Vaccines and Global Health: The Week in Review 29 August 2015

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

pdf version A pdf of the current issue is available here:  Vaccines and Global Health_The Week in Review_29 August 2015

blog edition: comprised of the approx. 35+ entries posted below on this date.

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
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Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
a program of the
– Division of Medical Ethics, NYU Medical School
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

EBOLA/EVD [to 29 August 2015]

EBOLA/EVD [to 29 August 2015]
Public Health Emergency of International Concern (PHEIC); “Threat to international peace and security” (UN Security Council)

WHO Director-General addresses the Review Committee of the International Health Regulations focused on the Ebola response
Dr Margaret Chan
Director-General of the World Health Organization
Opening remarks at the Review Committee on the role of the International Health Regulations in the Ebola outbreak and response
Geneva, Switzerland 24 August 2015

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Ebola Situation Report – 26 August 2015
[Excerpts]
SUMMARY
:: There were 3 confirmed cases of Ebola virus disease (EVD) reported in the week to 23 August, all of which were reported from Guinea. No new confirmed cases were reported from Sierra Leone for the second consecutive week. Overall case incidence has held at 3 confirmed cases per week for 4 consecutive weeks. In addition, the number of contacts under observation continues to fall, from over 800 on 16 August to approximately 600 on 23 August throughout 4 prefectures in Guinea and 2 districts in Sierra Leone…

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Sierra Leone celebrates milestone on road to ending Ebola
25 August 2015 — Sierra Leone celebrated an important milestone on Monday, 24 August 2015. For the first time in more than a year, there are no people being treated for Ebola virus disease and no confirmed cases of Ebola in the country. However, Ebola transmission is considered officially ended when Sierra Leone goes 42 days with no cases.

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WHO: The road to redemption: Ebola infection prevention and control
28 August 2015 — Redemption Hospital is the only public health facility in the area and serves some 90 000 people. In August 2014, the hospital was at the centre of the Ebola epidemic in Liberia. It quickly became overwhelmed and, for a time, had to close its inpatient department. Now, the community and its health workers feel safer coming to the hospital since adequate infection, prevention and control measures are in place.
Read about the measures taken to reopen the hospital

WHO Fact Sheets:
Ebola virus disease
26 August 2015

WHO: Stories from the field
Exploring fear to regain trust: Getting children to health care in Sierra Leone
21 August 2015
Ebola survivors clinic opens in Monrovia
12 August 2015
Sierra Leone: Tracing Ebola in Tonkolili
4 August 2015

POLIO [to 29 August 2015]

POLIO [to 29 August 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 26 August 2015
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
:: The Expert Review Committee met in Nigeria last week to review the progress made in Nigeria, identify ways to strengthen the gains of the last few years and identify the major risks to stopping polio across the country. More
:: A project to improve access to hard-to-reach (HTR) populations in Nigeria with polio vaccines is having a dramatic impact on the broader health needs of remote communities, demonstrating the legacy of polio eradication in action. More
:: Through a series of photographs, meet religious leaders, health care workers, volunteers, vaccinators, programme monitors and parents as they play their unique roles in protecting children across Afghanistan from polio.

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Selected excerpts from Country-specific Reports
Afghanistan
:: One new wild poliovirus type one (WPV1) case was confirmed this week in Achin district of Nangarhar. This most recent case, which was the second WPV1 case in the district this year, had onset of paralysis on 1 August. The total number of WPV1 cases for 2015 is now eight.
:: Intensive and strengthened supplementary immunization activities are planned in the coming months. Subnational Immunization Days (SNIDs) will take place across the south and east of the country on 20 – 22 September using bivalent OPV and National Immunization Days (NIDs) will take place on 18 – 20 October using trivalent OPV.

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Pakistan second endemic country to introduce IPV into routine immunization schedule
Islamabad, 24 August 2015 — Pakistan has taken another step towards a polio-free future on Thursday, introducing IPV into its routine immunization schedule at a ceremony presided over by the Minister of State, Ministry of National Health Services Regulation and Coordination, Mrs Saira Afzal Tarar, and attended by representatives of WHO, UNICEF, GAVI and other development partners, such as USAID and the UK Department for International Development, in the capital, Islamabad.

The introduction of the inactivated polio vaccine (IPV) across Pakistan will benefit more than 6 million children per year, and will be administered to children alongside other life-saving vaccines.

Pakistan is one of 3 countries in the world where polio remains endemic. Nigeria, which recently marked one year without a case of wild polio, introduced the vaccine earlier this year and Afghanistan is due to begin using IPV in the coming weeks.

Pakistan’s national introduction of IPV marks the fulfilment of the global commitment to meet one of the 4 major objectives of the Polio Endgame Strategy that calls on all oral polio vaccine (OPV)-only using countries to introduce at least one dose of IPV into routine immunization schedules by the end of 2015, strengthen routine immunization and withdraw OPV in a phased manner, starting with type 2-containing OPV.

The worldwide roll-out of IPV across 126 countries by the end of 2015 is part of the largest and fastest globally coordinated vaccine introduction project in history. The initiative is funded as part of the budget of the Global Polio Eradication Initiative (GPEI), and support is channelled through GAVI, the Vaccine Alliance, WHO and UNICEF…

MERS-CoV [to 29 August 2015]

MERS-CoV [to 29 August 2015]
Global Alert and Response (GAR) – Disease Outbreak News (DONs)
:: Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia – 27 August 2015
Between 22 and 23 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 13 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Twelve (12) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh city… Globally, since September 2012, WHO has been notified of 1,474 laboratory-confirmed cases of infection with MERS-CoV, including at least 515 related deaths.

WHO & Regionals [to 29 August 2015]

WHO & Regionals [to 29 August 2015]

Call for nominations: SAGE Working Group on Maternal and Neonatal Tetanus Elimination
25 August 2015

The Weekly Epidemiological Record (WER) 28 August 2015, vol. 90, 35 (pp. 433–460) includes:
…Pertussis vaccines: WHO position paper – September 2015

Water, sanitation and hygiene to eliminate neglected tropical diseases
27 August 2015 — WHO releases a global plan today to better integrate water, sanitation and hygiene (WASH) services with other public health interventions to accelerate progress in eliminating and eradicating neglected tropical diseases by 2020. Targeted water and sanitation interventions are expected to bolster ongoing efforts to tackle 16 neglected tropical diseases that affect more than 1 billion of the world’s most vulnerable populations.

Improving preterm birth outcomes: new guidance
August 2015 – WHO’s new guidance WHO recommendations on interventions to improve preterm birth outcomes has been launched to help prevent the complications and consequences of preterm birth. Adding to efforts worldwide to further reduce child mortality, the guidance offers recommendations on interventions which can be provided to the mother when preterm birth is imminent and to the preterm infant after birth, with the aim of improving outcomes for preterm infants.

WHO Fact Sheets:
Rabies
28 August 2015
Ebola virus disease
26 August 2015

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:: WHO Regional Offices
WHO African Region AFRO
:: Last Ebola case in Sierra Leone
Sierra Leone celebrated an important milestone on Monday, 24 August 2015. For the first time in more than a year, there are no people being treated for Ebola virus disease and no confirmed cases of Ebola in the country. Surrounded by singing, dancing and clapping health-care workers, Adama Sankou, palm oil trader, was released from the Makheni Ebola treatment unit. In the ceremony held to mark the final Ebola case, the President of Sierra Leone, Ernest Bai Koroma, described Madame Sankou’s release as “the beginning of the end of Ebola.” “‘Ebola nor don don” (Ebola is not yet finished), the President…
:: WHO staff on the ground essential to breaking Ebola transmission chains – 24 August 2015

WHO Region of the Americas PAHO
:: Latin American and Caribbean Countries Commit to a 75% Reduction in New HIV Infections in Adults and Young People by 2020 (08/24/2015)

WHO South-East Asia Region SEARO
No new digest content identified.

WHO European Region EURO
:: Exploring the cultural contexts of health and well-being 28-08-2015

WHO Eastern Mediterranean Region EMRO
:: Safe corridor needed to deliver health care to over 3 million people in Taiz, Yemen
Sana’a, 27 August 2015 – In Yemen, conflict and a resulting humanitarian crisis have left thousands of people in need of treatment, caused extensive damage to health facilities, and fanned a dengue fever outbreak in Taiz. The governorate has witnessed an extreme spike in cases of dengue fever in the past 2 weeks and a humanitarian corridor is needed not only to ensure access to health care for more than 3 million people in Taiz but to assess the outbreak and institute control measures. Read more about the situation in Taiz
:: Water, sanitation and hygiene to eliminate neglected tropical diseases
27 August 2015
:: Pakistan second endemic country to introduce IPV into routine immunization schedule
24 August 2015
:: WHO steps up response to the critical health needs in Taiz and Hodeida governorates as the humanitarian situation worsens
23 August 2015

WHO Western Pacific Region
:: WHO, DOH, KOICA Launch AcCESS for MNH project to improve health of mothers and newborns in Davao Region
DAVAO, Philippines, 28 August 2015 – The World Health Organization (WHO), Korea International Cooperation Agency (KOICA), and the Department of Health (DOH) Regional Office XI launched on 18 August 2015 at SMEX Convention Center, Davao City a three-year Subnational Initiative (SNI) project called “Accelerating Convergence Efforts through Systems Strengthening for Maternal and Newborn Health” or AcCESS for MNH. The project aims to improve the health of mothers and newborns in 10 local government units (LGUs) in Davao Region.

CDC: State exemption levels low, national vaccination rates high

CDC/MMWR/ACIP Watch [to 29 August 2015]
http://www.cdc.gov/media/index.html

State exemption levels low, national vaccination rates high
Local pockets of unvaccinated children can reveal nation’s vulnerabilities
Thursday, August 27, 2015
Vaccine exemption levels for kindergarteners are low for most states and infant vaccination rates are high nationally, according to data from two reports published in this week’s Morbidity and Mortality Weekly Report (MMWR).

The first report looked at vaccination coverage and exemption levels among children entering kindergarten for the 2014-2015 school year. Nationally, exemption levels remain low with a median level of 1.7 percent. However, state exemption levels ranged from a low of less than 0.1 percent in Mississippi to a high of 6.5 percent in Idaho. Additionally, five states did not meet the reporting standards for providing exemption data.

The second report examined vaccination rates among children ages 19 months through 35 months for 2014. Vaccination coverage remained high: over 90 percent for measles-mumps-rubella (MMR); polio; hepatitis B; and varicella vaccines. The percentage of children who do not receive vaccinations also remained low, at less than 1 percent.
“Collaborative efforts are the reason our nation has been able to achieve such high coverage nationally, but much work is still needed to shield our schools and communities from future outbreaks,” said Anne Schuchat, MD (RADM, USPHS), director of CDC’s National Center for Immunization and Respiratory Diseases.

One important change from 2013 to 2014 was the number of states that provided local coverage and exemption data online. There was an increase from 18 states providing such data in 2013 to 21 states providing these data in 2014. Making this information available publicly keeps parents informed, guides vaccination policies, and strengthens immunization programs.

When a disease like measles reaches a community with large numbers of unvaccinated people, it can spread very quickly. Therefore, local pockets of people who are missing vaccinations can leave communities vulnerable to outbreaks.

Consistent, high coverage rates are needed to provide community immunity (herd immunity) and protect children from disease outbreaks like measles.

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Transcript for CDC Telebriefing: CDC officials to discuss vaccine exemption levels and infant vaccination coverage
Thursday, August 27, 2015

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MMWR August 28, 2015 / Vol. 64 / No. 33
:: National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2014
:: Vaccination Coverage Among Children in Kindergarten — United States, 2014–15 School Year
:: World Health Organization Guidelines for Containment of Poliovirus Following Type-Specific Polio Eradication — Worldwide, 2015

Maternal and Neonatal Tetanus elimination in India will spare thousands of deaths: UNICEF

UNICEF [to 29 August 2015]
http://www.unicef.org/media/media_78364.html

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:: Maternal and Neonatal Tetanus elimination in India will spare thousands of deaths: UNICEF
NEW DELHI, 27 August 2015 – The Prime Minister of India, Narendra Modi, announced today during the Call to Action 2015 Summit that Maternal and Neonatal Tetanus (MNT) has been eliminated in India. This landmark achievement will save the lives of countless mothers and their newborns, UNICEF said.

India is one of the most populous countries in the world, with 327 million women of childbearing age and 26 million children born every year.

In 1988, tetanus killed as many as 160,000 young children in India. The drop ever since has been extraordinary. The elimination of MNT as a public health problem means that the annual rate is less than 1 per 1000 live births.

“India has shown strong leadership in overcoming two major threats to the prosperity and future of the nation: polio and now maternal and neonatal tetanus,” said Louis Arsenault, UNICEF Representative. “India’s remarkable achievement in eliminating maternal and neonatal tetanus shows that by making a strong commitment to investing in public health their youngest citizens and mothers will enjoy their right to health, thereby making us all stronger.”

In contrast to other countries, India did not carry out massive tetanus vaccination campaigns. The Government, instead, applied a mix of strategies which included a state by state and system approach starting in 2003 in Andhra Pradesh, with the technical support of UNICEF, WHO and other stakeholders.

Successful measures included providing cash incentives to families for delivering the baby in a health facility, training more skilled birth attendants and strengthening the institutional health delivery systems including the National Rural Health Mission (NRHM). In addition, there was a systematic vaccination of pregnant women attending antenatal care with Tetanus Toxoid (TT); and intensive behaviour change communication targeting communities to reduce harmful cord care practices.

These crucial steps have played a key role in eliminating the disease, contributing significantly to progress in the effort to save the lives of children under the age of five, most of whom die from preventable causes…