INTRODUCTION OF ROTA VACCINE INTO THE NATIONAL

IMMUNIZATION PROGRAMME IN YEMEN 31/08/2012 from Osama Mere, WCO Yemen

Under the patronage of H.E. Abdo Rabbo Mansour Hadi,

President of the Republic of Yemen, the launching ceremony

for introduction of Rota Vaccine into the National

Immunization Programme (NIP) was held on Wednesday 1

August 2012. The launching ceremony took place at the Prime

Minister’s main headquarter in Sanaa in the presence of Dr

Ahmed Qasem Al-Ansi, Minister of Public Health and

Population, Mr Abdelkader Hilal, State Minister and Governor

of Sana’a, the National Supreme Committee for Child Health,

the Secretary General of Yemeni Women Union, Dr Ghulam Popal, WHO Representative , as

well as Dr Seth Berkley, Chief Executive Officer, GAVI Alliance), representative from UNICEF,

Dr Ahmed Kasem Al Ansi, Minister of Health described the

process of introduction of the Rota Vaccine and thanked the

main partners GAVI, WHO and UNICEF for their great support.

He also announced that all vaccinators had completed the

training on the vaccine and the vaccines had already been

distributed to all health facilities. The Minister expressed the

highest commitments of Yemeni government to further enhance

the NIP and he added that the MoH is planning to introduce the

Rubella Vaccine into NIP in 2013 with the support of GAVI and other partners.

Dr Ghulam Popal, WHO Representative, who talked on behalf of WHO and GAVI, stated that

the introduction of rota vaccine into the NIP will significantly reduce child mortality and will play

an important role in improving the malnutrition status of children in Yemen.

WHO Representative stated that WHO is proud of its

constructive partnership with the MoH in Yemen in all areas

related to health system strengthening. WHO worked very

closely with the MoH for the introduction of Rota Vaccine in

Yemen, and provided technical support to the Ministry for

assessing the burden of Rota disease, enhancing the

surveillance network, developing guidelines and protocols,

training of health workers on Rota disease and vaccine, and

developing the Yemen proposal to GAVI for inclusion of the vaccine into the national programme.

Around 909,000 children under one year will be targeted by the Rota vaccine, which will be given

in two doses along with Polio, Pentavalent and Pneumococcal vaccines.

At the end of this launching ceremony, the Minister of Public Health and some other invitees

attended a vaccination session and administered vaccine to children. The event was well covered

by mass media including a live TV interview with the Minister of Health and the WHO

Representative which was broadcasted during prime-time on the Yemen National TV channel.

Technical Information

World Health Organization

31 August 2012 Global Immunization News

Global Immunization

News

Inside this issue:

World Hepatitis Day (28 July) 2

REMINDER: CALL FOR NOMINATIONS 2

WHO looking for a short-term consultant 2

What’s new with Effective Vaccine Management 3

NEW PUBLICATIONS 3

AFRICA

Accessing nomadic populations for vaccination

in West Africa

New Conjugate Vaccine To Combat Non-

Typhoidal Salmonellosis (NTS)

External Review of EPI associated with Immun-

ization Coverage SURVEY and KABP Survey in

Gabon

Intercountry Course of MLM on EPI Management

for Francophone Countries in Abidjan, Côte

d’Ivoire

4

4

4

5

AMERICAS

Fifth Meeting of the ProVac Centers of Excellence

Network

El Salvador Enacts Comprehensive Vaccine Law

and Swears in their National Immunization Tech-

nical Advisory Group (NITAG)

Meeting of PAHO’s Technical Advisory Group on

Vaccine-preventable Diseases (TAG) on Cholera

Vaccination

IDQA Pilot in Bolivia

Intensive Health Activities Focused on Children in

Haiti

5

6

6

7

7

WESTERN PACIFIC

Twenty-first Meeting of the Technical Advisory

Group (TAG) on Immunization and Vaccine Pre-

ventable Diseases in the Western Pacific Region

Celebrating World Hepatitis Day in the Western

Pacific Region

A province in China succeeding in an immuniza-

tion project visited by health officials from Lao

People's Democratic Republic starting a new

project Province, China, 22-27 July 2012

Effective Vaccine Management (EVM) Assess-

ment in Mongolia

8

8

9

10

Regional Meetings & Key Events 11

Related Links 12

Page 2

Technical Information

Global Immunization News

The information

contained in this

Newsletter de-

pends upon your

contributions

Please send inputs

for inclusion to:

gaudink@who.int

“Immunizing in

the context of

global

independence”

“Integrating

Immunization,

other linked

health

interventions

and surveillance

in the health

systems

context”

WORLD HEPATITIS DAY (28 JULY) 31/08/2012 from Hayatee Hasan, WHO HQ

Under this year’s World Hepatitis Day theme “It’s closer than you think”, WHO is urging governments to

strengthen efforts to fight viral hepatitis, an inflammation of the liver that kills about one million people every year.

In addition, an estimated 500 million people experience chronic illness from their infection with hepatitis; it is a

major cause of liver cancer and liver cirrhosis.

WHO has launched a new global framework to tackle the disease. The Prevention and control of viral hepatitis

infection: Framework for global action describes four areas of work to prevent and treat hepatitis infection. Raising

awareness, together with promoting partnerships and mobilizing resources constitute the first of the four

priorities in WHO’s new framework. The others are: transforming scientific evidence into policy and action;

preventing transmission; and screening, care and treatment. WHO will work with its Member States and partners

on all four priority areas of the framework to help expand access to prevention, care and treatment programmes

to people who need it. The framework will guide the development of regional and country-specific strategies to

combat hepatitis.

For more information on the global framework, click on this link.

To find out about World Hepatitis Day 2012, go to this webpage.

REMINDER: CALL FOR NOMINATIONS

The World Health Organization is soliciting nominations to fill a member seat of its Programmatic Suitability for

Prequalification (PSPQ) Standing Committee. The PSPQ Standing Committee is an advisory body to the WHO

Prequalification (PQ) Secretariat and the Director of Immunization, Vaccines and Biologicals. The Committee’s

mandate is to provide, at the request of the WHO PQ Secretariat, technical advice on the programmatic suitability

of vaccine candidates submitted for WHO prequalification.

The Committee, established in January 2012, is charged with reviewing vaccine characteristics and providing

recommendations in instances where vaccines are not in compliance with the critical characteristics as outlined in

the document “Assessing the Programmatic Suitability of Vaccine Candidates for WHO Prequalification” or where a

vaccine presentation is deemed to be as unique or innovative.

One committee member is being sought—with recognized experience in the management of developing country

immunization programmes, or regulatory expertise as it pertains to vaccines used in developing country

immunization programmes.

Deadline for applications is 13 September 2012.

For more information or to apply please visit this site.

WHO LOOKING FOR A SHORT-TERM CONSULTANT 31/08/2012 from Drew Meek, WHO HQ

WHO is looking to recruit a short-term consultant to support efforts to standardize vaccine labels. Candidates

should have knowledge of vaccine labelling and regulatory processes, as well as understanding of developing

country vaccine delivery if possible.

Interested applicants should submit their CV and cover letter by 13 September 2012 at this address. The full

posting and details can be found online.

Page 3

Technical Information

Global Immunization News

“Introducing new

vaccines and

technologies”

“Integrating

Immunization,

other linked

health

interventions

and surveillance

in the health

systems

context”

GAVI related

Information

Next GAVI

Review Dates: GAVI Call for

Proposals for

New Vaccine

Support (only):

Closing date

31 August 2012

WHAT’S NEW WITH EFFECTIVE VACCINE MANAGEMENT (EVM)? 31/08/2012 from Diana Chang Blanc, WHO HQ

This bulletin and all future bulletins will be posted on the Bulletin Board of the restricted EVM Assessment

website and on the TechNet21 forum.

The public EVM website has been rebuilt and new content has been added. Add the link to your favourites!

a) The EVM SOPs are available for download.

English and French versions of the SOP manual and the individual customizable generic SOPs are now available

for download from the public EVM website.

b) The revised EVM report template and improvement plan are available for download.

An EVM Improvement Plan working group was convened during the UNICEF Cold Chain Logistics (CCL) Task

Force workshop of November 2011 in New York. The content and format of the new report and improvement

plan reflect the recommendations of that group. Both the new and old versions are available for download. The

new versions contain summaries of the revisions made.

3. Revision of the EVM Assessment Tool is in process.

The EVM Assessment Tool is currently being revised in consultation with the original developer of the EVM

package.

The new version of the tool will be field tested in September 2012, and is scheduled for release in October 2012.

A further release of the assessment tool, incorporating new equipment inventory and stock management data

collection sheets, and new data analysis functionality, is scheduled for the end of 2012.

NEW PUBLICATIONS

UPDATED POSITION PAPER ON HEPATITIS A PUBLISHED 31/08/2012 from Hayatee Hasan, WHO HQ

In an updated position paper, published in the Weekly Epidemiological Record on 13 July 2012, WHO recom-

mends that hepatitis A vaccination be integrated into national immunization schedule for children over the age of

one, if indicated on the basis of acute hepatitis A incidence and consideration of cost-effectiveness.

Vaccination should particularly be considered in countries with improving socioeconomic status when there is a

change from high to intermediate endemicity and when the age of infection shifts to older age group thus increas-

ing the risk of more severe disease and mortality. In these situations vaccination is likely to be cost-effective. In

highly endemic countries where hepatitis A virus is widespread, almost all persons are infected with hepatitis A

virus in early childhood, when the infection is asymptomatic or results in very mild disease. In these countries,

large-scale vaccination programmes are not recommended.

Recommendations for hepatitis A vaccination in outbreak situations depend on the epidemiologic features of hep-

atitis A in the community and the feasibility of rapidly implementing a widespread vaccination programme. The

use of a single dose regimen of hepatitis A vaccine to control community-wide outbreaks has been most success-

ful in small self-contained communities, when vaccination was started early in the course of the outbreak, and

when high coverage of multiple age-cohorts was achieved. Vaccination efforts should be supplemented with

health education and improved sanitation. For more information, go to this webpage.

Page 4

Global Immunization News

NEW CONJUGATE VACCINE TO COMBAT NON-TYPHOIDAL SALMONELLOSIS (NTS)

31/08/2012 from Chris Nelson, Austin Lee, Coalition against Typhoid (CaT) Secretariat, USA

The University of Maryland School of Medicine's Center for Vaccine Development (CVD) has received a US$4

million award from the Wellcome Trust to support a collaboration with Bharat Biotech for clinical development

of a new conjugate vaccine to prevent lethal infectious disease caused by invasive non-typhoidal salmonella

(NTS). The Wellcome Trust’s Strategic Translation Award to Dr Mike Levine at the CVD will help to

accelerate the development of a new NTS vaccine and will fund work up to the clinical testing phase.

Recent research has shown that case fatality from NTS may be as high as 25% in African adults and children,

most acutely among immunosuppressed individuals. Multidrug-resistant NTS has caused epidemics in several

African countries, and has demanded the use of expensive antimicrobial drugs in some of the poorest health

settings in the world. Furthermore, as Salmonella Typhi and Paratyphi infections are controlled the importance of

controlling NTS infections will emerge. Kenyan researchers have noted that the changing cofactors of malaria,

HIV and urbanization will continue to drive typhoid and NTS epidemiology.

As a better understanding of NTS epidemiology emerges, including the widespread and growing prevalence of

multi drug resistant strains and the impact on immunosuppressed populations, the demand for new conjugate

vaccines to prevent these potentially lethal infections will also increase.

CO= Country office

DTP = Diphteria,

Tetanos, Pertussis

EPI = Expanded

programme on Im-

munization;

EVM SOP= Effec-

tive Vaccine Manage-

ment Standard Op-

erating Procedures HQ= Headquarters

IDQA= Immuniza-

tion Data Quality

Assessment tool

IST = Inter Country

Support Team;

KABP= Knowledge,

Attitude, Behaviour/

Practice

MLM = Mid Level

Management

MMR = Measles,

mumps and rubella

MoH = Ministry of

Health;

OPV = Oral Polio

Vaccine

PAHO= Pan Amer-

ican Health Organi-

zation

WCO= WHO

Country Office

WHO = World

Health Organization

“Protecting more

people in a

changing world”

ACCESSING NOMADIC POPULATIONS FOR VACCINATION IN WEST AFRICA

31/08/2012 from Crepin Hilaire Dadjo, WHO/IST West Africa

About 20 million of nomadic and mobile populations live in Africa. These include Internally Displaced People

(IDPs), refugees and migrants who might be fishermen, agriculturalists, pastoralists and traders. Because of their

way of life, these special populations live beyond the reach of established health programme strategies. Among

other consequences, the number of unimmunized children remains high while some polio cases were traced

within nomadic populations, in Nigeria for instance.

Drawing lessons from innovative projects developed in Kenya and Nigeria where these mobile communities

were found to have access to networks and institutions outside of the public health system, a “methodology

workshop” was convened in Ouagadougou, Burkina Faso from 28-30 August 2012 by WHO IST in

collaboration with CDC-Atlanta. Participants at the workshop consisted of epidemiologists, veterinary health

experts and communications specialists from five countries namely Burkina Faso, Chad, Mali, Mauritania and

Niger. The overall objective was to expose participants to the tools and methods for better access to nomadic

and migrant populations in West Africa with a view to increasing opportunities for improved access for

immunization and other services including epidemiological surveillance. It is expected that the two upcoming

rounds of Polio campaigns in October and November 2012 will have specific components to access these

special populations in the countries which participated at the workshop.

Country Information by Region

AFRICAN REGION

EXTERNAL REVIEW OF EPI ASSOCIATED WITH IMMUNIZATION COVERAGE

SURVEY AND KABP SURVEY IN GABON 31/08/2012 from Auguste Ambendet, WHO IST Central and E. Mutabaruka, WHO AFRO

The Ministry of Health of Gabon organized an external review of EPI associated with a survey on immunization

covering and a survey on KABP. The office in charge of statistics in the Ministry of the Plan was associated with

the immunization coverage survey and processing of the data from the review. Both exercises benefited from

the technical and financial support of WHO and UNICEF.

Page 5

Global Immunization News

“Introducing new

vaccines and

technologies”

“Integrating

Immunization,

other linked

health

interventions

and surveillance

in the health

systems

context”

GAVI related

Information

Next GAVI

Review Dates: GAVI Call for

Proposals for

New Vaccine

Support (only):

Closing date

31 August 2012

FIFTH MEETING OF THE PROVAC CENTERS OF EXCELLENCE NETWORK 31/08/2012 from Gabriela Felix, Cara Janusz and Barbara Jauregui, PAHO

The PAHO ProVac Initiative created a network of ProVac Centers of Excellence to foster south-south

collaboration among academic institutions specializing in the

areas of health economics and decision science to support

ongoing efforts to build national capacity around evidence-

based decision-making for new vaccine introduction in Latin

America and the Caribbean. The network is comprised of

research teams from the State University of Rio de Janeiro

(UERJ), São Paulo University, University of Cartagena,

National University of Colombia, and the Institute for Clinical

Effectiveness and Health Policy (IECS) in Buenos Aires,

Argentina. During the second year of the network, the five

participating academic institutions finalized the work plans

they had established during the Cartagena meeting in

December 2011.

The fifth Meeting of the ProVac Centers of Excellence was held in Washington, D.C., USA at PAHO’s

headquarters on 1-2 August 2012. During the meeting, senior and junior researchers from all five institutions were

joined by ProVac’s technical team in discussions over the work developed throughout the first year of the

network. The tools and guidelines developed during this first year are intended to aid economic analyses of

rotavirus and pneumococcal vaccine introduction. The work during this second year will focus on the

development of similar tools and guidelines for human papilloma virus (HPV) and dengue vaccines, among other

new and/or underutilized vaccines.

Participants also discussed the future of the network and the development of an online ProVac Tool Box, available

for country use, which will contain all ProVac tools, guidelines and additional resources. Access to this tool box

will be available to any country performing a cost-effectiveness analysis with technical cooperation from the

ProVac Initiative, including countries from other WHO Regions through the ProVac International Working Group.

The ProVac International Working Group is composed of the following partners: PAHO, WHO, the US Centers

for Disease Control and Prevention (CDC), the Sabin Vaccine Institute, PATH and the Agence de Médicine

Préventive (AMP). Its aim is to transfer ProVac tools, methods and lessons learned to non-PAHO Regions.

Country Information by Region

AFRICAN REGION

INTERCOUNTRY COURSE OF MLM ON EPI MANAGEMENT FOR FRANCOPHONE

COUNTRIES IN ABIDJAN, CÔTE D’IVOIRE 31/08/2012 from Auguste Ambendet, WHO IST Central and E. Mutabaruka, WHO AFRO

WHO (AFRO and CO) and UNICEF (WCAR and CO) organized an intercountry course of Mid-Level Managers

(MLM) on EPI Management in Abidjan, Côte d’Ivoire from 20 August-1 September 2012. It was preceded by an

orientation for facilitators from 18-19 August 2012.

The 53 participants included the Directors from the national EPI, teachers from the Health workers’ training

school, EPI country focal points from WHO and UNICEF. They came from the following countries: Benin,

Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Comoros, Côte d’Ivoire, Democratic

Republic of Congo, Equatorial Guinea, Guinea, Madagascar, Mali, Mauritania, Senegal and Togo.

The course was facilitated by 20 facilitators including one from the Agence de Médecine Préventive (AMP), two

from the Maternal and Child Health Integrated Programme (MCHIP/USAID), two from the Network for

Education and Support in Immunization (NESI), five from UNICEF (WCAR, Niger and Nigeria) and ten from

WHO (HQ, AFRO, ISTs and Cote d’Ivoire). Sixteen modules were covered and facilitators alternated. Each

participant received a certificate of attendance. This course represented another opportunity to test the revised

MLM modules after the courses organized in Nairobi, Kenya in October 2011 and in Kinshasa, RDC in May 2012.

AMERICAS

Country Information by Region

Page 6

Global Immunization News

CO= Country office

DTP = Diphteria,

Tetanos, Pertussis

EPI = Expanded

programme on Im-

munization;

EVM SOP= Effec-

tive Vaccine Manage-

ment Standard Op-

erating Procedures HQ= Headquarters

IDQA= Immuniza-

tion Data Quality

Assessment tool

IST = Inter Country

Support Team;

KABP= Knowledge,

Attitude, Behaviour/

Practice

MLM = Mid Level

Management

MMR = Measles,

mumps and rubella

MoH = Ministry of

Health;

OPV = Oral Polio

Vaccine

PAHO= Pan Amer-

ican Health Organi-

zation

WCO= WHO

Country Office

WHO = World

Health Organization

“Protecting more

people in a

changing world”

AMERICAS

EL SALVADOR ENACTS COMPREHENSIVE VACCINE LAW AND SWEARS IN THEIR

NATIONAL IMMUNIZATION TECHNICAL ADVISORY GROUP (NITAG) 31/08/2012 from Rafael Baltrons, PAHO-El Salvador, Gabriela Felix, Cara Janusz and Barbara Jauregui, PAHO-

Washington DC

During the first semester of 2012, El Salvador’s National Immunization

Programme (NIP) accomplished two major milestones: the enactment of

a comprehensive vaccine law and the swearing in of members recently

convoked to their legally chartered National Immunization Technical

Advisory Group (NITAG). The law was signed on 29 February 2012 and

came into effect on 23 March 2012. It contains declarative, operational,

and financial aspects aligned to recommendations issued by the Pan

American Health Organization (PAHO) on vaccine legislation.

On 12 July 2012, El Salvador’s Minister of Health, Dr María Isabel

Rodríguez, swore in the newly composed and legally chartered NITAG.

The El Salvadorian NITAG, which is called “Comité Asesor de Prácticas

de Inmunizaciones (CAPI)”, will also be bound by a regulatory guide. This regulatory document expands upon

Chapter III of the Vaccine Law, which broadly outlines the purpose, composition, terms, and modus operandi of a

NITAG, providing clear operational guidelines. Some key aspects outlined in the Vaccine Law and the NITAG reg-

ulations include: The NITAG will be composed of representatives from various government and public health agen-

cies; Members are to serve for three-year terms and may only be re-elected once; NITAG members are required

to disclose potential conflicts of interest and excuse themselves from voting on recommendations for which they

have a real or perceived conflict of interest.

These accomplishments exemplify how the El Salvadorian NIP is taking steps to strengthen the existing programme

and to ensure its sustainability in the future.

CAPI members are sworn in by the Minister

MEETING OF PAHO’S TECHNICAL ADVISORY GROUP ON VACCINE-PREVENTABLE

DISEASES (TAG) ON CHOLERA VACCINATION 31/08/2012 from Andrea Vicari, PAHO

On August 14, 2012 The Pan American Health Organization’s Technical Advisory Group on Vaccine-Preventable

Diseases (TAG) held a meeting in Washington, D.C. to discuss the use of oral cholera vaccine (OCV) on the Island

of Hispaniola (the island shared by Haiti and the Dominican Republic). More than half a million people in Haiti are

estimated to have been infected by cholera between October 2010 and July 2012, and more than 7,400 have lost

their lives. The Dominican Republic has reported more than 25,000 cases and over 400 cholera deaths.

According to PAHO TAG experts, the elimination of cholera transmission on the Island of Hispaniola can be

achieved by increasing and sustaining access to clean drinking water and adequate sanitation. Reaching this long-

term goal will be greatly aided with complementary short-term actions such as the expanded use of OCV.

After the presentation of cholera data and scientific evidence regarding OCV, in addition to the results of two

demonstration vaccination projects done in Haiti earlier this year, the TAG, chaired by Dr. Ciro de Quadros, rec-

ommended introducing the oral cholera vaccine.

Given that current global supply of OCV is limited, TAG experts recommended prioritizing vaccination in densely

populated urban areas with limited access to sanitation and drinking water, and in rural areas where access to

health services is most challenging. As manufacturers ramp up production in the near future, the experts unani-

mously recommended moving toward universal vaccination. However, they noted that doing so will require urgent

attention to mobilizing and sustaining the flow of financial resources, strengthening operational capacity, and ensur-

ing that vaccination efforts are well-integrated into the long-term vision of safe water and sanitation, WASH, to

stop cholera’s transmission.

The TAG also highlighted the importance of finding solutions to the global scarcity of cholera vaccines, as well as

the need to strengthen epidemiological surveillance in Haiti, which are critical in securing cholera prevention and

control. TAG members additionally stressed the need to conduct research to close current knowledge gaps on

OCVs.

Page 7

Country Information by Region

Global Immunization News

CO= Country

office

DTP = Diph-

teria, Tetanos,

Pertussis

EPI = Expand-

ed programme

on Immuniza-

tion;

EVM SOP= Effective Vac-

cine Manage-

ment Standard

Operating

Procedures

HQ= Head-

quarters

IDQA= Im-

munization

Data Quality

Assessment

tool

IST = Inter

Country Sup-

port Team;

KABP=

Knowledge,

Attitude, Be-

haviour/

Practice

MLM = Mid

Level Manage-

ment

MMR = Mea-

sles, mumps

and rubella

MoH = Min-

istry of

Health;

OPV = Oral

Polio Vaccine

PAHO= Pan

American

Health Organ-

ization

WCO=

WHO Coun-

try Office

WHO =

World Health Organization

“Protecting

more

people in a

changing

world”

AMERICAS

IDQA PILOT IN BOLIVIA 31/08/2012 from Hernan Aguila, Bolivia MOH; Deblina Datta, GAVI; Adam MacNeil, CDC; Carolina Danovaro, PAHO

-Washington DC; Desiree Pastor and Erick Machicao, PAHO-Bolivia

Between 26 July-10 August 2012, a pilot of the new GAVI Alliance Im-

munization Data Quality Assessment tool (IDQA) was conducted in Bo-

livia. The assessment team included members from the Bolivian MoH,

GAVI, the US Centers for Disease Control and Prevention (CDC) and

the PAHO. Two previous pilot activities have been performed in 2012 in

Ghana and Uganda. The objective of this activity was to field test the

IDQA protocol developed in 2011, in collaboration with an ad hoc task

team in a Latin American country, in order to assess the capacity of the

tool for diverse country-specific settings and inform the use of the IDQA

rollout, expected in 2013. Bolivia has had an excellent record in immun-

ization data quality, as evidenced by results from a data quality assess-

ment performed in 2010, as part of an EPI evaluation conducted by PA-

HO.

The IDQA pilot testing in 2012 began with data collection and interviews

of personnel from the national EPI programme and Health Information

System programme. Next, the team visited four municipalities

(randomly selected) and 24 health facilities randomly selected within each municipality. The assessment protocol in-

cluded staff interviews on data collection, reporting and archiving practices at each administrative level (national, mu-

nicipality, health unit); collection of vaccination coverage data for pentavalent, OPV, rotavirus and MMR from multiple

sources including daily registry books, vaccination cards, and monthly reports; collection of vaccine stock data; direct

observation of vaccination and recording practices; and data comparison between sources and levels of data aggrega-

tion.

Overall, results demonstrated excellent agreement between the different data sources within each administrative level

(e.g. vaccine register vs. monthly report) as well as between data from different administrative level (monthly reports

from health unit vs. aggregated data at municipality). This highlighted strong data recording practices, aided by the

routine use of a basic data comparison supervision tool at health facilities since the early 2000's. The integration of

immunization data into the national Health Information System was also a contributor to maintaining high data quality.

The results of the assessment, as well as recommendations for improvement, were presented to the Vice-Minister of

health and other Bolivian health authorities at the closure of the activity on 10 August 2012. Finally, the lessons

learned from this IDQA pilot and others will be considered by GAVI to finalize the IDQA tool.

Good Data Practices: Archiving folder for

monthly and daily health reports organized by

month, Taperas, San José de Chiquitos, Bolivia,

IDQA pilot, Aug 2012. Photo Credit: Carolina

Danovaro, PAHO

INTENSIVE HEALTH ACTIVITIES FOCUSED ON CHILDREN IN HAITI 31/08/2012 from Carlos Castillo-Solorzano, PAHO

In June, Haiti’s Ministry of Public Health and Population successfully concluded its intensive health activities focused on

children. A total of 3,045,529 Oral Polio Vaccine (OPV) doses were administered to children aged nine years or less

and 2,938,863 Measles/Rubella (MR) vaccine doses were administered to children aged between nine months and nine

years. Likewise, a total of 1,210,438 vitamin A capsules were administered to children aged between six months and

six years as well as 1,352,789 albendazol tablets to children aged two to nine years.

In the search for homogenous coverage, more than 1,500 Rapid Coverage Monitoring activities were conducted, with

a total of 68,715 persons responsible for children aged under nine years interviewed. Also, institutional and communi-

ty active case searches of suspected poliomyelitis, measles, rubella, and congenital rubella syndrome were conducted

during this same period. A coverage survey, supported by the US CDC was being implemented in August 2012.

The intensive vaccination activities, which started in April 2012, made an important contribution to Haiti’s immuniza-

tion programme, constituting the first steps to strengthen the routine vaccination activities. These results were possi-

ble thanks to the commitment and dedication of Haiti’s health care workers, the leadership and dedication of the MoH

and the technical teams implementing these activities. The next steps are the introduction of new vaccines, starting

with the pentavalent (DTP-Hib-HepB) in September 2012, increasing coverage for all vaccines and strengthening epi-

demiological surveillance. In the mid-term, the country expects to have a solid and quality vaccination programme that

can serve as a gateway to access other primary health care services.

Country Information by Region

Page 8

Global Immunization News

TWENTY-FIRST MEETING OF THE TECHNICAL ADVISORY GROUP (TAG) ON

IMMUNIZATION AND VACCINE PREVENTABLE DISEASES IN THE WESTERN

PACIFIC REGION

31/08/2012 from Sigrun Roesel, Sergey Diorditsa, Kimberley Fox and Karen Hennessey, WHO WPRO

The Region’s TAG on Immunization met from 21-23

August 2012 to review efforts and the status of these

important targets. Dr Shin Young-soo, WHO Regional

Director, opened the 21st Meeting of the TAG on

Immunization and Vaccine Preventable Diseases in the

Western Pacific Region (WPR). He welcomed

immunization experts, representatives of national

immunization programmes and key partners by

highlighting how the TAG has guided the Region for over

two decades to continuously strengthen immunization

programmes. “I am delighted”, Dr Shin said, “that the work of countries and areas in the Region has produced

impressive results towards achieving our 2012 targets for eliminating measles, reducing hepatitis B infection in

children to under 2%, and staying polio-free. It confirms this Region's continued leadership in vaccine preventable

disease control.” This is an exceptional year for immunization programmes in the WPR: 2012 is the year countries

aim to eliminate measles, reduce childhood hepatitis B infection rates to <2%, and stay polio-free. Immunization

experts, country representatives and key partners assessed programme performance and challenges, and provided

recommendations for achieving the regional disease specific goals, introducing new vaccines and strengthening

immunization systems

CO= Country office

DTP = Diphteria,

Tetanos, Pertussis

EPI = Expanded

programme on Im-

munization;

EVM SOP= Effec-

tive Vaccine Manage-

ment Standard Op-

erating Procedures HQ= Headquarters

IDQA= Immuniza-

tion Data Quality

Assessment tool

IST = Inter Country

Support Team;

KABP= Knowledge,

Attitude, Behaviour/

Practice

MLM = Mid Level

Management

MMR = Measles,

mumps and rubella

MoH = Ministry of

Health;

OPV = Oral Polio

Vaccine

PAHO= Pan Amer-

ican Health Organi-

zation

WCO= WHO

Country Office

WHO = World

Health Organization

“Protecting more

people in a

changing world”

WESTERN PACIFIC REGION

CELEBRATING WORLD HEPATITIS DAY IN THE WESTERN PACIFIC REGION 31/08/2012 from Rebecca Virata & Karen Hennessey, WPRO

The WHO Western Pacific Region (WPR) marked this year’s World Hepatitis Day (28 July 2012) by celebrating

the remarkable achievements in fighting hepatitis B while pledging to expand efforts to control the other hepatitis

viruses. “Know the Risks, Stop the Spread" was this year’s Regional theme; globally the theme was ‘it’s closer than

you think’. Despite its staggering toll on health, the impact of viral hepatitis remains largely unknown. This cam-

paign aimed to raise awareness of viral hepatitis: how it is spread, who is at risk and how to prevent and treat it.

In 2005, member states in the Region com-

mitted to reducing hepatitis B infection

rates in children to less than 2% by 2012

through vaccination. Great progress has

been made in the Region towards meeting

this milestone, but much work still needs to

be done to stop hepatitis C. In the WPR,

an estimated 160 million people have

chronic hepatitis B and more than 60 mil-

lion have hepatitis C. Together, these in-

fections are the leading cause of liver can-

cer and cirrhosis.

To celebrate World Hepatitis Day, coun-

tries around the Region conducted a variety

of activities. These included displaying World Hepatitis Day messages on the giant globe at the world’s third larg-

est mall, Mall of Asia in Manila, Philippines (see photo); opening a hotline on viral hepatitis for the general public

and engaging the capital and 21 provincial health departments in World Hepatitis Day activities in Mongolia, and

contributing to the World Hepatitis Alliance’s global effort to set a Guinness World Record of having the most

people perform “see no evil, hear no evil, speak no evil” in a 24 hour period -- at a football match of 12,500 fans in

Yokohama, Japan.

World Hepatitis Day Image on the Mall of Asia Globe, Manila, Philippines.

Photo Credit: Arturo Alera II

Page 9

Country Information by Region

Global Immunization News

A PROVINCE IN CHINA SUCCEEDING IN AN IMMUNIZATION PROJECT VISITED BY

HEALTH OFFICIALS FROM LAO PEOPLE'S DEMOCRATIC REPUBLIC STARTING A

NEW PROJECT PROVINCE, CHINA, 22-27 JULY 2012

31/08/2012 from An Zhijie, Alejandro Ramirez-Gonzalez and Yoshihiro Takashima

On 22-27 July 2012, five Lao People's

Democratic Republic health experts, including

high-level officials of the MoH and the Phongsaly

Provincial Health Bureau in the Lao People's

Democratic Republic, National EPI Manager and

Provincial EPI Manager, visited Guizhou Province

in China with support of WHO and MoH China.

Guizhou, with a population of 40 million, is one

of the least developed provinces in China with

the highest measles morbidity and mortality until 2003. To exploit a successful model of strengthening routine

immunization service and accelerating measles control in the most difficult parts of China, MoH China developed

and implemented a demonstration project with Guizhou Provincial Government and Provincial Health Bureau from

2003 to 2009 with support of WHO, United Nations Children's Fund (UNICEF) and United States Center for

Disease Control and Prevention (US CDC). The main strategies of the project were: conducting a province-wide

catch up measles vaccination campaign (2003-2004) followed by actively strengthening the routine immunization

programme with the introduction of vaccination history check followed by catch-up vaccination at the entry in

primary school and kindergarten (2005-), strengthening vaccine preventable diseases surveillance, particularly for

measles, with an enhanced laboratory diagnostic network (2005-); and mobilizing local government commitments

and supports to the immunization programme through the "yellow card" warning to the local government of

counties with poor performance in immunization services. As a result, the routine immunization programme in the

Guizhou Province was remarkably improved with sustaining very high vaccination coverage over the province, and

the measles incidence dramatically decreased to lower than 1/100,000 since 2009 with 98% reduction compared

with the period before 2003.

Phongsaly is one of the least developed provinces in the Lao People's Democratic Republic with one of the lowest

performing immunization programme over the country and shares many characteristics with the Guizhou Province

in terms of the challenges facing the immunization programme. To strengthen routine immunization programme in

all seven districts of the Phongsaly Province, the MoH from Lao PDR proposed to adopt the Reach Every District

approach within the province's immunization programme and develop a model service delivery for the integrated

MNCH package using immunization programme as backbone. The MoH of Lao PDR developed a pilot project in

Phongsaly Province called "Phongsaly Reach Every Village Project", on strengthening provincial and district

immunization with technical and financial assistance of WHO in 2011.

To learn lessons from the Guizhou Province in strengthening immunization programme and controlling measles in

one of the most difficult areas of the country and in effectively and successfully implementing and managing a

demonstration project with international immunization partners, the delegation from the Lao PDR and Phongsaly

Province visited provincial, prefecture, county, township and village levels of the Guizhou Province. During this visit

they observed the practices of the immunization programme, school entry immunization checks, vaccine logistic and

cold chain management and had meetings with the staff from health bureaux, local CDCs, hospitals, schools, and

vaccination sites and listened to their experiences.

CO= Country

office

DTP = Diph-

teria, Tetanos,

Pertussis

EPI = Expand-

ed programme

on Immuniza-

tion;

EVM SOP= Effective Vac-

cine Manage-

ment Standard

Operating

Procedures

HQ= Head-

quarters

IDQA= Im-

munization

Data Quality

Assessment

tool

IST = Inter

Country Sup-

port Team;

KABP=

Knowledge,

Attitude, Be-

haviour/

Practice

MLM = Mid

Level Manage-

ment

MMR = Mea-

sles, mumps

and rubella

MoH = Min-

istry of

Health;

OPV = Oral

Polio Vaccine

PAHO= Pan

American

Health Organ-

ization

WCO=

WHO Coun-

try Office

WHO =

World Health Organization

“Protecting

more

people in a

changing

world”

WESTERN PACIFIC REGION

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Page 10

Global Immunization News

EFFECTIVE VACCINE MANAGEMENT (EVM) ASSESSMENT IN MONGOLIA 31/08/2012 from Sodbayar Demberelsuren, Nurdin Kadrov and Md. Shafiqul Hossain

A good quality vaccine supply chain is an essential

element of an immunization system. A consistently high

standard of performance can only be achieved if all the

links in this chain are effectively and regularly monitored

and assessed.

Since January 2012 Mongolia introduced Hepatitis A

vaccination in 12 provinces and in the Ulan Bator city.

From January 2013 it will be part of the routine

immunization schedule. Mongolia has also piloted human

papillomavirus (HPV) vaccine in two provinces and two

districts of Ulan Bator.

With the support from WHO, the MoH conducted an

EVM assessment from 23 July-20 August 2012. Twenty participants were selected as assessors and attended

a five-day training. The 27 vaccine stores were selected using the EVM site-selection tool. Based on the

results of the assessment, an EVM improvement plan was developed in consultation with all partners. The

National immunization programme is considering implementation of the activities of the improvement plan to

strengthen and sustain the good quality of the immunization programme in the coming years.

CO= Country office

DTP = Diphteria,

Tetanos, Pertussis

EPI = Expanded

programme on Im-

munization;

EVM SOP= Effec-

tive Vaccine Manage-

ment Standard Op-

erating Procedures HQ= Headquarters

IDQA= Immuniza-

tion Data Quality

Assessment tool

IST = Inter Country

Support Team;

KABP= Knowledge,

Attitude, Behaviour/

Practice

MLM = Mid Level

Management

MMR = Measles,

mumps and rubella

MoH = Ministry of

Health;

OPV = Oral Polio

Vaccine

PAHO= Pan Amer-

ican Health Organi-

zation

WCO= WHO

Country Office

WHO = World

Health Organization

“Protecting more

people in a

changing world”

WESTERN PACIFIC REGION

Global Immunization News

Regional Meetings & Key Events Related to Immunization

Title of Meeting Start Finish Location Region

2012 Meetings

Annual African Vaccine Regulatory Forum (AVAREF) meeting

14-Sep 17-Sep Gabon AFRO

EMRO Regional Expanded Programme on Immuniza-tion managers meeting-Regional meeting on measles/Rubella elimination

16-Sep 18-Sep Sharm-el-Sheikh, Morocco EMRO

Measles Initiative Annual Meeting 18-Sep 19-Sep Washington, USA Global

Tenth International Rotavirus Symposium 19-Sep 21-Sep Bangkok, Thailand Global

Tenth Annual Meningitis Meeting 24-Sep 26-Sep Lome, Togo AFRO

AFRO Working Group on Immunization (WGI) in Cen-tral and West Africa

25-Sep 26-Sep Ouagadougou, Burkina Faso

AFRO

Global Measles/Rubella and Polio Labnet Meeting Sep Sep Geneva, Switzerland Global

EURO Regional GAVI Working Group meeting Sep Sep TBD EURO

EURO Invasive Bacterial Disease (IBD) surveillance sub-regional meeting

Sep Sep TBD EURO

WHO-GAVI HSS Capacity Building Programme 01-Oct 05-Oct Hammamet, Tunisia EMRO

Immunization Practices Advisory Committee IPAC 02-Oct 04-Oct Geneva, Switzerland Global

SEAR Regional Immunization Review Meeting (including EPI Managers meeting)

09-Oct 12-Oct Bangkok, Thailand SEARO

AFRO Regional Committee 22-Oct 26-Oct Luanda, Angola AFRO

Global Vaccine Safety Initiative 29-Oct 30-Oct Geneva, Switzerland Global

European Technical Advisory Group of Experts on Im-munization (ETAGE)

Oct Oct TBD EURO

Global Invasive Bacterial Disease (IBD) Surveillance meeting

Oct Oct Washington, USA Global

Global Vaccine Research Forum Oct Oct TBD Global

Global Vaccine Safety Initiative Oct Oct TBD Global

Strategic Advisory Group of Experts (SAGE) on immun-ization

06-Nov 08-Nov TBD Global

WPRO Asia-Pacific Leadership and Policy Dialogue for Women’s and Children’s Health

08-Nov 09-Nov Manila, Philippines WPRO

Workshop on Graduating Countries 03-Dec 04-Dec Dar-es-Salaam, Tanzania Global

Pre-GACVS meeting, Global Advisory Committee on Vaccine Safety (GACVS) meeting

04-Dec 06-Dec Geneva, Switzerland Global

GAVI Partners' Forum 05-Dec 07-Dec Dar-es-Salaam, Tanzania Global

Annual Regional Conference on Immunization (ARCI) and the Annual African Regional Inter-Agency Coordi-nation Committee

10-Dec 13-Dec Dar-es-Salaam, Tanzania AFRO

Regional consultations on new vaccine introduction and the polio end game

11-Dec 14-Dec Bangkok, Thailand SEARO

2013 Meetings

TechNet21 meeting 05-Feb 11-Feb Dakar, Senegal Global

Links Relevant to Immunization

Page 12

Global Immunization News

Regional Websites New Vaccines in AFRO PAHO’s website for Immunization Vaccine Preventable Diseases in EURO New Vaccines in SEARO Immunization in WPRO

Newsletters PAHO/Comprehensive Family Immunization Program-FCH: Immunization Newsletter The Civil Society Dose - A quarterly newsletter of the GAVI CSO Constituency

Optimize Newsletter

Produced by WHO, in collaboration with UNICEF and the GAVI Alliance:

Global Websites Department of Immunization, Vaccines & Biologicals, World Health Organization WHO New Vaccines Immunization Financing Immunization Monitoring Agence de Médecine Préventive EPIVAC GAVI Alliance Website IMMUNIZATION basics (JSI) International Vaccine Institute PATH Vaccine Resource Library Dengue Vaccine Initiative SABIN Sustainable Immunization Financing SIVAC Program Website UNICEF Supply Division Website Hib Initiative Website Japanese Encephalitis Resources Malaria Vaccine Initiative Measles Initiative Meningitis Vaccine Project Multinational Influenza Seasonal Mortality Study (MISMS) RotaADIP RHO Cervical Cancer (HPV Vaccine) WHO/ICO Information Center on HPV and Cervical Cancer SIGN Updates Technet Vaccine Information Management System PneumoAction

Global Websites International Vaccine Access Center American Red Cross Child Survival PAHO ProVac Initiative NUVI Website Gardasil Access Program

Maternal and Child Health Integrated Program (MCHIP) LOGIVAC Project