European Advisory Group on the Expanded Programme on Immunization (EAG/EPI) : report on the fourteenth meeting, London, United Kingdom 27-29 January 1998

The EAG proposed targets and recommendations for the elimination of poliomyelitis, neonatal tetanus, indigenous diphtheria and measles, for reducing the carrier incidence of hepatitis B virus in children under five years, and for controlling mumps, pertussis, congenital rubella and invasive disease caused by Haemophilus influenzae type b. Achieving these targets would require appropriate political will, well defined strategies, the necessary managerial and financial resources, well organized public health systems with laboratory-based infectious diseases surveillance, high immunization coverage, national and international collaboration, and national immunization programmes that were sustainable and self-sufficient from the earliest possible date. The EAG agreed that poliomyelitis eradication remained the first priority for national elimination programmes. It believed, however, that measles elimination strategies needed to be accelerated and that an operational plan should be developed. The EAG agreed that hepatitis B prevention was a high priority. The Group recommended that all countries implement systems to monitor adverse events following immunization and safe immunization practices. The EAG was aware that public and professional concerns about vaccine safety would increase in both developed and developing countries, with the potential to seriously undermine confidence in immunization. The EAG considered that, subject to public health justifications for resource utilization, there could be useful roles for rotavirus and varicella vaccines in routine programmes. The Group recognized the advantages of new combination vaccines, but was also aware of some of their shortcomings. The EAG was appreciative of the progress towards poliomyelitis eradication in the Region, and endorsed the definition for classification of vaccine-associated paralytic poliomyelitis