meeting for the South-East Asian

Region

Jakarta, Indonesia

27-31 Global IB-VPD and RV Sentinel Surveillance Meetings Geneva, Switzerland

November

3-7 64th Session of the WHO Regional Committee for Africa Cotonou, Benin

10-12 EURO Regional Verification Commission for Measles and Rubella Elimi-

nation

Copenhagen, Denmark

10-21 GAVI Independent Review Committee (IRC) Applications Review Com-

mittee

Geneva, Switzerland

11-13 Meeting on Using Information and Communication Technology (ICT) to

improve immunization programmes

Istanbul, Turkey

17-18 Rotavirus Technical Working Group LabNet Meeting Rio de Janeiro, Brasil

17-20 28th Intercountry Meeting of National Managers of the Expanded Pro-

gramme on Immunization

Amman, Jordan

22-25 15th Intercountry Meeting on Measles and Rubella Control and Elimina-

tion

Amman, Jordan

Global Immunization News (GIN) September 2014

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December

3-4 Global Advisory Committee on Vaccine Safety (GACVS) meeting Geneva, Switzerland

8-12 Vaccine-Preventable Diseases Laboratory Network Meeting Manila, Philippines

9-10 SEARO Regional Working Group on New Vaccines Introduction and Health

Systems Strengthening

Myanmar

10-11 GAVI Board Meeting Geneva, Switzerland

2015

February

16-20 cMYP Training Workshop Geneva, Switzerland

April

14-16 Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization Geneva, Switzerland

May

12-14 2015 Technet Consultation TBD, Thailand

October

20-22 Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization Geneva, Switzerland

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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 Newsletter (PAHO) The Civil Society Dose (GAVI CSO Constituency) TechNet Digest RotaFlash (PATH) GAVI Programme Bulletin (GAVI)

Organizations and Initiatives American Red Cross Child Survival Agence de Médecine Préventive Africhol EpiVacPlus LOGIVAC Project SIVAC Centers for Disease Control and Prevention Polio Global Vaccines and Immunization Johns Hopkins International Vaccine Access Center Vaccine Information Management System JSI Africa Routine Immunization Systems Essentials Project IMMUNIZATIONbasics Maternal and Child Health Integrated Program (MCHIP) PAHO ProVac Initiative PATH Vaccine Resource Library Rotavirus Vaccine Access and Delivery Malaria Vaccine Initiative Meningitis Vaccine Project 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 Dengue Vaccine Initiative European Vaccine Initiative Gardasil Access Program GAVI Alliance International Association of Public Health Logisticians International Vaccine Institute Measles & Rubella Initiative Multinational Influenza Seasonal Mortality Study TechNet-21 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) September 2014