Vaccines and Global Health: The Week in Review 23 July 2016

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_23 July 2016

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

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

Vaccines and Global Health: The Week in Review 16 July 2016

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_16 July 2016

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

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
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.

.
David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

WHO: Global immunization coverage sustained in past 5 years

WHO: Global immunization coverage sustained in past 5 years
Geneva, 15 July 2016
The latest WHO and UNICEF data on global immunization coverage show that 86% of the world’s children received the required 3 doses of diphtheria-tetanus-pertussis containing vaccines (DTP3) in 2015, a coverage level that has been sustained above 85% since 2010.

As a result, the number of children who did not receive routine vaccinations has dropped to an estimated 19.4 million, down from 33.8 million in 2000.1

However, this progress falls short of global immunization targets of the Global Vaccine Action Plan (GVAP) for the Decade of Vaccines of achieving 90% or more DTP3 vaccination coverage at the national level and 80% or more in all districts2 in all countries by 2015.

Gaps in immunization coverage
Among the 194 WHO Member States, 126 countries achieved and sustained the 90% immunization target for DTP3, up from 63 in 2000. Many of these countries, especially the low and middle income countries, need to continue strengthening their health systems as they add vaccines to their national programmes so that coverage with all vaccines reach and sustain at the 90% or more target.

Countries such as Congo, Guatemala, Iraq, Mauritania, Philippines and South Sudan have experienced recent decline in coverage due to under-investments in national immunization programmes, vaccine stock-outs, disease outbreaks or conflicts and have not been able to establish or maintain strong health systems that are needed to sustainably deliver vaccination services to reach and sustain high immunization coverage.

Six countries had less than 50% coverage with DTP3 in 2015, many of which are fragile states and affected by emergencies: Central African Republic, Equatorial Guinea, Somalia, South Sudan, Syrian Arab Republic and Ukraine.

Inequities in immunization coverage
In addition to generating estimates of national immunization coverage, WHO and UNICEF also collect and report data on coverage at subnational levels. National coverage estimates often mask large inequities in coverage within countries. Achieving high and equitable coverage requires targeted actions at subnational levels.

There were 158 countries that reported coverage estimates at the district level for 2015. While WHO and UNICEF estimates showed that 126 countries had DTP3 coverage of 90% or more at the national level, only 90 countries reported subnational coverage. Of these, only 53 countries had coverage of 80% or more in all districts. Worldwide, of the 32201 districts from which data were available, 25% had coverage below 80%; the proportion could be higher given the nature and quality of the administrative coverage data at the district level.

WHO and UNICEF are increasing efforts to gather subnational coverage data and support countries in improving the quality and use of the subnational coverage data to take actions to achieve high and equitable immunization coverage.

Introducing under-utilized vaccines
The updated WHO/UNICEF estimates also show that coverage with vaccines other than DTP, has improved. Worldwide, the number of children protected against hepatitis B is high and increasing steadily. In 2000, just 29% of children received three doses of vaccine against the viral disease; this has increased to 84% in 2015. However, more still needs to be done to ensure that all infants receive a hepatitis B vaccine dose within their first 24 hours of life.

Only three countries ─ China, Russia and Thailand ─ have yet to introduce Haemophilus influenzae type b (Hib) vaccine, a globally recommended vaccine. Global coverage of Hib vaccine is 64%. However, in countries that are using the vaccine in their national immunization programmes, coverage is similar to DTP3. Generally, Hib and DTP vaccines are used together in combination vaccines, which help to achieve the same levels of coverage as DTP in countries using the vaccine.

The number of countries using new vaccines such as rotavirus and pneumococcal conjugate vaccine has increased, but challenges remain.

While 128 countries introduced pneumococcal vaccine in national immunization programmes, global coverage for three doses of the vaccine reached just 37% in 2015. Among the middle income countries, the vaccination coverage is only at 24% with 58 out of 104 countries using the vaccine in their national programmes. However, vaccination coverage in low income countries is at 68% with 24 out of 31 countries using the vaccine, mainly with support from Gavi, the Vaccine Alliance and 84% in high income countries, with 45 out of 57 countries using the vaccine.

Additionally, rotavirus vaccine was introduced in 81 countries and global coverage reached 23% in 2015. This also shows under-performance in middle income countries, where vaccination coverage only reached 16% with 44 out of 104 middle income countries using the vaccine; compared to 44% vaccination coverage in low income countries with 18 out of 31 countries using the vaccine, also mainly with Gavi’s support; and 40% vaccination coverage in high income countries with 19 out of 57 countries using the vaccine.

Tracking global plan
In October 2016, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) will review progress against the GVAP targets, including the immunization coverage targets, and provide its assessment of progress and recommendations for corrective actions for discussion at the World Health Assembly in May 2017.
Note
Since 2000, WHO and UNICEF jointly produce national immunization coverage estimates for each of the 194 WHO Member States on an annual basis. In addition to producing the immunization coverage estimates for 2015, the WHO and UNICEF estimation process revises the entire historical series of immunization data with the latest available information. The 2015 revision covers 35 years from 1980 to 2015.

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Immunization coverage
WHO Fact sheet – 15 July 2016

Zika virus [to 16 July 2016]

Zika virus [to 16 July 2016]
Public Health Emergency of International Concern (PHEIC)
http://www.who.int/emergencies/zika-virus/en/

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Zika situation report – 14 July 2016
Full report: http://apps.who.int/iris/bitstream/10665/246222/1/zikasitrep14Jul16-eng.pdf?ua=1
[No significant new content]

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Zika Open [to 16 July 2016]
[Bulletin of the World Health Organization]
:: All papers available here
RESEARCH IN EMERGENCIES
Antisense inhibition of selenoprotein synthesis by Zika virus may contribute to neurological disorders and microcephaly by mimicking SePP1 knockout and the genetic disease progressive cerebello-cerebral atrophy
– Ethan Will Taylor & Jan A. Ruzicka
Posted: 13 July 2016
http://dx.doi.org/10.2471/BLT.16.182071

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CDC/ACIP [to 16 July 2016]
http://www.cdc.gov/media/index.html
Media Statement
FRIDAY, JULY 15, 2016
First female-to-male sexual transmission of Zika virus infection reported in New York City
The New York City report of female-to-male sexual transmission of Zika virus infection is the first documented case of sexual transmission of Zika from a woman to her sex partner……

Media Statement
THURSDAY, JULY 14, 2016
CDC adds St. Eustatius to interim travel guidance related to Zika virus
CDC is working with other public health officials to monitor for ongoing Zika virus? transmission. Today, CDC posted a Zika virus travel notice for St. Eustatius.

Media Statement
WEDNESDAY, JULY 13, 2016
CDC Models Risk of Zika Virus Importation Resulting from Travel to the 2016 Olympic and Paralympic Games
According to the Brazilian Tourism Board, approximately 350,000 – 500,000 international visitors and athletes from 207 countries are expected to travel to Rio de Janeiro, Brazil for the 2016 Olympic…

EBOLA/EVD [to 16 July 2016]

EBOLA/EVD [to 16 July 2016]
“Threat to international peace and security” (UN Security Council)

[Editor’s Note:
We deduce that WHO has suspended issuance of new Situation Reports after resuming them for several weekly cycles. The most recent report posted is EBOLA VIRUS DISEASE – Situation Report – 10 JUNE 2016 ]

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IOM / International Organization for Migration [to 16 July 2016]
http://www.iom.int/press-room/press-releases

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07/15/16
IOM Guinea Launches Community Event-Based Surveillance Activities in Forest Region
Guinea – IOM, in partnership with Plan International, this week launched a Community Event-Based Surveillance (CEBS) system in the Forest region prefecture of Macenta on the Guinea-Liberia border to combat the spread of Ebola. The project is funded by the US Centers for Disease Control (CDC).

POLIO [to 16 July 2016]

POLIO [to 16 July 2016]
Public Health Emergency of International Concern (PHEIC)

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Polio this week as of 12 July 2016
:: The Technical Advisory Group on polio eradication for Afghanistan met in Kabul on 11-13 July and reviewed progress towards interrupting the transmission of polio and discussed solutions to upcoming challenges.

:: The Pakistan Technical Advisory Group met in Islamabad on 28-29 June and concluded that a united focus between partners and enhanced community ownership of programme interventions has been key to continuing progress in the country towards eradicating polio. More.[see below]

:: The Independent Monitoring Board will meet in London next week to assess progress towards polio eradication.

Selected Country Levels Updates [excerpted]
No new cases at country level reported.

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Technical Advisory Group Meets to Assess Eradication Efforts in Pakistan
Experts gathered in Pakistan in June to review progress and to renew plans for the coming months.
Monday, July 04, 2016
The Technical Advisory Group (TAG) on polio eradication has met in Islamabad for the second time this year to discuss progress, remaining obstacles and opportunities as Pakistan edges closer to achieving the goal of stopping transmission of the virus.

Senior leaders from across the Global Polio Eradication Initiative joined Federal and Provincial team leads as they briefed TAG members on the progress made since the last meeting in January 2016. The group also assessed plans for updates to the 2016/17 National Emergency Action Plan leading into the next low transmission season.

Progress in Pakistan
As of the end of June 2016, 12 cases of wild poliovirus type 1 have been reported, a 57 per cent reduction from the same time in 2015. This improvement was attributed by the Global Polio Eradication Initiative to the united front now being presented by the team of partners working together under the leadership of the government through a network of Emergency Operation Centers. Progress was also ascribed to other strategies, such as the expansion of community based vaccination and health camps, which have helped with enhancing community ownership of the programme interventions. In addition, thousands of trained and dedicated frontline workers have ensured that 280 million children have received polio drops during nine campaigns conducted in the low transmission season. The successful campaigns of the inactivated polio vaccine in targeted high risk areas of Karachi, Khyber Peshawar and Quetta block helped in quick immunity boosting of approximately 3 million vulnerable children…

Yellow Fever [to 16 July 2016]

Yellow Fever [to 16 July 2016]
http://www.who.int/emergencies/yellow-fever/en/

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Yellow Fever – Situation Report – 15 July 2016
Full Report: http://apps.who.int/iris/bitstream/10665/246224/1/yellowfeversitrep-15Jul16-eng.pdf?ua=1
[No significant new content]

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WHO: The many challenges to fighting yellow fever in Democratic Republic of the Congo
11 July 2016
The Democratic Republic of the Congo faces many challenges in responding to the yellow fever outbreak. Access to areas along the Angolan border is extremely difficult and there is a lack of essential resources, such as fuel to run electricity generators.

WHO is working with the government and partners to organize a mass vaccination campaign of approximately 3 million people along the border with Angola. This photo story highlights some of the challenges in providing health services to this remote area.