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2.
MMWR Morb Mortal Wkly Rep ; 71(15): 538-544, 2022 Apr 15.
Article in English | MEDLINE | ID: mdl-35421079

ABSTRACT

Since the Global Polio Eradication Initiative (GPEI) was established in 1988, the number of reported poliomyelitis cases worldwide has declined by approximately 99.99%. By the end of 2021, wild poliovirus (WPV) remained endemic in only two countries (Pakistan and Afghanistan). However, a WPV type 1 (WPV1) case with paralysis onset in 2021, was reported by Malawi a year after the World Health Organization (WHO) African Region (AFR) was certified as WPV-free and circulating vaccine-derived poliovirus (cVDPV) cases were reported from 31 countries during 2020-2021 (1,2). cVDPVs are oral poliovirus vaccine-derived viruses that can emerge after prolonged circulation in populations with low immunity and cause paralysis. The primary means of detecting poliovirus transmission is through surveillance for acute flaccid paralysis (AFP) among persons aged <15 years, with confirmation through stool specimen testing by WHO-accredited laboratories, supplemented by systematic sampling of sewage and testing for the presence of poliovirus (environmental surveillance). The COVID-19 pandemic caused disruptions in polio vaccination and surveillance activities across WHO regions in 2020; during January-September 2020, the number of reported cases of AFP declined and the interval between stool collection and receipt by laboratories increased compared with the same period in 2019 (3). This report summarizes surveillance performance indicators for 2020 and 2021 in 43 priority countries* and updates previous reports (4). In 2021, a total of 32 (74%) priority countries† met two key surveillance performance indicator targets nationally, an improvement from 2020 when only 23 (53%) met both targets; however, substantial national and subnational gaps persist. High-performing poliovirus surveillance is critical to tracking poliovirus transmission. Frequent monitoring of surveillance indicators could help identify gaps, guide improvements, and enhance the overall sensitivity and timelines of poliovirus detection to successfully achieve polio eradication.


Subject(s)
COVID-19 , Poliomyelitis , Poliovirus , Disease Eradication , Global Health , Humans , Immunization Programs , Pandemics , Paralysis/epidemiology , Poliomyelitis/diagnosis , Poliomyelitis/epidemiology , Poliomyelitis/prevention & control , Poliovirus Vaccine, Oral , Population Surveillance , alpha-Fetoproteins
3.
Viruses ; 14(4)2022 Mar 29.
Article in English | MEDLINE | ID: mdl-35458439

ABSTRACT

Rabies is a deadly viral disease present mainly in low-income countries of Africa and Asia. Dogs are the main reservoir and the source of human deaths. Mass vaccination campaigns of dogs are pivotal to achieve rabies elimination. The monitoring of the immune response of the dog population is necessary to evaluate the effectiveness of these campaigns, taking into account field conditions. This study explores the feasibility and the performance of a new tool using filter papers (FPs) to collect blood samples associated with an Enzyme-Linked ImmunoSorbent Assay (ELISA) titration of rabies antibodies in dogs. A total of 216 eluates from FP samples were collected from 111 dogs kept in experimental facilities in France and 29 dogs from the field in Tunisia. Sera were also analyzed using both the Fluorescence Antibody Virus Neutralization test (FAVNt) and ELISA. A high specificity (98.0%) was obtained by testing FP blood eluates from 51 unvaccinated dogs, with the results compared with those of FAVNt and ELISA on serum samples. The coefficients of concordance between FP eluates and tested sera were 88.9% for FAVNt and 88.0% for ELISA. Blood filter papers coupled with the titration of rabies antibodies by ELISA provide a reliable, simple, and effective solution to overcome the issues of the logistics and transport of samples, especially in low-income countries.


Subject(s)
Dog Diseases , Rabies Vaccines , Rabies virus , Rabies , Animals , Antibodies, Viral , Dog Diseases/prevention & control , Dogs , Enzyme-Linked Immunosorbent Assay/methods , Immunization Programs , Rabies/prevention & control , Rabies/veterinary , Sensitivity and Specificity , Tunisia , Vaccination/veterinary
4.
BMJ Open ; 12(4): e060103, 2022 Apr 21.
Article in English | MEDLINE | ID: mdl-35450915

ABSTRACT

OBJECTIVE: To identify, characterise and map the existing knowledge about (1) immunisation programmes that provide evidence-based support about vaccines to Canadians and reduce barriers to vaccination; and (2) barriers and facilitators to the delivery of immunisation support programmes. INTRODUCTION: Vaccine hesitancy is a complex issue that has significant repercussions for the health and safety of Canadians. Engaging in evidence-based communication about vaccines can reduce vaccine hesitancy and increase participation in immunisation programmes. METHODS: The Joanna Briggs Institute methodology for scoping reviews will be used for this scoping review. A comprehensive keyword search strategy was developed and translated for six electronic databases on 19 November 2021: CINAHL via EBSCOhost, APA PsycINFO via EBSCOhost, Academic Search Complete via EBSCOhost, Scopus, Medline via EBSCOhost and EmCare via Ovid. We will identify unpublished literature by searching websites listed in CADTH's Grey Matters checklist and other relevant sources in January 2022. Two independent raters will screen and extract data from identified material. Data will be presented in a tabular form. INCLUSION CRITERIA: We will consider Canadian programmes that target the general public and exclude papers targeting health professionals. Our review will not limit by vaccine type and will consider any intervention that aims to inform individuals about immunisation. Our primary concept involves mapping the characteristics of programmes (eg, programme description, delivery format) and our secondary concept will examine barriers and facilitators to programme delivery. ETHICS AND DISSEMINATION: Ethical approval is not required as this study is a review of the published and publicly reported literature. Findings from this review will be disseminated to academic and health system stakeholders to inform immunisation programmes across a wide range of vaccine types and settings. We intend to use the results of this review to develop an immunisation support programme in Prince Edward Island, Canada.


Subject(s)
Immunization Programs , Vaccines , Canada , Communication , Humans , Research Design , Review Literature as Topic , Vaccination
5.
BMJ Open ; 12(4): e053236, 2022 Apr 04.
Article in English | MEDLINE | ID: mdl-35379619

ABSTRACT

OBJECTIVES: Several studies have highlighted the effects of combination vaccines on immunisation coverage at the national or subnational level. This study examined the effects globally. Worldwide introduction of whole-cell pertussis pentavalent (wP-pentavalent) allowed estimation of incremental coverage effects of combination vaccines on the third doses of diphtheria, tetanus, pertussis (DTP3); hepatitis B (HepB3) and Haemophilus influenzae type B (Hib3). DESIGN: Multicountry panel data analysis. DATA SOURCES: Country-level vaccine coverage data of WHO/UNICEF for the years 1980-2018. METHODS: Linear mixed models were used to estimate the effects of wP-pentavalent introduction by incorporating proxy variables to control for time trend and other time-dependent changes in the immunisation programmes. RESULTS: Introduction of combination vaccines may have improved the coverage of DTP3 by 3percentage points(95% CI 2.5% to 3.6%) globally compared with the coverage in the pre-combination vaccine era. The comparison of coverage rates of HepB3 and Hib3 in before and after wP-pentavalent periods indicates that the introduction of combination vaccines improved the coverage by 10.1 percentage points (95% CI 8.4% to 11.7%) for HepB3 and 9.9 (95% CI 7.1% to 12.7%) for Hib3 in countries that introduced those antigens prior to adoption of wP-pentavalent. Even though the incremental coverage increase of DTP3 appears quite modest, it is still a significant result, especially because DTP vaccine has been in the national immunisation programmes of all countries for about 24 years prior to the introduction of wP-pentavalent. Additionally, the introduction of pentavalent also allowed inclusion of Hib and HepB in the vaccine schedule for a large number of countries (85 and 37, respectively, of the 102 countries included in our analysis). CONCLUSION: The findings suggest that development of combination vaccines with additional antigens is likely to help sustain and improve coverage of existing as well as new childhood vaccines.


Subject(s)
Data Analysis , Immunization Programs , Child , Diphtheria-Tetanus-Pertussis Vaccine , Humans , Immunization Schedule , Vaccination Coverage
7.
Cad Saude Publica ; 38(3): e00045721, 2022.
Article in English | MEDLINE | ID: mdl-35384993

ABSTRACT

Influenza is a severe, vaccine-preventable disease. Vaccination programs across Latin American countries show contrasting coverage rates, from 29% in Paraguay to 89% in Brazil. This study explores how national influenza vaccination programs in the chosen South American countries address vaccine confidence and convenience, as well as complacency toward the disease. Barriers and facilitators to influenza vaccination programs in their relation to vaccine hesitancy were observed by documentary analysis and interviews with 38 national immunization program officers in high- (Brazil and Chile) and low-performing (Paraguay, Peru, and Uruguay) countries. Influenza vaccination policies, financing, purchasing, coordination, and accessibility are considered good or acceptable. National communication strategies focus on vaccine availability during campaigns. In Chile, Paraguay, and Uruguay, anti-vaccine propaganda was mentioned as a problem. Programming and implementation face human resource shortages across most countries. Statistical information, health information systems, and nominal risk-group records are available, with limitations in Peru and Paraguay. Health promotion, supervision, monitoring, and evaluation are perceived as opportunities to address confidence and complacency. Influenza vaccination programs identify and act on most barriers and facilitators affecting influenza vaccine hesitancy via supply-side strategies which mostly address vaccine convenience. Confidence and complacency are insufficiently addressed, except for Uruguay. Programs have the opportunity to develop integral supply and demand-side approaches.


Subject(s)
Influenza Vaccines , Influenza, Human , Brazil , Humans , Immunization Programs , Influenza, Human/prevention & control , Vaccination
8.
PLoS Negl Trop Dis ; 16(4): e0010358, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35442958

ABSTRACT

BACKGROUND: A global stockpile of oral cholera vaccine (OCV) was established in 2013 for use in outbreak response and are licensed as two-dose regimens. Vaccine availability, however, remains limited. Previous studies have found that a single dose of OCV may provide substantial protection against cholera. METHODS: Using a mathematical model with two age groups paired with optimization algorithms, we determine the optimal vaccination strategy with one and two doses of vaccine to minimize cumulative overall infections, symptomatic infections, and deaths. We explore counterfactual vaccination scenarios in three distinct settings: Maela, the largest refugee camp in Thailand, with high in- and out-migration; N'Djamena, Chad, a densely populated region; and Haiti, where departments are connected by rivers and roads. RESULTS: Over the short term under limited vaccine supply, the optimal strategies for all objectives prioritize one dose to the older age group (over five years old), irrespective of setting and level of vaccination coverage. As more vaccine becomes available, it is optimal to administer a second dose for long-term protection. With enough vaccine to cover the whole population with one dose, the optimal strategies can avert up to 30% to 90% of deaths and 36% to 92% of symptomatic infections across the three settings over one year. The one-dose optimal strategies can avert 1.2 to 1.8 times as many cases and deaths compared to the standard two-dose strategy. CONCLUSIONS: In an outbreak setting, speedy vaccination campaigns with a single dose of OCV is likely to avert more cases and deaths than a two-dose pro-rata campaign under a limited vaccine supply.


Subject(s)
Cholera Vaccines , Cholera , Administration, Oral , Aged , Child, Preschool , Cholera/epidemiology , Cholera/prevention & control , Disease Outbreaks/prevention & control , Humans , Immunization Programs
9.
10.
Article in English | MEDLINE | ID: mdl-35410045

ABSTRACT

Assessing knowledge, attitudes and behaviours towards vaccination is a key strategy when implementing national and international immunisation programmes aimed at improving compliance among the population and thereby increasing vaccination coverage. While vaccination's role as a powerful life-saving weapon in the fight against infectious diseases has been further highlighted following the introduction of the Coronavirus Disease 2019 (COVID-19) vaccine, there is still a discrepancy between the scientific evidence on the effectiveness of vaccines and the perception of the risk attributed to them. Known as "Vaccine Hesitancy" (VH), this phenomenon is the delay in acceptance or refusal of vaccines, despite the availability of services. VH can be found in at least 15% of the worldwide population, and even professional groups tasked with promoting vaccination as a primary prevention measure, e.g., healthcare workers (HCWs), sometimes have doubts regarding vaccination. Since 2014, this Public Health problem has been increasing in 90% of countries worldwide, to the extent that in 2019 it was listed as one of the ten greatest threats to global health by the World Health Organization (WHO). VH has also affected COVID-19 vaccination, hampering the achievement of desired vaccination coverage. Monitoring this trend by studying people's behaviour and attitudes could be a useful tool to aid Public Health, in orienting vaccination policies and designing new health education and continuous training interventions, aimed at both the general public and accountable cohorts, such as HCWs.


Subject(s)
COVID-19 , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Cross-Sectional Studies , Humans , Immunization Programs , Pandemics/prevention & control , SARS-CoV-2 , Vaccination
11.
Internist (Berl) ; 63(5): 476-483, 2022 May.
Article in German | MEDLINE | ID: mdl-35376975

ABSTRACT

Due to the effectiveness of vaccines some particularly threatening infectious diseases have become rare; however, vaccines are meanwhile the victims of their own success. Due to insufficient compliance and inadequate vaccination rates, there is a danger that the effectiveness of vaccination as a preventive measure will continuously disappear. In 2019 the World Health Organization classified doubts on the effectiveness of vaccines as 1 of the 10 greatest dangers to health worldwide. This article discusses important questions on vaccinations and vaccines as well as their effects in the interplay with the immune system. The following topics are covered: comparison of naturally acquired immunity and that acquired by vaccination, factors that necessitate a refresher vaccination, the role of herd immunity, prerequisites for successful eradication of a disease, influence of various T cells on the effect of vaccination, the role of immunologic memory, factors that influence protection by vaccination, vaccinations in cases of immunodeficiency, the potential and areas of implementation of passive immunization. In view of the corona pandemic and the running vaccination campaign, it must be hoped that this triggers a general renaissance of vaccinations against infectious diseases.


Subject(s)
Immunologic Memory , Vaccines , Humans , Immunity, Herd , Immunization Programs , Vaccination
13.
Vaccine ; 40(21): 2940-2948, 2022 May 09.
Article in English | MEDLINE | ID: mdl-35410816

ABSTRACT

INTRODUCTION: Annual vaccination of children against influenza is a key component of vaccination programs in many countries. However, past infection and vaccination may affect an individual's susceptibility to infection. Little research has evaluated whether annual vaccination is the best strategy. Using the United Kingdom as our motivating example, we developed a framework to assess the impact of different childhood vaccination strategies, specifically annual and biennial (every other year), on attack rate and expected number of infections. METHODS AND FINDINGS: We present a multi-annual, individual-based, stochastic, force of infection model that accounts for individual exposure histories and disease/vaccine dynamics influencing susceptibility. We simulate birth cohorts that experience yearly influenza epidemics and follow them until age 18 to determine attack rates and the number of infections during childhood. We perform simulations under baseline conditions, with an assumed vaccination coverage of 44%, to compare annual vaccination to no and biennial vaccination. We relax our baseline assumptions to explore how our model assumptions impact vaccination program performance. At baseline, we observed less than half the number of infections between the ages 2 and 10 under annual vaccination in children who had been vaccinated at least half the time compared to no vaccination. When averaged over all ages 0-18, the number of infections under annual vaccination was 2.07 (2.06, 2.08) compared to 2.63 (2.62, 2.64) under no vaccination, and 2.38 (2.37, 2.40) under biennial vaccination. When we introduced a penalty for repeated exposures, we observed a decrease in the difference in infections between the vaccination strategies. Specifically, the difference in childhood infections under biennial compared to annual vaccination decreased from 0.31 to 0.04 as exposure penalty increased. CONCLUSION: Our results indicate that while annual vaccination averts more childhood infections than biennial vaccination, this difference is small. Our work confirms the value of annual vaccination in children, even with modest vaccination coverage, but also shows that similar benefits of vaccination may be obtained by implementing a biennial vaccination program. AUTHOR SUMMARY: Many countries include annual vaccination of children against influenza in their vaccination programs. In the United Kingdom (UK), annual vaccination of children aged of 2 to 10 against influenza is recommended. However, little research has evaluated whether annual vaccination is the best strategy, while accounting for how past infection and vaccination may affect an individual's susceptibility to infection in the current influenza season. Prior work has suggested that there may be a negative effect of repeated vaccination. In this work we developed a stochastic, individual-based model to assess the impact of repeated vaccination strategies on childhood infections. Specifically, we first compare annual vaccination to no vaccination and then annual vaccination to biennial (every other year) vaccination. We use the UK as our motivating example. We found that an annual vaccination strategy resulted in the fewest childhood infections, followed by biennial vaccination. The difference in number of childhood infections between the different vaccination strategies decreased when we introduced a penalty for repeated exposures. Our work confirms the value of annual vaccination in children, but also shows that similar benefits of vaccination can be obtained by implementing a biennial vaccination program, particularly when there is a negative effect of repeated vaccinations.


Subject(s)
Influenza Vaccines , Influenza, Human , Child , Child, Preschool , Humans , Immunization Programs , Influenza Vaccines/adverse effects , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Seasons , Vaccination
14.
Vaccine ; 40(22): 3055-3063, 2022 May 11.
Article in English | MEDLINE | ID: mdl-35437190

ABSTRACT

BACKGROUND: Although monitoring of vaccination program performance is usually evaluated by measurement of vaccine coverage, timely uptake is rarely part of this assessment. This study aims to examine the timeliness of the administration of a measles-containing-vaccine (MCV) for 2-year-old children between 2005 and 2019. METHODS: We used data from the Swiss National Vaccination Coverage Survey 2005-2019 for the study. We defined timely vaccinated as a vaccination administered within the recommended age specified in the Swiss National Vaccination Schedule, with an added tolerance period of 30.4 days for both MCV 1 and 2 doses. The median delay time was estimated by Kaplan-Meier survival curve and examined using log-rank test. A Cox hazard ratio was used to identify factors associated with delay. RESULTS: 81% (95% CI:79-82%) of toddlers were timely vaccinated for MCV1 and 82% (95% CI:81-83%) for MCV2 in survey period 2017-2019. Between 2005 and 2019, the median age of vaccinated children ranged between 12.2 and 12.5 and 18.3-22.0 months for MCV1 and MCV2 with median delay of 44 and 38 days, respectively, at the national level. Children in the French-, Italian- and German-speaking regions were vaccinated earlier between 2005 and 2019 for MCV1 (vaccination coverage range before 10 months of age: 1.7-45.9%, 1.2-35.3% and 1.4-15.0%, respectively). Nationality, linguistic regions, and survey periods were the strongest predictive factors related to prolonged delay time. CONCLUSION: Overall adherence to recommendations has improved over time, as MCV coverage has significantly increased over the years with differences across linguistic regions. Vaccinations were administered earlier and with shorter delay time.


Subject(s)
Measles Vaccine , Measles , Adolescent , Adult , Child , Child, Preschool , Humans , Immunization Programs , Immunization Schedule , Infant , Measles/prevention & control , Middle Aged , Surveys and Questionnaires , Switzerland , Vaccination , Young Adult
15.
WMJ ; 121(1): 58-60, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35442581

ABSTRACT

BACKGROUND: The objective of this study was to measure the recovery of routine pediatric immunization after a period of reduced vaccine administrations in the early weeks of the COVID-19 pandemic. METHODS: We recorded data on vaccines administered in Children's Wisconsin primary care or urgent care clinics from January 2019 through December 2020 and aggregated data by date and insurance type. RESULTS: During the gradual reopening period after week 21 in 2020, vaccine administration returned to prepandemic levels for children with commercial insurance but remained below baseline rates until the end of 2020 for children with Medicaid insurance. DISCUSSION: The decline in pediatric vaccination in 2020 disproportionately affected children with Medicaid insurance.


Subject(s)
COVID-19 , Vaccines , Ambulatory Care Facilities , COVID-19/epidemiology , COVID-19/prevention & control , Child , Humans , Immunization , Immunization Programs , Pandemics/prevention & control , United States/epidemiology , Vaccination
17.
Pan Afr Med J ; 41: 104, 2022.
Article in English | MEDLINE | ID: mdl-35432705

ABSTRACT

Introduction: the COVID-19 outbreak was declared a public health emergency of international concern by the WHO on the 30th January 2020. The occurrence of measles outbreaks in the context of COVID-19, both highly infectious respiratory illnesses, impacts additional challenges to the health system in a state with an ongoing humanitarian crisis. This article documents the implementation of an outbreak response immunization (ORI) during the COVID-19 pandemic and the implementation of global guidelines for mass vaccination. Methods: a retrospective review of the response to measles outbreak implemented in Borno state across six local government areas (LGAs) in 2019 was conducted. This review assessed the utilization of the World Health Organization (WHO) decision making framework, measles and COVID-19 epidemiological reports and the measle's vaccination response data. Results: an outbreak response immunization was implemented in six LGAs in Borno State, with a validated post campaign coverage of 96.3% (95% CI: 93.0 - 98.1). In total, 181,634 children aged 9 months-9 years were vaccinated with 27,961 (15.4%) receiving the measles vaccine for the first time. Prior to the interventions, 20 COVID-19 cases were reported in the six LGAs while only seven suspected cases were reported with only two cases confirmed in one of the six LGAs four weeks after the ORI. Conclusion: the WHO decision-making framework for implementing mass vaccinations in the context of the COVID-19 Pandemic was utilized for the outbreak response immunization in Borno State, Nigeria with 181,634 children aged 9 Months-9 years vaccinated with the measles vaccine. The use of the WHO decision-making framework to assess risk benefits of initiating mass vaccination campaigns remains a very important practical tool. These types of responses in Nigeria and other low and middle income countries (LMICs), with hitherto suboptimal immunization coverage and weak health systems and other settings, affected by humanitarian emergencies is essential in the achievement of the regional measle's elimination targets.


Subject(s)
COVID-19 , Measles , COVID-19/prevention & control , Child , Disease Outbreaks/prevention & control , Humans , Immunization , Immunization Programs , Infant , Mass Vaccination , Measles/epidemiology , Measles/prevention & control , Measles Vaccine , Nigeria/epidemiology , Pandemics , Vaccination
18.
Vaccine ; 40(19): 2741-2748, 2022 Apr 26.
Article in English | MEDLINE | ID: mdl-35361502

ABSTRACT

Sierra Leone is highly endemic for hepatitis B virus (HBV) infection and thus recommends three doses of hepatitis B vaccine (HepB3) from 6 weeks of age but does not recommend a birth dose (HepB-BD) to prevent mother-to-child transmission (MTCT). We evaluated impact of the existing HepB3 schedule and risk for MTCT of HBV. We conducted a community-based serosurvey among 4-30-month-olds, their mothers, and 5-9-year-olds in three districts in Sierra Leone. Participants had an HBV surface antigen (HBsAg) rapid test; all HBsAg-positive and one HBsAg-negative mother per cluster were tested for HBV markers. We collected children's HepB3 vaccination history. Among 1889 children aged 4-30 months, HepB3 coverage was 85% and 20 (1·3% [95% CI 0·8-2·0]) were HBsAg-positive, of whom 70% had received HepB3. Among 2025 children aged 5-9 years, HepB3 coverage was 77% and 32 (1·6% [1·1-2·3]) were HBsAg-positive, of whom 56% had received HepB3. Of 1776 mothers, 169 (9·8% [8·1-11·7]) were HBsAg-positive. HBsAg prevalence was 5·9% among children of HBsAg-positive mothers compared to 0·7% among children of HBsAg-negative mothers (adjusted OR = 10·6 [2·8-40·8]). HBsAg positivity in children was associated with maternal HBsAg (p = 0·026), HBV e antigen (p < 0·001), and HBV DNA levels ≥ 200 000 IU/mL (p < 0·001). HBsAg prevalence was lower among children than mothers, for whom HepB was not available, suggesting routine infant HepB vaccination has lowered HBV burden. Since HBsAg positivity in children was strongly associated with maternal HBV infection and most of the HBsAg-positive children in the survey received HepB3, HepB-BD may prevent MTCT and chronic HBV infection.


Subject(s)
Hepatitis B Vaccines , Hepatitis B , Child , Female , Hepatitis B/epidemiology , Hepatitis B/prevention & control , Hepatitis B Antibodies , Hepatitis B Surface Antigens , Hepatitis B virus , Humans , Immunization Programs , Infant , Infectious Disease Transmission, Vertical/prevention & control , Mothers , Seroepidemiologic Studies , Sierra Leone/epidemiology , Vaccination
19.
BMC Public Health ; 22(1): 691, 2022 04 08.
Article in English | MEDLINE | ID: mdl-35395753

ABSTRACT

BACKGROUND: As of October 2021, 47 (80%) of the 59 countries, identified at highest risk for Maternal and Neonatal Tetanus (MNT), had been validated for elimination. We assessed sustainability of MNT elimination (MNTE) in 28 countries that were validated during 2011‒2020. METHODS: We assessed the attainment of the following MNTE sustainability indicators: 1) ≥ 90% coverage with three doses of Diphtheria-Tetanus-Pertussis vaccine (DTP3) among infants < 1 year, 2) ≥ 80% coverage with at least two doses of tetanus toxoid-containing vaccine (TTCV2 +) among pregnant women, 3) ≥ 80% protection at birth (PAB), 4) ≥ 70% skilled birth attendance (SBA), and 4) ≥ 80% first (ANC1) and fourth antenatal care (ANC4) visits. We assessed the introduction of TTCV booster doses. Data sources included the 2020 WHO /UNICEF Joint Reporting Forms, and the latest Demographic and Health Survey (DHS) or Multi-Indicator Cluster Surveys (MICS) for each country, if available. We reviewed literature and used DHS/MICS data to identify barriers to sustaining MNTE. RESULTS: Of 28 assessed countries, 7 (25%) reported ≥ 90% DTP3 coverage, 4 of 26 (16%) reported ≥ 80% TTCV2 + coverage, and 23 of 27 (85%) reported ≥ 80% PAB coverage. Based on DHS/MICS in 15 of the 28 countries, 10 (67%) achieved ≥ 70% SBA delivery, 13 (87%) achieved ≥ 80% ANC1 visit coverage, and 3 (20%) ≥ 80% ANC4 visit coverage. We observed sub-optimal coverage in many countries at the subnational level. The first, second and third booster doses of TTCV respectively have been introduced in 6 (21%), 5 (18%), and 1 (4%) of 28 countries. Only three countries conducted post-MNTE validation assessments. Barriers to MNTE sustainability included: competing program priorities, limited resources to introduce TTCV booster doses and implement corrective immunization in high-risk districts and socio-economic factors. CONCLUSIONS: Despite good performance of MNTE indicators in several countries, MNTE sustainability appears threatened in some countries. Integration and coordination of MNTE activities with other immunization activities in the context of the Immunization Agenda 2030 lifecourse vaccination strategy such as providing tetanus booster doses in school-based vaccination platforms, during measles second dose and HPV vaccination, and integrating MNTE post-validation assessments with immunization program reviews will ensure MNTE is sustained.


Subject(s)
Tetanus , Diphtheria-Tetanus-Pertussis Vaccine , Female , Humans , Immunization , Immunization Programs , Infant , Infant, Newborn , Pregnancy , Tetanus/prevention & control , Vaccination
20.
Washington, D.C.; OPAS; 2022-04-28.
in Portuguese | PAHO-IRIS | ID: phr-55946

ABSTRACT

Um dos componentes essenciais de um sistema de vacinação seguro é a vigilância de eventos supostamente atribuíveis à vacinação ou imunização (ESAVI). Por meio dessa vigilância, busca-se detectar precocemente qualquer evento adverso que ocorra após a vacinação, a fim de controlar e classificar os riscos relacionados à vacina ou aos processos de fabricação, transporte, armazenamento e aplicação, bem como a qualquer situação inerente à pessoa vacinada ou para afastar a relação de tais eventos com a vacina. Este manual foi adaptado para a Região das Américas a partir do Manual Global para Vigilância de Eventos Adversos Pós-Vacinação, publicado pela Organização Mundial da Saúde em 2014. Ele fornece uma revisão técnica abrangente de todos os processos e procedimentos para implementar e operar sistemas de alta qualidade para a vigilância de ESAVI. Reúne a experiência de vários especialistas em segurança de vacinas da Região e do mundo, especialistas de programas nacionais de imunização, autoridades reguladoras nacionais e outras instituições que desenvolveram conhecimento relevante para a vigilância desses eventos. Espera-se que este documento sirva de guia para que os responsáveis pelos programas nacionais de imunização, os diretores de farmacovigilância das autoridades reguladoras nacionais e as demais instituições responsáveis pelo monitoramento da segurança das vacinas tenham ferramentas que facilitem sua tarefa e permitam a aplicação de normas internacionais em temas como detecção e investigação de ESAVI, análise de causalidade, gerenciamento de dados e comunicação de risco, entre outros.


Subject(s)
Immunization , Immunization Programs , Immunity, Herd , Mass Vaccination , Immunization, Passive , Vaccines , Vaccines, Attenuated , Adjuvants, Immunologic , Anti-Bacterial Agents
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