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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
2 2
3
3
4
4
5
Past meetings / workshops
615
Calendar 16
Links 17
Global Immunization News (GIN) February 2017
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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 ([email protected]) 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:
www.who.int/immunization/gin
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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