News In this issue

News

IPV Introduced to Accelerate Polio

Eradication in Afghanistan

Integrated VPD Surveillance

Review in Lao People's DR

Supplementary Immunization Ac-tivities for Measles and Rubella

Vaccine in Vanuatu

Recommendations on malaria vaccine use and the global removal

of type two oral polio vaccine agreed for April 2106

St. Lucia Launches a Vaccination Coverage Survey for the MMR2

Vaccine, October 2015

The AMP officially launches the

LOGIVAC+ project

Chile Launches a National Vaccina-tion Campaign Against Measles and Rubella

Gavi Country portal

Gavi’s CCE optimization platform

Vaccinations made friendly

Global polio vaccine switch con-firmed for April 2106

2

2

3

3

4

4

5

5

6

6

7

Past meetings / workshops

Implementing HPV vaccination in

Africa: opportunities for strength-ening adolescent health

Improving Routine Immunization Coverage in Rajasthan: Brain-storming Workshop

Polio outbreak simulation exercise

Workshop on Polio Outbreak SOPs for Francophone countries

Polio Eradication Stakeholders’

Symposium

Training Workshop on the imple-

mentation of wVSSM in Jamaica

National Review Workshop on Full Immunization Progr. Sustaina-bility & Resource Mobilization

8

9

9

10

11

12

13

Resources 14

Calendar 15-16

Links 17

Global Immunization News (GIN) October 2015

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interested in and access it directly! Vaccine introductions: a strategy to reduce child mortality in

Afghanistan Fazil Ahmad, Raveesha R Mugali and Sherin Varkey, UNICEF Afghanistan Country Office; Ab-

dul Waciqi Shakoor, WHO Afghanistan Country Office; Agagul Dost National EPI adviser;

Sardar Parwiz, Ministry of Public Health of Afghanistan; Andreas Hasman, UNICEF Regional

Office for South Asia

On 30 September 2015, Afghanistan

introduced inactivated polio vaccine

(IPV) into routine immunization. For

countries that are using only oral polio

vaccines (OPV), the introduction of at

least one dose of IPV into routine

immunization schedules before the

end of 2015 is part of the final phase

of polio eradication, outlined in the

Polio Eradication and Endgame Strategic

Plan 2013-2018.

In Afghanistan, IPV is only the latest in

a series of vaccine introductions in

recent years. Afghanistan has intro-

duced five vaccines in the last 10 years

and is planning to introduce three

additional vaccines in the near future. In 2006, the tetravalent vaccine containing a new antigen

for hepatitis B became the first expansion for the Expanded Programme on Immunization

(EPI) schedule. In 2009, this was followed by the introduction of pentavalent vaccine, then in

2013, pneumococcal conjugate vaccine (PCV) and Hepatitis B vaccine birth dose were intro-

duced.

The introduction of new and underutilized vaccines is now an important strategic tool to im-

prove coverage of all antigens in routine immunization, and to reduce the sizable burden of

vaccine preventable diseases in the country.

Mortality in children under five years of age stands at 97 per 1000 live births in Afghanistan –

compared to 58 in Bangladesh and 10 in Sri Lanka. A recent analysis by UNICEF using the LiST

tool shows that 35% of deaths among children under five can be averted through lifesaving

vaccination between 2015 and 2020.

The Government of Afghanistan recognizes that reducing mortality requires the introduction

of new vaccines – and that coverage with all childhood vaccines must be improved. There is

now a commitment to include the rotavirus vaccine in the routine schedule in 2017, and to

add the rubella vaccine to the existing vaccine against measles.

Afghanistan is placing new vaccine introductions at the centre of national strategies to signifi-

cantly reduce preventable child mortality. In close collaboration with key partners UNICEF,

WHO and Gavi, that vision is now being realized.

H.E Dr. Ferozuddin Feroz, Minister of Public Health ad-

ministers the first dose of inactivated polio vaccine in

Afghanistan

Page 2

Global Immunization News (GIN) October 2015

Inactivated Polio Vaccine Introduced to Accelerate Polio Eradication in Afghanistan

Sini Ramo, WHO Country Office, Afghanistan

Afghanistan introduced the Inactivated Polio Vaccine (IPV) into the schedule of

the routine vaccination programme for all children under the age of one at a

ceremony held in Kabul on 30 September

2015.

The new vaccine is now available free of

charge at all health facilities in the country.

Afghanistan is one of the two remaining po-

lio endemic countries in the world and has

reported 12 cases of polio in 2015 as of late

September 2015. The use of OPV and one

dose of IPV will complement the Polio Eradication Programme campaigns and

will boost the immunity of children against polio.

“The introduction of IPV is a crucial step towards securing a polio-free Afghani-

stan and protecting the health of children,” said Dr Richard Peeperkorn, WHO

Representative in Afghanistan. “Our use of the routine immunization programme to deliver IPV is critical to helping

sustain the gains made by eradication efforts and protecting children against lifelong polio paralysis around the coun-

try.”

Read the news release

The new IPV vaccine was launched

at a ceremony held in Kabul, sup-

ported by the Ministry of Public

Health, WHO and UNICEF.

Integrated Vaccine- Preventable Diseases (VPD) Surveillance Review in Lao People's

Democratic Republic Siddhartha Datta, WHO- Lao People's Democratic Republic (PDR); Santosh Gurung, Heather Scobie, and Saleena

Subaiya, United States Centers for Disease Control and Prevention (US-CDC); and Roberta Pastore and William

Schluter, Regional Office for the Western Pacific.

Vaccine preventable disease (VPD) surveillance provides critical information

for monitoring progress towards disease control and elimination and the

initiation of a timely public health response.

The Lao People’s Democratic Republic (Lao PDR) established the Early

Warning Alert and Response (EWAR) surveillance system in 2009, which

includes reporting of acute flaccid paralysis (AFP), measles, rubella, neonatal

tetanus, diphtheria and pertussis. Over the last four years, the sensitivity of

AFP surveillance has declined in Lao PDR, and measles surveillance perfor-

mance indicators have varied by province. During September 2015, the

World Health Organization (WHO), the United States Centers for Disease

Control and Prevention (US-CDC), the National Immunization Programme

(NIP), and the National Center for Laboratory and Epidemiology (NCLE) conducted the first systematic review of

VPD surveillance in Lao PDR to assess the quality of the existing system, and identify areas for improvement.

The results of the review demonstrated that dedicated surveillance staff are present at all levels and understood the

protocol for reporting. VPD surveillance is well integrated into the EWAR surveillance reporting platform and stand-

ard tools are in place. “Zero reporting” of VPDs at sub-provincial level varied considerably. Supervision was con-

ducted systematically by the provincial and district level officers, though detection of unreported fever, rash and AFP

cases during the review indicated a sub-optimal quality of active case searches. Data analysis and the use of data for

action was limited at sub-national levels. Case investigation and specimen collection were usually initiated by the

provincial surveillance team, and outbreaks were often detected at provincial hospitals or after a death occurred.

Outbreak response committees exist on all levels, but delays were reported in the availability of contingency funds.

Strategic recommendations included strengthening VPD surveillance with a focus on provincial and district hospitals

and on active case search; improving the quality of supportive supervision; and conducting refresher trainings and

regular sub-national surveillance reviews.

Mosawer is the first child to re-

ceive the new IPV polio vaccine in

Afghanistan.

From Left to right. The team compris-

ing of MoH Lao PDR -WHO-US CDC.

Credit: WHO Lao PDR.

Global Immunization News (GIN) October 2015

Page 3

Supplementary Immunization Activities for Measles and Rubella Vaccine in Vanuatu Ridwan Gustiana, UNICEF Immunization Officer and Achyut Shrestha, WHO Country office Vanuatu

The Ministry of Health (MoH) Vanuatu in partnership with

UNICEF and WHO are conducting Supplementary Immunization

Activities (SIA) for Measles and Rubella (MR) vaccines in response

to a measles outbreak in early 2015.

The SIA will also introduce the Rubella Vaccine into the routine

immunization schedule along with the Measles Containing Vaccine

(MCV). Targeting almost 100,000 children nationwide from one to

15 years old, this is the largest cohort of children ever to be vac-

cinated in SIAs in Vanuatu. During the campaign, children aged

one to five years also received Vitamin A, Deworming tablets and

Oral Polio Vaccines (OPV).

Vanuatu is divided into six provinces and more than 80 islands. As

a result, the campaign will be conducted in two phases; the South-

ern Provinces of Malampa, Shefa and Tafea implemented the SIAs in September 2015 and the Northern Provinces of

Penama, Sanma and Torba will continue in October 2015.

Despite the aftereffects of Tropical Cyclone Pam that occurred in

March 2015, Vanuatu proceeded with the planning and the implemen-

tation of this massive nationwide campaign. Prior to the implementa-

tion, immunization training and microplanning workshops were held

to ensure high coverage was achieved through detailed planning, ef-

fective social mobilization, efficient resource utilization as well as ap-

propriate cold chain management.

Social mobilization activities were conducted before and during the

implementation of the campaign. A national advocacy meeting was

held in July 2015 and was attended by multiple stakeholders from the

government, civil society organizations, religious leaders, Non-

Governmental Organizations and the private sector including airlines,

mobile phone companies and media. This ensured effective collabora-

tion and coordination to achieve a successful campaign.

Mobile phone messaging is used to reach mobile phone users across the country. Radio spots are aired daily to reach

communities in rural areas, while urban populations are reached through television panel discussions and regular

newspaper articles. A large majority of people are also targeted through direct community and school awareness

programmes. In urban areas, the MoH is successfully using sports for development programmes to mobilize school

children during the campaign either through football games or volley ball games, which are popular among school

children.

Young children receiving vaccinations in Vanuatu’s

capital, Port Vila. Credit: Philip Metois and © WHO

Vanuatu/2015/Shrestha.

The Fanafo vaccination team heading out to re-

mote villages on Espiritu Santo in Vanuatu. Cred-

it: Philip Metois and © WHO Vanuatu/2015/

Shrestha.

Recommendations on malaria vaccine use and the global removal of type two oral

polio vaccine agreed for April 2016 Hayatee Hasan, WHO Headquarters

Following the WHO’s Strategic Advisory Group of Experts on Immunization

(SAGE) meeting held in Geneva from 20-22 October, several key recommenda-

tions were made by the advisory group including the use of malaria vaccine and

the globally synchronized switch from trivalent oral polio vaccine (tOPV) to

bivalent OPV (bOPV).

Read the summary of the SAGE meeting.

Read the news release.

Participants at the SAGE meeting in

October 2015. Credit: WHO_H.

Hasan

Global Immunization News (GIN) October 2015

St. Lucia Launches a Vaccination Coverage Survey for the MMR2 Vaccine, October

2015 Sharon Belmar-George and Julietta Frederick Cassius, Ministry of Health–St. Lucia; Pamela Bravo and Karen Lewis-

Bell, PAHO

St. Lucia recently started a vaccination coverage survey for the second dose of the mea-

sles-mumps-rubella-containing vaccine (MMR2), with the purpose of estimating the actual

coverage among children aged five-11 years old (grades K to five). Low MMR2 coverage

was of concern to the Ministry of Health of St. Lucia, but there are reasons to believe that

the actual coverage is higher than reported. To elucidate this situation, the country decid-

ed to implement the survey and requested support from the Pan American Health Organ-

ization (PAHO).

A sample selection was done using a list of schools as the sampling frame. To this end,

two-three students per grade were randomly selected, resulting in a total of 832 children

aged five-11 years old. In addition, 83 school principals were also randomly selected, to

assess their knowledge, attitudes and behaviors towards vaccination services.

Survey implementation is being conducted by trained registered nurses not working in immunization. Written in-

formed consent was sought and after the interview, parents/guardians are being informed on whether their children

are up-to-date with their immunizations and advised to visit a health facility, in case vaccination is needed. Photos of

the health passports are being taken in the field, to assess MMR2 coverage and timeliness. Supervisors (who are public

health nurses from a different region) will monitor the quality of data collection. These supervisors will also collect

vaccination information from health facilities for children without health passports at home and for those that, follow-

ing data processing, were identified as being vaccinated with MMR2 earlier than the recommended age.

Survey results will be available at the end of this year. These results will help tailor strategies to increase MMR2 cov-

erage and/or better document vaccination with MMR2; strengthen collaboration between the Expanded Programme

on Immunization, the private health sector and the schools; and may facilitate recommendations to improve the data

quality of health passports and/or records in health facilities.

Page 4

Field work for MMR2 vac-

cination coverage research

in St. Lucia, October 2015.

The Agence de Médecine Préventive (AMP) officially launches the LOGIVAC+

project Philippe Jaillard and Hamed Idrissa Traoré, Agence de Médecine Préventive (AMP)

The Agence de Médecine Préventive (AMP), in collaboration with the Ministry of Health of Benin and the United Na-

tions Children’s Fund (UNICEF), announced the official launch of “LOGIVAC+” on 8 October 2015 in Cotonou, Be-

nin. LOGIVAC+ is the development of the LOGIVAC project, which enabled the creation of a regional reference and

resource centre for health logistics and the optimization of the vaccine supply system in the Comè health area on a

pilot basis.

Given the positive results and achievements of the pilot project in Comé, LOGIVAC+ will expand the new logistics

system in the country over the next three years.

For the deployment of the optimized system, the project will follow a systematic approach in each health area: situa-

tion analysis of the logistics system; discussion of results with health area teams to identify needs and to define action

plans; implementation, including the provision of cold chain equipment and training of health agents involved in logis-

tics management; and monitoring and evaluation.

“LOGIVAC+ will provide technical support to the Expanded Immunization Programme in Benin. This first part of the

extension will be done in eight of the country’s health areas, bringing to nine (of 34) the number of health areas cov-

ered in Benin,” explained Dr Hamed Idrissa Traoré, Director of AMP’s Benin Office.

To make it possible to ensure the redesign of the vaccine supply chain in the whole country, the Minister of Health,

Dr Togbe, has appealed to partners for their support and funding of the remaining health areas.

Global Immunization News (GIN) October 2015

Page 5

Chile Launches a National Vaccination Campaign Against Measles and Rubella Desiree Pastor, PAHO-Washington, DC; Roberto del Aguila, PAHO-Chile

Chile’s National Vaccination Campaign (NVC) was planned in accord-

ance with the accumulation of susceptible populations after the last na-

tional campaign carried out in 2010. In 2015, there are a total of 225,000

susceptible children aged one-five years old, a number equivalent to the

size of a cohort of newborns. The national goal for this NVC is of

1,240,584 children aged one-five years old in the 15 regions of the coun-

try.

The national vaccination campaign was launched in Santiago on 6 Octo-

ber 2015. The President of Chile, Dr Michelle Bachelet; the Minister of

Health, Dr Carmen Castillo and high-level political and technical authori-

ties from the Ministries of Health and Education were in attendance.

Also in attendance were Dr Paloma Cuchi, PAHO/WHO’s representative in Chile; Dr Rob-

erto del Aguila, PAHO-Chile’s immunization focal point and Dr Desiree Pastor, PAHO/

WHO regional advisor on immunization.

President Bachelet’s speech reflected the high degree of political commitment in measles and ru-

bella elimination at the regional, country, and global level. She acknowledged the risk of measles

and rubella virus importations, given the recent outbreak of nine imported measles cases in the

country and encouraged parents to receive the booster dose indiscriminately throughout the cam-

paign.

Dr Fernando Muñoz, chief of the National Immunization Programme (NIP), along with his technical

NIP team and the Ministry’s social media team, had been planning this campaign since June 2015

and have coordinated the planning and implementation phases in order to achieve the goal by 30

November 2015.

To this end, a ministerial resolution was made with a compulsory mandate for vaccination as a

public health measure, in order to avoid the reestablishment of the endemic circulation of measles

and rubella in Chile.

Poster for Chile’s

National Vaccination

Campaign against measles and rubella,

October 2015. Child being vaccinated as

part of the National Vac-cination Campaign in Chile, October 2015.

President of Chile,

Dr Michelle Bach-elet, initiating the launch of the Na-

tional Vaccination Campaign against measles and rubel-la, October 2015.

Gavi Country portal Ariane Leroy, Gavi the Vaccine Alliance

Gavi’s new online country portal is a one-stop shop ensuring that each country has quick and easy access to up-to-

date information about its portfolio of Gavi support. The new country portal replaces the previous portal, through

which countries can: submit online applications for new funding support, report back on performance and provide key

data according to their own planning. Requests to renew support can also be submitted through the portal.

The following new functionalities of the portal make it easier for countries to work with Gavi:

User-friendly interface: that will work even in low connectivity settings.

Streamlined data entry: wherever possible, the portal will use existing data to pre-populate Gavi forms, reducing the

amount of information countries have to input. Country-reported data will automatically appear in all relevant sec-

tions of the portal.

Year-round access: countries will be able to input data and information according to their national grant cycles.

Autosave: the portal will autosave, reducing the risk of data loss if the internet connection is lost.

Improved transparency: Gavi stakeholders will have instant access to the latest country information.

Customized content: users can customize how they view information. For example, by country or type of grant.

The portal improves the way the Alliance partners assess performance, pinpoint areas of need, and address challenges

to strengthening immunization.

The Gavi country portal will be accessible gradually starting in late 2015. As of November 2015, countries will be pro-

vided with ongoing communication and training including written guidance, training sessions, teleconferences/webinars.

For more information about Gavi’s country portal, please contact your senior country manager.

Page 6

Global Immunization News (GIN) October 2015

Gavi’s cold chain equipment (CCE) optimization platform Ariane Leroy, Gavi the Vaccine Alliance

Today many immunization supply chains struggle with cold chain equipment

that is poorly functioning and in need of modernization, or health facilities that

are unequipped. Strengthening cold chains is a pre-requisite for advancing the

Alliance’s Supply Chain Strategy and achieving its coverage and equity goals.

To respond to this need, Gavi has recently established the cold chain equip-

ment (CCE) optimization platform which aims to:

accelerate the upgrade of existing equipment and the deployment of higher-

performing, innovative devices to health facilities in Gavi-supported coun-

tries;

extend the cold chain into health facilities which have no equipment; and

incentivize stronger CCE management and maintenance.

Fifty five Gavi-eligible and transitioning countries will be able to apply for plat-

form support. Based on their Gross National Income (GNI) per capita, these

countries would receive funding for 50-80% of the total purchase, delivery and installation price of devices sup-

ported by the platform. The remaining share of the total cost will be funded by countries. The country co-

investment funds can come from national budgets, bilateral funds, vaccine introduction grants (VIG), or Health

System Strengthening (HSS) support.

Products eligible for funding include a subset of the following WHO Performance, Quality and Safety (PQS) listed

devices:

Solar direct drive (SDD) refrigerators without ancillary battery

Ice-lined refrigerators (ILRs) bundled with a voltage regulator

Freezers bundled with a voltage regulator

Long-term passive devices

Cold boxes

Vaccine carriers

Voltage regulators

Temperature monitoring devices

Spare parts for platform-eligible devices.

Further details on the platform application requirements will be shared in the 2016 HSS application guidelines

anticipated in Q4 2015. A full technical support package will also be available, and countries can access this on the

Technet portal in November 2015.

For more details, please contact your Gavi country manager, or send an email.

Solar direct drive

Vaccinations made friendly Hayatee Hasan, WHO Headquarters

Globally, one in five children still do not receive routine life-saving im-

munizations, and an estimated 1.5 million children die each year of dis-

eases that could be prevented by vaccines that already exist. WHO rec-

ommends how to reduce the pain at the time of vaccination across all

age groups.

Read the feature story.

Read the WHO position paper on reducing pain at time of vaccination.

School girls in Lao People's Democratic

Republic received HPV vaccination. Cred-

it: WHO_C. McNab

Page 7

Global Immunization News (GIN) October 2015

Global polio vaccine switch confirmed for April 2016

The Strategic Advisory Group of Experts on immunization (SAGE) convened by WHO on 20 October 2015 has con-

firmed that the globally coordinated withdrawal of the type 2 component in the oral poliovirus vaccine (OPV) will

take place in April 2016.

SAGE confirmed that every country should stop using tOPV and introduce bOPV on a single day of its choosing be-

tween 17 April and 1 May 2016, then remove all stocks of tOPV within two weeks of that date and confirm its

removal from service delivery points to WHO.

SAGE’s landmark decision follows the endorsement by the World Health Assembly (WHA) in May 2015, when Minis-

ters of Health from 194 member states adopted a resolution on the global effort to eradicate polio, as part of the

Polio Endgame Strategy.

In a milestone towards the switch, wild poliovirus (WPV) type 2 was recently declared as eradicated worldwide.

WPV type 3 has not been detected globally since November 2012, and the only remaining endemic WPV type 1

strains are now restricted to Pakistan and Afghanistan. The globally synchronized switch is therefore of great signifi-

cance for the polio eradication programme with tremendous public health benefits.

Countries have already demonstrated an exceptional level of commitment to meeting the timelines of the Polio End-

game. It is also critical that countries meet established deadlines to protect populations by moving the world towards

destruction of WPV2 type 2 stocks or their appropriate containment in designated ‘poliovirus essential’ facilities. The

requirements for containment are detailed in the Global Action Plan III and steps for countries are summarized here.

For more information on the OPV switch and reference materials to guide switch implementation, communications,

training, and monitoring, please consult the OPV switch section on the Polio Endgame objective 2 website.

Any questions on the switch can be directed to Alejandro Ramirez Gonzalez or Lisa Menning.

Countdown to the switch: from 01 Nov 2015 to 17 April 2016, 168 days to go!

At this stage, countries should finalize their national switch plans, closely monitor

tOPV inventories, and place bOPV orders.

Timing is also ideal for: Convening the management and monitoring structures, and securing human and financial resources

Conducting a situational analysis to inform operational preparations, logistics and training plans Developing a monitoring framework, a waste management plan, and a communications strategy

Past Meetings/Workshops

Page 8

Global Immunization News (GIN) October 2015

Implementing HPV vaccination in Africa: opportunities for strengthening

adolescent health

Carine Dochez, Network for Education and Support in Immunization (NESI)/University of Antwerp, Belgium,

Rosemary J. Burnett, South African Vaccination and Immunization Centre (SAVIC)/Sefako Makgatho Health Sci-

ences University (SMU), South Africa and M. Jeffrey Mphahlele, South African Vaccination and Immunization Cen-

tre (SAVIC)/Sefako Makgatho Health Sciences University (SMU), South Africa and South African Medical Research

Council (SA-MRC), South Africa.

Location: Johannesburg, South Africa

Date: 5-7 October 2015

Participants: A total of 54 participants, including representatives of the Minis-

try of Health of Botswana, Malawi, South Africa, Swaziland,

Zambia and Zimbabwe; representative of the Ministry of Prima-

ry and Secondary Education of Zimbabwe; WHO representa-

tives of Malawi, Mozambique, Namibia, South Africa and Zimba-

bwe. Facilitators were from WHO, Gavi the Vaccine Alliance, South

African Medical Research Council and academia (University of

Cape Town, Stellenbosch University, University of the Witwa-

tersrand, University of the Free State, Sefako Makgatho Health

Sciences University, London School of Hygiene and Tropical

Medicine and University of Antwerp).

Group Photo from the workshop on

implementing HPV vaccination in Africa

Purpose: (a) Promote successful and effective introduction of HPV vaccination and other adolescent health

interventions in the southern African region; (b) Create a multi-disciplinary resourceful team of experts to support and advocate for the intro-

duction of HPV vaccines and other adolescent health interventions in the southern African region;

and (c) Increase synergy between academics, educators and Ministries of Health to revive and strengthen

school-based health programmes as delivery platforms of adolescent immunization services in the

southern African region.

Details: The workshop was organized by SAVIC/SMU, SA-MRC and NESI/University of Antwerp. Support was

received from the Flemish Government, Belgium, and WHO/AFRO, Congo-Brazzaville. The first day of the workshop comprised of short presentations highlighting key aspects of cervical

cancer, HPV screening, HPV vaccines, adolescent health interventions, delivery platform for HPV vac-

cination, and effective communication strategies for building public trust in HPV vaccination. The second day of the workshop focused on country presentations which were grouped in three ses-

sions: (a) countries with a national HPV vaccination programme; (b) countries with a demonstration

project; (c) countries planning for HPV vaccine introduction. During the third day of the workshop country group presentations were made, highlighting for each

country the strengths, gaps and challenges based on the feedback received during day two. Countries

also identified how they could assist each other in successful implementation of HPV vaccination and

other adolescent health services. The workshop was well appreciated by the participants. Providing a forum for the country participants

to present their current status of HPV vaccine introduction and exchange best practices and challenges

among countries, resulted in building a multi-disciplinary network of experts and in increased owner-

ship of the workshop.

Global Immunization News (GIN) October 2015

Page 9

Polio outbreak simulation exercise (POSE)

Catharina de Kat-Reynen, WHO EURO

Location: Bucharest, Romania

Date: 7-8 October 2015

Participants: Polio control professionals from the Czech Republic, Hunga-

ry, the Republic of Moldova, Romania and Slovakia, and part-

ners.

Purpose: To increase countries’ preparedness for potential importation

of poliovirus. Mock interview conducted during the simu-

lation exercise. Credit: WHO/S. Deshevoi

Details: The exercise, organized by WHO/Europe and co-facilitated by Public Health England, brought together

surveillance, immunization and communications professionals as well as International Health Regula-

tions experts. Among other assignments, mock interviews were conducted to prepare participants for

informing the public and answering media inquiries in the event of an outbreak.

Though planned well in advance, the exercise came at an opportune time following the announcement

on 1 September 2015 that two polio cases had been detected in Ukraine. In addition to implementing a

simulation exercise, all Member States bordering Ukraine have been encouraged to strengthen surveil-

lance for the disease and review immunity gaps in their populations, particularly in areas located close

to the border.

Improving Routine Immunization Coverage in Rajasthan: Brainstorming Workshop

Arup Deb Roy, Immunization Technical Support Unit (ITSU), New Delhi and Jain, UNICEF, Jaipur

Location: Jaipur, Rajasthan, India

Date: 21-22 August 2015

Participants: Fifty one participants representing the Ministry of Health &

Family Welfare (MoHFW), Government of India, Department

of Health, Government of Rajasthan, State Institute of Health

and Family Welfare (SIHFW), state representatives of World

Health Organization (WHO), United Nations Children Fund

(UNICEF), United Nations Population Fund (UNFPA), Norway

India Partnership Initiative (NIPI), United Nations Development

Programme (UNDP), Rotary International

All participants at the state level brain-

storming workshop in Jaipur, Rajasthan,

India

Purpose: The workshop aimed at bringing together all stakeholders working in the Universal Immunization Pro-

gramme (UIP) in the state of Rajasthan, India to deliberate and develop an action plan to improve the

immunization coverage with all available vaccines under the National Immunization Schedule (NIS).

Details: The MoHFW, Government of India has been collaboratively devising strategies for strengthening the

UIP. One of the important initiatives is to support high priority states to develop state specific plan to

ensure sustained improvement in immunization coverage. Immunization Technical Support Unit

(ITSU), the technical arm of the MoHFW has been leading these efforts on behalf of the Ministry. In

Rajasthan, ITSU supported the Department of Health, Government of Rajasthan, in organizing the state

level brainstorming workshop to develop the immunization coverage improvement plan.

As a precursor to the workshop, ITSU collaborated with other stakeholders to develop a detailed con-

cept note landscaping the immunization ecosystem of Rajasthan. In the workshop, State Immunization

Officer, and representatives of the routine immunization partner agencies made presentations. This was

followed by the discussion on identified focus areas i.e. programme operations and monitoring, adverse

events following immunization (AEFI) and vaccine preventable disease (VPD) surveillance, communica-

tion and social mobilization, vaccine and cold chain management, special immunization drives and new

vaccine introduction. The workshop was chaired by the Mission Director (National Health Mission),

Rajasthan. Under the leadership of the Deputy Commissioner (Immunization), MoHFW, Government of

India, a detailed action plan was developed at the end of the two-day workshop. This action plan will

guide the state, in optimizing utilization of the available resources to further improve the immunization

coverage.

Page 10

Global Immunization News (GIN) October 2015

Workshop on Polio Outbreak Standard Operating Procedures (SOPs) for

Francophone countries

Crépin Hilaire Dadjo, WHO/Inter-Country Support Team for West Africa

Location: Mbour, Senegal

Date: 16-17 October 2015

Participants: About 40 participants from 11 Francophone coun-

tries including Benin, Burkina Faso, Guinea, Mali,

Niger, Senegal in West Africa and Cameroon, the

Central African Republic, Chad, the Democratic

Republic of Congo and Gabon in Central Africa.

Participants were EPI Managers, Surveillance Offic-

ers in the Ministries of Health of countries; EPI

Focal Points at country Offices of UNICEF and

WHO. Facilitators were mainly from WHO/HQ,

WHO/IST West Africa, WHO/IST Central Africa,

UNICEF/WCARO, supported by an independent

consultant.

Group photo from the workshop on Polio Outbreak

SOPs for Francophone countries

Purpose: To familiarize the participants with the newly released Standard Operating Procedures (SOPs) when

responding to a poliovirus outbreak.

Details: No wild polio virus has been detected for 14 months in the AFRO Region. In addition, Nigeria has

been removed from the list of Polio endemic countries. However this tremendous progress is being

met with a new environment that calls, for instance, for a swift and robust response in case of any

new infection due to poliovirus (both wild poliovirus or from derived vaccine (cf Objective 1 of the

Polio Eradication and Endgame Strategic Plan 2013-2018). On 5 May 2014 the Director-General de-

clared the international spread of wild poliovirus in 2014 a Public Health Emergency of International

Concern (PHEIC) under the International Health Regulations [IHR 2005]. These recent developments have led the Global Polio Eradication Initiative (GPEI) partners to update

the SOPs for outbreaks response, especially for polio-free countries when faced with a rapid re-

sponse to a new polio outbreak. A total of 12 sessions were delivered in four days, mixed with plenary sessions, group work and sim-

ulation exercises. On the last day of the workshop, all countries had to develop their preparedness and response plans,

which are expected to be completed by the end of November 2015. A workshop for Anglophone countries is expected to take place before the end of 2015.

Global Immunization News (GIN) October 2015

Page 11

Polio Eradication Stakeholders’ Symposium

Ngokoana Khomo and Maila J. Matjila, Chairs of the National Certification Committee, c/o National Department

of Health, South Africa and M. Jeffrey Mphahlele, Chair of the National Task Force on Laboratory Containment of

Poliovirus, c/o National Department of Health, South Africa

Location: Johannesburg, South Africa

Date: 10-11 September 2015

Participants: Over 114 delegates from the South African National

Department of Health and the nine Provincial De-

partments of Health, mainly representing Child

Health, Public Health and Maternal Health; WHO;

UNICEF; Rotary International; Statistics-SA; South

African and Swaziland polio committees (NCC, NTF,

NPEC); academics from Public health and Paediatric

departments; Laboratory managers; members of

District Clinical Specialist Teams; Partners (National

Institute for Communicable Diseases (NICD),

SAVIC, RTC, FPD, PATH and World Vision Interna-

tional); Professional bodies (e.g. SA Paediatric Asso-

ciation and SA Nursing Council); private health sec-

tor and the vaccine manufacturers (Biovac, GSK and

Sanofi Pasteur). Two delegates, each from Nigeria and India, and

were invited to share their country experiences.

Two South African polio survivors were invited to

share their personal experiences.

Group photo of the South African Minister of Health

with key partners and speakers

Purpose: To build on the previous South African success of achieving polio free status, share plans for polio end-

game strategies, strengthen co-operation among all key stakeholders nationally, strengthen Acute Flac-

cid Paralysis (AFP) surveillance, strengthen activities for the containment of poliovirus, promote social

mobilization and advocacy for the Polio Eradication Initiative in the course of preparing South Africa

for a switch from trivalent OPV to bivalent OPV in 2016 in line with global timelines as set by WHO

and to ensure South Africa’s readiness for eradication of polio by 2018 in accordance with the Global

Polio Eradication Strategy (GPEI).

Details: The Minister of Health, Dr Aaron Motsoaledi, officially opened the symposium. Prof Oyewale Tomori

from Nigeria and Dr Hemant Shukla from India shared their respective country experiences that led to

their recent successes. The achievements in each country were underpinned by a number of factors:

political commitment; provision of funding; meticulous data-driven planning, execution and monitoring

of immunization activities; improved immunization coverage; improved supplementary immunization

activities (SIAs) targeting vulnerable populations; sustained sensitive surveillance; mitigation of the risk

of wild polio virus importation; social mobilization; and effective partnerships. Mr Oswell Bila and Dr Linda Bailey who both suffered from polio as children gave touching and pas-

sionate accounts of their experiences and pledged their support for childhood immunizations and to

become ambassadors of the GPEI. Based on lessons learnt from India and Nigeria, as well as presentations by various Experts from South

African Polio Committees, academia and health sector at large, participants committed themselves to

achieving polio eradication by 2018 through a number of activities in line with the Polio Eradication and

Endgame Strategic Plan 2013-2018. The key message was that no country can consider itself free of polio and put down its guard since

polio can easily re-infect any country and lead to a reversal of all the gains.

Page 12

Global Immunization News (GIN) October 2015

Training Workshop on the implementation of web-based Vaccine Supply and Stock

Management (wVSSM) in Jamaica

Simon Spence, Ministry of Health, Jamaica

Location: Kingston, Jamaica

Date: 1-9 October 2015

Participants: Ministry of Health, Jamaica; National Health

Fund Pharmaceutical Division, Jamaica

(Central Vaccine Store); fiveParish Health

Departments: Kingston and St. Andrew, St.

Catherine, Manchester, St. Ann and St. James;

Ministry of Public Health, Guyana; Ministry of

Health, Bermuda

Purpose: The web-based Vaccine Supplies and Stock

Management (wVSSM) software developed by

WHO was selected as the national tool for

the management and control of inventories

for vaccines, syringes and other supplies in

Jamaica. The purpose of the workshop was to

train users at the top three levels of the sup-

ply chain in Jamaica, and sensitize administra-

tors in Bermuda and Guyana to the use and

implementation of the wVSSM application.

Five parish health departments (supply chain

level three) were selected for the pilot pro-

gramme with a view to fully roll out in all

parishes within 12 months.

Group photo from the Training workshop on the implementation of web-based wVSSM in Jamaica

Details: The workshop was executed over seven days with a total of 30 participants. Four representatives

from the central planning unit in the Ministry of Health and five from the central vaccine storage fa-

cility (National Health Fund Pharmaceutical Division) were trained as administrators in the first three

days, with representatives from Bermuda and Guyana joining on day three. Representatives from the five selected parishes participated in the latter four days. Opening stock

and recipient data were entered into the live system. Skills in basic software functions such as arrival

and dispatch management, stock reporting and adjustments, and user management were taught using

the demo version of the software. Participants were given liberal access to the demo site throughout the workshop for individual and

group exercises. Current cold chain and stock management practices were openly discussed so that

existing processes could be integrated into standard operating procedures going forward. Partici-

pants gave a favorable evaluation of the utility of wVSSM in supporting cold chain and stock manage-

ment operations and made suggestions for future versions of the software. Overall, the participants fully embraced the software tool and demonstrated to the facilitators that

they had acquired the knowledge and skills for full implementation.

Global Immunization News (GIN) October 2015

Page 13

National Review Workshop on Full Immunization Programme Sustainability &

Resource Mobilization

Sanjita Thapa, WHO Nepal

Location: Soaltee Crown Plaza, Kathmandu, Nepal

Date: 11-12 October 2015

Participants: Honorable Minister of Health & Population (MoHP) Nepal,

Secretary-MoHP, Joint Secretaries, Under Secretaries-

Ministry of Federal Affairs & Local Development (MoFALD),

Director General of Department of Health Services (DoHS),

Chief Specialists from MoHP, Director-National Health Train-

ing Center, Director-Child Health Division (CHD), WHO

Representative to Nepal, Environmental Health Team Leader

-USAID, Representatives from Municipality Association Nepal

(MuAN), WHO, UNICEF, USAID, CHD, Regional Health

Directors (RHDs), Health officials from 54 districts - District

Health Officers (DHOs), EPI Supervisors, Local Development

Officers (LDOs)

Inauguration of the National Review by the Hon. Minister of Health & Population

Purpose: To evaluate the full immunization process and the commitment in action towards the ultimate goal to

make the nation full immunized by 2017. 3% of the children in Nepal do not receive vaccines at all and

13% do not receive full immunization. Full immunization refers to the receipt of all antigens by all eligi-

ble children under one year of age as per the nation's immunization schedule. With the aim to reach

every child, Nepal has initiated a unique and inventive tool to strengthen its immunization system

through local community ownership and local resource mobilization using the "appreciative inquiry

(AI) and transformational technology" approach. The journey of full immunization that started in 2012

from Bhageshwore Village Development Committee (VDC), the first VDC to declare fully immunized

in Accham district of Nepal, has expanded now to 1100 VDCs, 50 municipalities and ten districts. Ne-

pal is set to declare the whole country fully immunized by 2017.

Details: A two-day national review workshop was organized by the collaborative effort of the DoHS and

WHO-Nepal to review the full immunization programme sustainability and resource mobilization.

Attendees included representatives from 54 districts. Day one included the discussion of the objec-

tives of the review workshop and an update on the current immunization status in the country fol-

lowed by an overview of the full immunization process and the full immunization guideline. The health

officials got an opportunity to sit in groups of their respective districts and share their programme

achievements and key lessons learned. Day II focused on creating distinctions about key thematic are-

as; sustainability, quality, standardization and local resource mobilization. Following the discussions and

group work, the participants developed recommendations for the way forward. The district representatives participated in discussions about Nepal’s use of innovative local approach-

es to vaccinating every child in the community and how they intend to ensure that they continue to

sustain the full immunization status. With the shared goal of reaching every child to build the founda-

tion towards a healthy nation, each of the members affirmed their commitment to building on their

achievements and drew an active and collective image of the future of full immunization in Nepal. Recommendations from the districts included the continuation of coordination and commitment be-

tween central level authorities and political parties; the development of local strategies and guidelines;

the orientation of all districts in an appreciative inquiry (AI) workshop, annual review meetings at the

district to the grassroot level to discuss the progress and prospects; the formation and mobilization of

local and active monitoring committees; the guaranteed provision of quality vaccines and other logis-

tics so as to not hinder full immunization advocacy; the integration of immunization with other nation-

al campaigns such as the Open Defecation Free (ODF), full literacy, safe home delivery, and the mo-

bilization of school teachers, students, female community health volunteers, mother groups. Every child has the right to a healthy life and immunization ensures that. Nepal is set to build a nation

of healthier children and achieve full immunization by the year 2017.

Resources

Page 14

Global Immunization News (GIN) October 2015

Polio Outbreak Simulation Exercise: How to test national preparedness plans using

the POSE model Catharina de Kat-Reynen, WHO EURO

The aim of a Polio Outbreak Simulation Exercise (POSE) is to critically review and update

national plans for responding to the detection of wild or vaccine-derived polioviruses. This

publication provides material for a one-day exercise, including guidance notes for facilitators

and explanatory documents for participants.

Any national organization or health agency interested in implementing the exercise may

send an email to receive the materials in editable formats for easy adaptation to the local

context.

Global Vaccine Action Plan Monitoring, Evaluation & Accountability Secretariat

Annual Report 2015 Kamel Senouci and Daniela Urfer, WHO Headquarters

The Global Vaccine Action Plan (GVAP) Secretariat Report is now available on

the Immunization, Vaccines and Biologicals website.

The yearly report is prepared by the Secretariat for the Decade of Vaccines

(DoV), which is

made up of the Bill & Melinda Gates Foundation, Gavi the Vaccine Alliance,

UNICEF, US National Institute of Allergy and Infectious Diseases and the

World Health Organization (WHO).

This GVAP Secretariat report serves as the basis for the independent review

of the Strategic Advisory Group of Experts on immunization (SAGE). The re-

port reviews progress against each of the indicators in the Monitoring and

Evaluation/ Accountability Framework of the GVAP.

In addition it contains a narrative report on trends in vaccine prices, short

updates on Tracking Resources and Commitments to Immunization and inde-

pendent voluntary submissions from various partners on the activities they

conducted under the GVAP umbrella (Civil Society Organizations, Technical

Agencies, Manufacturers…).

To facilitate the exploration of the data, some data visualizations that measure progress against the goals and strate-

gic objectives of the GVAP have been made available on the TechNet-21.org website.

You can share your opinions or ask questions about these visualizations on the TechNet-21.org forum:

For more information on the Decade of Vaccines Collaboration and the Global Vaccine Action Plan, please contact

this address.

Global Immunization News (GIN) October 2015

Page 15

Calendar 2015

November

3-4 First Regional Dengue Symposium Rio de Janeiro, Brazil

6-20 Gavi Independent Review Committee (IRC) for new proposals Geneva, Switzerland

10-11 AFRO East & South Gavi Regional Working Group Maseru, Lesotho

10-12 Global meeting on lessons learned from HPV vaccine introduction Geneva, Switzerland

16-20 Global IB-VPD and RV Sentinel Surveillance and Laboratory Meetings Geneva, Switzerland

17-20 31st Meeting of Caribbean Immunization Managers Georgetown, Guyana

20 Gavi EURO Regional Working Group Meeting TBD

29-3Dec EMRO Twenty- Ninth Meeting of National Managers of the Expanded Pro-

gramme on Immunization and the Sixteenth Inter-country Meeting on Mea-

sles/Rubella Control and Elimination

Amman, Jordan

December

1-5 Briefing on WHO tools and guidance related to data quality and coverage

survey

Istanbul, Turkey

2-3 Gavi Alliance Board Meeting Geneva, Switzerland

2-4 AFRO Task Force on Immunization (TFI) TBD

3-4 AFRO West and Central Gavi Regional Working Group Libreville, Gabon

5-6 EMRO Meeting of the Regional Technical Advisory Group on Immunization

(RTAG) and Regional Verification Commission (RVC) of Measles Elimination

and Hepatitis B Control

Amman, Jordan

8-9 Vaccine patch meeting Geneva, Switzerland

11-13 EMRO Training Workshop on the tOPV-bOPV Switch Planning and Imple-

mentation

Cairo, Egypt

2016

January

19-20 WPRO Gavi Regional Working Group meeting Manila, Philippines

25-30 Executive Board Geneva, Switzerland

29-2Mar Institut Pasteur Vaccinology course Paris, France

February

24-25 AFRO ministerial conference on immunization Addis Ababa, Ethiopia

29-

25Mar

Institut Pasteur Vaccinology Course Paris, France

March

14-16 PAHO Regional Workshop on Evidence-Based Decision-Making (ProVac) and

Data Quality

TBD

15-17 Global Vaccine and Immunization Research Forum (GVIRF) Johannesburg, South Africa

Global Immunization News (GIN) October 2015

Page 16

April

12-14 Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization Geneva, Switzerland

June

13-17 WPRO Technical Advisory Group TBD

22-23 Gavi Board Meeting TBD

July

4-8 PAHO Technical Advisory Group TBD

October

18-20 Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization Geneva, Switzerland

December

7-8 Gavi Board Meeting TBD

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) Gavi Programme Bulletin (Gavi)

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 Vaccine Information Management System JSI Africa Routine Immunization Systems Essentials Project IMMUNIZATIONbasics Immunization Center Maternal and Child Health Integrated Program (MCHIP) PAHO ProVac Initiative PATH Vaccine Resource Library Rotavirus Vaccine Access and Delivery Malaria Vaccine Initiative Meningitis Vaccine Project RHO Cervical Cancer

Sabin Vaccine Institute Sustainable Immunization Financing UNICEF Immunization Supplies and Logistics USAID Maternal and Child Health Integrated Program WHO Department of Immunization, Vaccines & Biologicals New and Under-utilized Vaccines Implementation ICO Information Centre on HPV and Cancer Immunization financing Immunization service delivery Immunization surveillance, assessment and monitoring SIGN Alliance Other Coalition Against Typhoid Dengue Vaccine Initiative European Vaccine Initiative Gardasil Access Program Gavi 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) October 2015