News In this issue

News

New Measles risk assessment

tool launched

New tool helps countries

assess immunization financing options: Immunization financ-

ing

Ceremony Marks Cold Chain

Equipment Donation in Benin

Three new documents on

vaccine pricing and trends available on the V3P website

Pfizer, GSK targeted for vac-cine pricing in MSF Twitter

spree

Check the source: WHO-

validated websites provide trustworthy information on vaccine safety

EMRO-RTAG on Immuniza-

tion: Request for nominations

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Past meetings / workshops

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Polio Outbreak in Guinea is interrupted Ado Mpia Bwaka, Crépin Hilaire Dadjo and Modjirom Ndoutabe, WHO Inter-Country Support

Team for West Africa

Following an independent evaluation conducted

in January 2017, the Minister of Health of Guin-

ea, Dr Abdourahmane Diallo, officially an-

nounced the interruption of poliovirus trans-

mission in Guinea. The first cases of circulating

Vaccine Derived Polio Viruses type 2 (cVDPV2)

were reported in the country in September

2015. The last case had its onset of paralysis on

15 December 2015.

As per WHO Standard Operating Procedures

(SOPs) for responding to a poliovirus event and

outbreak, the independent Outbreak Response

Assessment (OBRA) – the third in the series –

was carried out 12 months after the detection

of the last case. Two OBRA exercises were previously conducted in March and August 2016.

Investigators were composed of experts from WHO, UNICEF, CDC, the Bill and Melinda Gates

Foundation with support from national staff. Five regions, 10 provinces, 24 health facilities and six

hospitals were visited.

Compared to the last OBRA held in August 2016, investi-

gators reported tremendous progress in areas such as

political will, early disbursement of funds at least two

weeks ahead of the polio campaign, specific strategies to

reach underserved children, and functional cold chain avail-

ability in almost every health facility. All eight regions have

a polio emergency task force despite only being fully oper-

ational during mass campaign periods.

Above all, the two key surveillance indicators are strong:

the non-Polio Acute Flaccid Paralysis (AFP) rate which

should equal or go beyond 3/100,000 for under 15 year-

olds reached 21.2/100,000 at national level; the percentage

of stools collected within 14 days for two samples is excel-

lent for every region except Conakry, the capital city (77.3%), the average being set at least 80%.

On the whole, the investigating team concluded that the transmission of poliovirus has been inter-

rupted pending laboratory results from the 2016 AFP cases and environmental samples yet to be

examined. The team also called on the government to keep a close eye on two regions including

the capital city Conakry and Kankan where the outbreak originated. A key recommendation was

for a post outbreak simulation exercise to be organized before June 2017 and that the AFP and

laboratory data bases be reconciled.

From left to right, the Minister of

Health, Dr A Diallo and the WHO

Representative to Guinea, Prof George

Alfred Ki-Zerbo_ Credit Photo WHO

Guinea.

The Minister of Health Dr A Diallo vaccinating a

child during Polio NIDs in January 2016_ Credit

Photo_CHDadjo WHO-IST West Africa

Page 2

Global Immunization News (GIN) February 2017

New Measles risk assessment tool launched Minal Patel, WHO Headquarters

With support from the Gates Foundation, CDC, WHO regional and country offices, and various Ministries of

Health, we are pleased to announce the launch of the measles programmatic risk assessment tool.

This tool is intended to help countries identify areas not meeting measles program-

matic targets, and based on the findings, guide and strengthen measles elimination

program activities and reduce the risk of outbreaks. This Excel-based tool assesses

subnational programmatic risk as the sum of indicator scores in four categories: pop-

ulation immunity, surveillance quality, program performance, and threat assessment.

Each subnational area is assigned to a programmatic risk category of low, medium,

high, or very high risk based on the overall risk score. Scoring for each indicator was

developed based on expert consensus.

To ensure programmatic utility of the tool, it is designed to be used annually by national program managers to moni-

tor implementation of measles elimination strategies within a country. The required data inputs include readily-

available and routinely collected data from the immunization and surveillance programs. Results are shown in table

and map formats, with subnational areas color-coded by risk category. In addition, subnational risk scores can be

displayed by indicator category, facilitating better understanding of programmatic weaknesses that are driving the

overall risk score. Country reports can be created directly from the tool.

The user guide and the tool are available in English and in French.

New tool helps countries assess immunization financing options: Immunization

financing: a resource guide for advocates, policymaker, and program managers Daniel Arias, Danielle Bloom, Cheryl Cashin, Helen Saxenian, and Paul Wilson, Results for Development

A new resource guide, Immunization Financing: A Resource Guide for Advocates, Policymakers, and Program Managers,

provides practical advice to low- and middle-income countries seeking to mobilize resources for immunization pro-

grams. The guide offers 26 briefs, including eight country case studies, to assist countries looking to sustainably fi-

nance immunization.

The guide was prepared by Results for Development based on research funded in part by the Bill & Melinda Gates

Foundation.

The guide is an update to the Immunization Financing Toolkit: A Resource for Policy-Makers and Program Managers,

published by the World Bank and the Gavi Alliance in December 2010. Since the publication of the toolkit in 2010,

several important trends have emerged, including the availability of new vaccines, increased country transitions from

Gavi support, and growing commitments to immunization financing and universal health coverage.

The new guide is comprised of 26 briefs, with eight country case studies, and is intended for both Gavi and non-Gavi

eligible countries. Copies are available for download at this link. A French translation of the guide will be available in

March/April 2017, and translations in additional languages may be undertaken depending on demand.

Please send an email (darias@r4d.org) to request printed copies of the guide or to discuss possible dissemination

events.

Global Immunization News (GIN) February 2017

Page 3

Ceremony Marks Cold Chain Equipment Donation in Benin Amel Bouziani, Agence de Médecine Préventive (AMP)

The Agence de Médecine Préventive (AMP) celebrated a donation by its

LOGIVAC+ project of a large quantity of cold chain equipment to five health

zones in Benin. The ceremony was held on 16 February 2017 at the Ministry

of Health in Cotonou, Benin, with the country’s Minister of Health, Dr Alas-

sane Seidou, AMP’s Africa Regional Director, Dr Tené-Alima Essoh and its

Benin Programme Director, Dr Idrissa Hamed Traore. Dr Essoh opened the

ceremony before presenting the equipment to Dr Seidou and the health zone

representatives.

The following health zones Allada-Zè-Toffo,

Lokossa-Athiémé, Aplahoue-Djakotomey-Dogbo, KlouekaminTovinklin-Lalo, and

Comè-Bopa-GrandPopo-Houeyogbe received 37 solar refrigerators, four mobile ware-

houses for vaccine distribution, four freezers, and eight refrigerators.

The aim behind the donation is to ensure improved

vaccine distribution and storage, in line with the

LOGIVAC+ project’s activities to deploy an optimized

logistics system, previously implemented as a test case

in Comè’s health zone.

The results from the Comè pilot case showed that an optimized logistics system had

a significant impact on vaccine logistics, vaccine and data quality, and health personnel

motivation. It also guaranteed continued access to quality vaccines at the right time,

in the right place, at the lowest cost.

Three new documents on vaccine pricing and trends available

on the V3P website Stephanie Mariat, WHO Headquarters

At countries’ request, WHO has worked with UNICEF and PAHO to enhance transparency

of vaccine prices, through the creation and maintenance of the Vaccine Product, Price and

Procurement Initiative (V3P).

Thanks to the hard work of colleagues and partners, last year 51 countries shared their vac-

cine price information with the V3P database. Together with the data shared by PAHO and

UNICEF, the V3P database now provides visibility to prices accessible to 70% of the world.

All data and analyses are directly available on the V3P website.

In order to facilitate access to price information, WHO EPI has created the following three

documents:

WHO Price Report 2016: this is a standalone version of the pricing section (also known as the “GVAP price

report͟”) published annually as part of the GVAP Secretariat report. It provides a short overview of vaccine pricing

and trends.

V3P Price Digest 2016: the price digest is a directory of vaccine prices and is meant to ease access to the price

information available on the website. The digest presents vaccine price data points and ranges from the V3P data-

base per vaccine, with an emphasis on those that are posing the biggest affordability issues. The extracted tables

are complemented by procurement and pricing analyses on each vaccine.

Factsheet on vaccine pricing for Gavi transitioning countries 2016: countries have brought to our atten-

tion their challenges in accessing information about price commitments by manufacturers for countries transition-

ing out of Gavi support and for fully self-financing countries. This factsheet aims at clarifying the manufacturers’

price commitments and presents prices accessible to each of these countries.

The documents are available on the V3P information repository webpage.

Dr Essoh presenting the keys

to the country’s Minister of

Health, Dr Alassane Seidou

Dr Essoh giving her speech

during the ceremony

AMP’s Mobile Warehouses

Global Immunization News (GIN) February 2017

Page 4

Pfizer, GSK targeted for vaccine pricing in MSF Twitter spree Vivian Peng, Médecins sans Frontières

Even after Pfizer and GlaxoSmithKline (GSK) offered their pneumococcal conjugate vaccine (PCV) pricing concessions

last fall 2016, Médecins Sans Frontières (MSF) is continuing to maintain the pressure on vaccine manufacturers. The

global charity took to social media on Valentine’s Day to call for further price reductions in developing countries.

In a series of Tweets and Facebook posts, MSF and its employees called on Pfizer and GSK to lower the price of their

shots to $5 for all three doses in developing countries so children may have access to lifesaving vaccines where they

currently do not.

MSF noted that the posts were part of the group’s long-term efforts to bring prices for the vaccines down. GSK mar-

kets Synflorix and Pfizer sells Prevenar, by far the world’s bestselling vaccine.

Last year, after long term protests by MSF, Glaxo and Pfizer pledged to lower their vaccine prices during humanitar-

ian emergencies, but those reductions have not yet materialized in signed contracts.

Going forward, MSF plans a number of actions in the coming months to keep up the pressure. They include World

Immunization Week in April 2017 and the World Health Assembly in May 2017.

Check the source: WHO-validated websites provide trustworthy information on

vaccine safety Hayatee Hasan, WHO Headquarters

When people need advice about topics

like health, careers, or relationships, the

first place they often look is the internet.

The same is true when parents and care-

givers are seeking credible information

about whether vaccines are safe for their

children.

However, finding that information often

isn't easy. In recent years a number of

websites providing unbalanced, misleading,

and alarming vaccine safety information

have been established, prompting a wave

of undue fears.

"Every day, misinformation about vaccines

continues to proliferate on the internet,"

says Isabelle Sahinovic, Vaccine Safety Net

coordinator at WHO. "This is dangerous.

We need to make sure that all parents,

caregivers, and health care professionals can easily access accurate and trustworthy information about vaccines."

WHO’s Vaccine Safety Net, a global network of vaccine safety websites, aims to do just this. Today, the network has

47 member websites in 12 languages. It is estimated that more than 173 million users every month access VSN web-

sites that contain, among other information, credible vaccine safety information.

Read the full story here.

Credit: WHO/J. Holmes

Global Immunization News (GIN) February 2017

Page 5

VIEW PREVIOUS EDITIONS

For previous editions of the GIN,

visit the GIN archive on the WHO website:

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WHO Eastern Mediterranean Regional Office (EMRO) - Regional Technical Advisory

Group (RTAG) on Immunization: Request for nominations

WHO is soliciting proposals for nominations for vacancies on its RTAG. Nominations are solicited from the Eastern

Mediterranean Region (EMR) and should be submitted no later than 31 March 2017. Nominations will then be re-

viewed by the EMR RTAG membership selection panel, which will propose nominees to the Regional Director (RD)

of EMRO for appointment.

The RTAG is the technical committee established to provide advice to WHO/EMRO on matters related to strength-

ening immunizations programmes and achieving the regional target of elimination and control of vaccine preventable

diseases. The RTAG is formally established by the EMRO RD with reporting to the RD or delegated senior staff of

the department of communicable diseases prevention and control (DVD) and the unit of vaccine preventable diseas-

es and immunization (VPI).

Please see this link for the Standard Operating Procedures and detailed Terms of Reference of the RTAG.

Members are acknowledged experts in areas relevant to immunization programmes, serving in their own capacity.

Members will represent a broad range of disciplines (vaccinology, epidemiology, immunology, public health, paediat-

rics, family medicine, internal medicine, health economy, regulations, vaccine delivery, communication etc.) and a

range of affiliations (governmental, academia, private practice). Consideration is given to ensuring appropriate gender

balance and geographic representation of the region.

Instructions for nominations are available at this link.

----------------------------------------------------------------------------------------------------------------------------------------------

OMS Bureau régional pour la Méditerranée orientale (EMRO), Le Groupe

consultatif technique régional sur la vaccination (RTAG) de l'OMS : Appel à

candidatures

EMRO lance un appel à candidatures en vue de pourvoir aux vacances actuelles au sein de son RTAG. Les nomina-

tions doivent être soumises au plus tard le 31 mars 2017. Les candidatures seront examinées attentivement par le

panel de sélection des membres du RTAG, qui soumettra la liste des candidats retenus au Directeur régional (DR)

d’EMRO.

Le RTAG est le groupe consultatif technique mis en place pour conseiller le Bureau régional sur les questions liées au

renforcement des programmes d’immunisation et à l’accomplissement des objectifs régionaux d’élimination et de con-

trôle des maladies évitables par la vaccination. Le RTAG est mis en place par le DR et rend compte directement au

DR ou par délégation aux cadres supérieurs du département de la prévention et du contrôle des maladies transmis-

sibles (DVD) ou de l’unité de vaccination et maladies évitables par la vaccination (VPI). Des informations supplémen-

taires sur le RTAG et ses modes opératoires normalisés ainsi que ses termes de références spécifiques sont dispo-

nibles à ce lien.

Les membres du groupe sont des experts reconnus dans les domaines ayant un intérêt pour les programmes de vac-

cination. Ils siègent à titre personnel. Les membres du RTAG représentent diverses disciplines (vaccinologie, épidé-

miologie, immunologie, santé publique, pédiatrie, médecine familiale, médecine interne, économie de la santé, poli-

tiques, vaccination, communication, etc.) et un large éventail d’affiliations (gouvernement, université, secteur privé). La

représentation géographique et un équilibre des genres sont pris en considération.

Les instructions pour la soumission des candidatures sont disponibles à ce lien.

Page 6

Global Immunization News (GIN) February 2017

Past Meetings/Workshops Accelerating Measles-Rubella elimination through research and innovation

James Goodson and Gavin Grant, US Centers for Disease Control and Prevention

Location: PAHO Offices, Washington, DC, USA

Date: 29-30 November 2016

Participants: Thirty-nine participants from American Red

Cross; Centers for Disease Control and

Prevention; World Health Organization HQ,

AFRO, and PAHO; UNICEF, United Nations

Foundation; Sabin Vaccine Institute, Task

Force for Global Health; Bill and Melinda

Gates Foundation; Emory University; Univer-

sity of Jordan; Ministries of Health- Oman,

Brazil, Sri Lanka; Fundacao Oswaldo Cruz,

Brazil; Pennsylvania State University; John

Hopkins University; Kid Risk, Inc.; and Inter-

active Research & Development.

Group photo at the meeting on Accelerating

Measles-Rubella elimination through research

and innovation

Purpose: To define the current set of global measles

and rubella research priorities to guide fu-

ture investments. The meeting was the final

step in a prioritization process led by the

Measles & Rubella (M&RI) Initiative Research

& Innovation Workgroup that aimed to

reach consensus on the critical research

questions and innovations needed to make

further progress toward achieving measles

and rubella elimination goals.

Details: The meeting developed a framework to focus the discussions involving subject area experts in

the following four workgroups: 1) epidemiology and economics, 2) surveillance and vaccine, 3)

immunization strategies, and 4) demand creation and social mobilization. Each workgroup re-

viewed previous research priorities, the recent Measles and Rubella Global Strategic Plan 2012-

2020, the report of the recent M&RI Midterm Review, and inputs from the broader immuniza-

tion community collected in October 2016 through a web survey designed specifically for this

prioritization process. Each workgroup identified and prioritized five research questions to address during the next

few years and focused on activities that would improve programmatic outcomes. The final report will be available on the M&RI Research and Innovations Workgroup website

once finalized in April 2016.

Global Immunization News (GIN) February 2017

Page 7

The Fifth Intercountry Meeting of WHO Polio Staff of the Eastern Mediterranean

Region

Joseph Swan, WHO Country office Jordan

Location: Amman, Jordan

Date: 5-8 December 2016

Participants: 65 participants attended the meeting including WHO

Regional Director Dr Ala Alwan, WHO Regional Di-

rector-elect Dr Mahmoud Fikri, and WHO staff from

the regional office and country offices. A delegation

from the Bill & Melinda Gates Foundation including

President of the Foundation’s global development pro-

gramme, Dr Chris Elias, observed the meeting.

Participants of the Fifth Intercountry

Meeting of WHO Polio Staff of the East-

ern Mediterranean Region. Photo:

WHO

Purpose: 2016 saw the lowest number of polio cases recorded in

history (37 cases globally). With 2017 hoped to be the

last year of poliovirus transmission, WHO polio staff of

the Eastern Mediterranean Region convened to evalu-

ate progress in implementing recommendations made

at the fourth regional polio staff meeting (27-29 Octo-

ber 2015), examine the current polio epidemiological

situation, assess new programme risks and challenges,

and set priorities for 2017 to ensure the achievement

of goals set out in the Polio Eradication and Endgame

Plan 2013-2019.

A young boy is vaccinated against polio

during a subnational immunization drive

in Afghanistan, July 2016. Photo: WHO/J

Swan

Details: Countries of the Eastern Mediterranean Region were divided into three categories in order of

priority – endemic, at-risk and low-risk. The overriding priority for the regional polio programme in 2017 is to stop transmission of all

types of poliovirus in endemic Pakistan and Afghanistan through supporting both countries to

effectively implement their country-specific National Emergency Action Plans. Focus will remain on protecting at-risk and low-risk countries from outbreaks of wild poliovirus

(WPV) and circulating vaccine-derived polioviruses (cVDPVs) through i) conducting mass supple-

mentary immunization activities (at-risk countries), targeted pulse immunization campaigns (low-

risk countries) and supporting the strengthening of basic immunization services to ensure mainte-

nance of high population immunity especially in high risk groups, ii) strengthening acute flaccid

paralysis (AFP) and environmental surveillance system quality and sensitivity, iii) establishing quar-

terly detailed risk assessments to better define risks and develop risk mitigation plans accordingly,

and iv) maintaining and updating outbreak preparedness and response plans and testing these

through simulation exercises. The regional team in Amman will continue to provide technical, operational and administrative

support to country teams in areas of capacity building and training, surveillance reviews, risk as-

sessment, resource mobilization and advocacy, programme and grant management reviews, tran-

sition planning, and certification and containment.

Page 8

Global Immunization News (GIN) February 2017

Sub-regional training workshop on responding to vaccine deniers in public

Katrine Bach Habersaat and Philipp Schmid, WHO EURO

Location: Copenhagen, Denmark

Date: 20–22 December 2016

Participants: Eight participants representing five countries (Bulgaria,

Denmark, Ireland, Romania, UK) and WHO

Purpose: To share experiences across Member States and to im-

prove the quality and effectiveness of evidence-based

responses to vocal vaccine deniers in public.

Details: Public trust in vaccines is the foundation for controlling the spread of serious vaccine-preventable

diseases. Vocal vaccine deniers may erode this trust and promote vaccine hesitancy when they

spread myths and misinformation and deny scientific evidence on the benefits of vaccination. Meeting such vaccine deniers in public – on TV or at a conference, for example – is challenging for

health spokespersons. To support them, WHO Europe conducted this training workshop, which

featured presentations, discussions and simulation exercises. The training was based on the WHO/

Europe publication Best practice guidance: How to respond to vocal vaccine deniers in public. Experts in

psychology, communication, vaccinology and journalism facilitated the workshop.

The European Vaccine Action Plan underlines that protecting the public health gains made by im-

munization programmes and improving their impact depend on individuals understanding the bene-

fits and risks of vaccination and demanding immunization as their right and responsibility. When

facing a vocal vaccine denier in public it is important to highlight the existing scientific evidence but

also to prepare messages that mitigate the negative influence of denial beliefs on the general public.

Health officials and the scientific community need to discuss and refine approaches that support

spokespersons in their public response to vocal vaccine deniers.

Global Immunization News (GIN) February 2017

Page 9

Meeting on measles and rubella elimination for German-speaking countries and

regions

Catharina de Kat, WHO EURO

Location: Innsbruck, Austria

Date: 12-13 January 2017

Participants: Members of the national verification commit-

tees for measles and rubella elimination

(NVCs) of Austria, Germany, Luxembourg

and Switzerland, responsible persons for mea-

sles and rubella control in Liechtenstein and

the Autonomous Province of Bolzano (Italy),

public health officials, paediatricians, experts

from WHO/Europe and the European Centre

for Disease Prevention and Control, and the

chair of the Regional Verification Commission

for Measles and Rubella Elimination (RVC).

Group photo of the participants in the meeting on measles

and rubella elimination for German-speaking countries and

regions. Credit: Medical University Innsbruck

Purpose: The countries represented share a common language at the national or regional level, and have similar

practices in surveillance and immunization data collection and reporting. The meeting’s objective was

to review and facilitate the sharing of good practice and lessons learned across countries on: • the epidemiological situation of measles and rubella; • the organization and function of NVCs; • the evidence needed to demonstrate interruption and the process of verifying the elimination

of these diseases; • possibilities for collaboration between NVCs, and • ideas and experiences related to electronic immunization registries, and advocacy and com-

munication, particularly for European Immunization Week. The meeting was hosted by the Division of Hygiene and Medical Microbiology of the Medical Universi-

ty of Innsbruck with support from WHO/Europe and the Austrian Society for Hygiene, Microbiology

and Preventive Medicine.

Details: The meeting facilitated the sharing of ideas and information between NVCs, WHO and other stake-

holders. It also offered the opportunity for NVC members to view the annual status update reports of

fellow German-speaking countries and to obtain further clarifications on their completion. Improving

the documentation of surveillance data with greater focus on molecular surveillance and better linkage

of epidemiologic and laboratory data is considered crucial. All participants agreed on the importance of maintaining public confidence in vaccines, including

through information campaigns, proactive collaboration with media and capacity-building in communi-

cation for health workers.

Page 10

Global Immunization News (GIN) February 2017

Workshop for Laboratories in the WHO European Polio Laboratory Network

Catharina de Kat, WHO

Location: Tel Hashomer, Israel

Date: 23-26 January 2017

Participants: 11 virologists from WHO-accredited nation-

al polio labs in Albania, Belarus, France, Ire-

land, Israel, Spain, Sweden, Ukraine and the

United Kingdom

Purpose: WHO/Europe organized this hands-on

workshop as a first step to support labora-

tories in the WHO European Polio Labora-

tory Network to increase their poliovirus

diagnostic capacities by upgrading to po-

liovirus intratypic differentiation (ITD).

Group photo at the Workshop for WHO polio labor-

atory network laboratories on poliovirus real-time PCR

for ITD5.0.

Details: Successful completion of this training will enable virologists to differentiate between wild, vac-

cine and vaccine-derived polioviruses in their own laboratories. This initiative should decrease

the number of samples undergoing transborder shipment, ensure quicker sample-to-result

turnaround, and provide a foundation for poliovirus direct detection and characterization in

clinical samples in the future. ITD implementation does not require additional installation of equipment as it relies on the

instrumentation already available in the laboratories. WHO commits to providing this initial

platform-specific training to all labs in the Network, and to providing access to WHO poly-

merase chain reaction (PCR) ITD kits, annual proficiency tests and subsequent trouble-

shooting. All 11 trainees in this first workshop successfully completed the necessary practical exercises

and proficiency test.

Global Immunization News (GIN) February 2017

Page 11

Statistical Training on Vaccination Coverage Surveys

Mamadou Diallo, UNICEF HQ and Carolina Danovaro, WHO HQ

Location: Dakar, Senegal

Date: 24-27 January 2017

Participants: Persons from Immunization Programmes, National Sta-

tistics Offices or Research Institutes from Gabon, Guin-

ea-Bissau, Madagascar, Morocco, and Senegal; all coun-

tries planning a vaccination coverage survey in 2017,

with the exception of Morocco that conducts periodic

health surveys that include immunization indicators.

Other participants were Swiss Tropical Institute,

Agence de Médecine Préventive (AMP)-Côte d’Ivoire,

AFR WHO data managers from the Inter Country Sup-

port Teams (IST) Central and West; UNICEF WCARO;

and independent consultants. The facilitators were from

UNICEF and the World Health Organization (WHO

and epidemiologists/ statisticians from Burkina Faso,

Cameroon, Côte d’Ivoire, and Peru, who had been

trained on the new WHO vaccination survey in Madrid

in 2016 (See GIN Oct 2016), in an effort to strengthen

regional capacities.

Purpose: 1. Understand the recommendations from the 2015 WHO Vaccination Coverage Cluster Survey

Reference Manual 2. Recognize the most common immunization indicators obtained from vaccination coverage surveys 3. Recognize the tasks in vaccination coverage survey planning which require statistician expertise 4. Make recommendations regarding sampling design and sample size in different settings 5. Determine appropriate adjustments to make when encountering challenges in the field 6. Calculate sampling weights and use them as well as the design features to conduct data analysis 7. Introduce the tool “Vaccination Coverage Quality Indicators (VCQI)” to analyze survey data

Details: In 2015, the Expanded Programme on Immunization (EPI) at WHO released a working draft of a new

WHO Vaccination Coverage Cluster Survey Reference Manual. This new Manual was the result of an

extensive review and revision of coverage survey methods and materials aimed at improving survey

accuracy and overall quality.

While the sampling and analytical methods outlined in the Survey Manual are commonly used on large

households health surveys, such as Demographic and Health Surveys (DHS) and UNICEF’s Multiple-

Cluster Indicator Surveys (MICS), Immunization Programmes are less familiar with them and will likely

lack the expertise needed to properly conduct the sampling and analyses recommended in the Survey

Manual. To this end, WHO and UNICEF have joined efforts to train a cadre of persons with statistical exper-

tise to support vaccination coverage surveys using the new WHO Survey Manual. This not only helps

to ensure technical quality, but also promotes capacity-building on survey statistics in countries where

surveys are to be implemented. This training was similar to one conducted in September 2016 (see GIN, October 2016), but now

targeting francophone participants. Work was organized in three groups using a mix of presentations

and work group with practical exercises and a case study. Participants’ evaluations were positive for

the overall training. Work will continue in order to assist participants when they need to be engaged

in survey design and/or analysis and report writing.

Global Immunization News (GIN) February 2017

Page 12

GAPIII Auditors Training Workshop, New Delhi, India

Sigrun Roesel, WHO South East Asia Region

Location: New Delhi, India

Date: 30 January - 3 February 2017

Participants: A list of key organizations that attended GAPIII auditors from Australia, India, Indonesia and

the Republic of Korea Representatives of National Authorities for Contain-

ment WHO HQ, SEARO, WPRO, India and Indonesia

Purpose: As a result of poliovirus containment certification

activities associated with the GAPIII Containment

Certification Scheme (CCS), national authorities for

containment (NAC) need to develop strong polio

containment auditing teams and increase their con-

tainment certification capacity. This first workshop of

a series of such trainings was hosted by WHO

SEARO and clarified containment certification expec-

tations, requirements and timelines as described in

the CCS clarified roles and responsibilities of con-

tainment certification stakeholders and prepared

trainees for containment audits.

Participants in the GAPIII Auditors training

workshop in New Delhi, India

Details: The CCS defines the recommended mechanism for certification associated with global confirmation of

poliovirus containment within poliovirus-essential facilities (PEFs). It supplements the WHO Global

Action Plan to minimize poliovirus facility-associated risk after type-specific eradication of wild po-

lioviruses and sequential cessation of oral polio vaccine use (GAPIII) and poliovirus eradication time-

lines and requirements to minimize facility-associated poliovirus risk.

The aim of the CCS is to ensure a globally harmonized approach for the certification of PEFs against

the implementation of primary safeguards of containment. The CCS provides guidance to stakeholders

in terms of expectations, mechanisms, roles, responsibilities and timelines associated with the certifica-

tion process. The successful adoption of this mechanism by countries hosting PEFs will result in the

ability to award a certificate of containment endorsed by the Global Certification Commission (GCC)

as established for this purpose. In addition to developing audit team capacities and capabilities, exercises, group work and discussions

lead to clarifications on containment certification issues related to polio vaccine production and other

poliovirus-essential facilities, on acceptable interim bio-risk management measures, and many other

relevant aspects.

Page 13

Global Immunization News (GIN) February 2017

Experts from WHO’s SAGE Visit PAHO’s Comprehensive Family Immunization

Unit

Cuauhtemoc Ruiz Matus and Octavia Silva, PAHO-Washington, DC

Location: Washington DC, USA

Date: 13 February 2017

Participants: Four experts from WHO’s Strategic Advisory Group of

Experts (SAGE) on Immunization, including chair Dr.

Alejandro Cravioto, Dr. Kate O’Brien and Dr. Noni

MacDonald, as well as Dr. Cuauhtemoc Ruiz Matus,

Immunization Unit Chief, and technical staff from PA-

HO’s Immunization Unit.

Group photo of the visit

Purpose: To give the SAGE members a better idea of what PA-

HO’s Immunization Unit is doing for the Region of the

Americas.

Details: Presentations were given on the following topics:

Current status of the Expanded Program on Immunization (EPI) in the Americas

1. Polio 2. Measles and rubella 3. Influenza and Hepatitis B 4. Yellow Fever 5. New Vaccines: Rotavirus and the Pneumococcal Conjugate Vaccine (PCV) 6. Human Papilloma Virus and Dengue 7. Information Systems and Data Quality 8. Vaccination Week in the Americas At the end of each presentation, the SAGE members had follow-up questions and comments,

inciting interesting group discussion on the topics presented.

Global Immunization News (GIN) February 2017

Page 14

United Republic of Tanzania develops polio outbreak response plans

Christopher Kamugisha, William Mwengee and Ghirmay Redae Andemichael, WHO Country Office Tanzania

Location: Zanzibar, Tanzania

Date: 14-16 February 2017

Participants: Participants from South Africa and Malawi

and facilitated by WHO HQ, AFRO and

UNICEF ESARO. WHO, UNICEF, Ministry

of Health, Aga Khan Foundation

Purpose: To develop plans to respond to the polio

events or outbreaks in case they are import-

ed or emerge in the country.

Group photo of the workshop participants

Details: During the opening of the workshop, Director of Preventive Health Services Zanzibar Dr Fadhil

Mohammed said that the last polio case in Tanzania was reported in 1996. Routine immunization

coverage of OPV3 is consistently above 90% and surveillance indicators have been achieved at sub

national level for more than five years. However, Tanzania remains at risk because some coun-

tries still have circulating polio viruses. This requires the country to be prepared in case of an

event or outbreak due to importation. Zanzibar WHO Liaison Officer Dr Andemichael Ghirmay, on behalf the UN Agencies, congratu-

lated the Government for their efforts to ensure the polio endgame strategies are implemented

and indicators achieved. Dr Ghirmay also commended the Government decision to develop the

Polio Outbreak Response Plans, in line with polio eradication initiatives. He reiterated that the

UN family is committed to supporting the Government to ensure that polio is no longer a public

health risk in Tanzania. On her opening speech, the Principal Secretary of Ministry of Health Madam Asha Abdalla re-

quested that immunization partners not be complacent with the current achievements and urged

them to continue to support the implementation of strategies to help ensure that polio paralysis

does not return to the country. Government is committed to ensuring that once the event or

outbreak happens, the response is implemented as per GPEI Standard Operating Procedures, ac-

cording to a well prepared national response plan, so that the government takes the required

steps as recommended.

Page 15

Global Immunization News (GIN) February 2017

Workshop on revitalization of Home Based Records (HBR) in the AFR

Anya Blanche and Alain Poy, WHO/AFRO and Marta Gacic Dobo, WHO Headquarters

Location: Kampala, Uganda

Date: 21-24 February 2017

Participants: Participants represented 6 African countries,

(Cameroon, Ethiopia, Liberia, Nigeria, Ugan-

da and Rwanda). Organizations & Partners: WHO (IST Cen-

tral Africa, West, East & South, AFRO, HQ),

UNICEF, BMGF, JSI, Claro Partners and

Salesforce.

Purpose: To contribute to the end-to-end improve-

ment of participant countries’ home-based

records (HBR) for immunization, and the

related supply chain, with the aim of improv-

ing decision making and increasing vaccina-

tion coverage. The workshop provided an opportunity to

apply the principles outlined in the WHO

guidance on home-based records. It included

an exploration of the uses and users of

home-based records, the role of design, and

hands-on work to build prototypes of im-

proved cards.

Details: Home-based records are a simple and effective way to capture an individual’s vaccination sta-

tus. Unfortunately, the ability of HBRs to fulfill their primary function is often compromised as a

result of shortages or stock outs at health facilities, illegible or improperly completed records,

loss/ damage of the record itself, or a lack of importance placed on these documents by

healthcare workers and/or caregivers. During the workshop, an overview presentation was made on the context of HBR globally and

in the African region. The six participating countries presented an analysis of their findings of

pre-workshop information-gathering on HBR for caregivers, health workers and health adminis-

trators. These presentations were followed by discussions on commonalities and differences. The user

centric approach was presented and country teams prioritized needs/challenges for each of the

three HBR user-groups, and identified key actions to be implemented for improving HBR. They

also prioritized prototype elements to use for the development of new prototypes. At the end of the workshop, five countries had developed prototypes of HBR and drafted im-

plementation plans with next steps. The workshop facilitators agreed to continue supporting

countries after the workshop, through finalization, pretesting and endorsement of the revised

HBR.

Calendar

Global Immunization News (GIN) February 2017

Page 16

2017

April

4-6 Tenth International Conference on Typhoid and Other Invasive Salmonelloses Kampala, Uganda

18-21 Sharing lessons learned on Vaccination Coverage Surveys and defining a survey-

related Research agenda

Geneva, Switzerland

18-22 2nd Regional Rota and IBD lab net meeting Manila, Philippines

24-30 Fifth World Immunization Week Worldwide

25-27 Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization Geneva, Switzerland

May

8-19 Immunization information management system, data quality review and improve-

ment planning capacity building workshop for remaining 21 Gavi eligible countries

(back to back English and French)

Kigali, Rwanda

15-31 70th World Health Assembly Geneva, Switzerland

16-18 AFRO East and South Regional Working Group Maputo, Mozambique

30-

1June

IVIR Advisory Committee meeting Geneva, Switzerland

June

6-10 7th Meeting of South-East Asia Regional Immunization Technical Advisory Group

(SEAR-ITAG)

New Delhi, India

7-8 Measles & Rubella Initiative partners’ meeting Washington DC, USA

9-10 AFRO West and Central Regional working group Abidjan, Cote d’Ivoire

13-23 Immunization information management system, data quality review and improve-

ment planning capacity building workshop for consultants and other local institu-

tions to increase country support capacity (back to back English and French)

Nairobi, Kenya

14-16 AFRO East & South Gavi Regional Working Group meeting Nairobi, Kenya

20-23 Fifteenth Global Measles and Rubella Laboratory Network Meeting TBD

23-24 Fifth Measles Virus mini symposium Rochester, MN USA

26-30 10th International Symposium on Pneumococci & Pneumococcal Diseases Glasgow, UK

March

14-17 JRF peer review, data analysis and quality workshop - IST CA+ Madagascar and

Comoros

Brazzaville, Congo

20-23 EPI Managers’ Meeting for East & Southern Africa Kampala, Uganda

21-24 JRF peer review, data analysis and quality workshop - IST WA Cotonou, Benin

22-23 Immunization in the elderly meeting Geneva, Switzerland

27-31 JRF peer review, data analysis and quality workshop - IST ESA Pretoria, South Africa

29-30 HSV Vaccine Preferred Product Characteristics Global Stakeholder Consultation Geneva, Switzerland

Page 17

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 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 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 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) February 2017