Europe retains polio-free status

The European Regional Certification Commission for Poliomyelitis Eradication (RCC) announced that Europe will retain its polio-free status after the importation of wild poliovirus type 1 in 2010. At their 25th meeting in Copenhagen, Denmark this week, the RCC “noted that wild poliovirus transmission has been interrupted. No new cases have been reported since September 2010 because countries have taken effective action.” Zsuzsanna Jakab, WHO Regional Director for Europe, commented, “The RCC decision is tremendous news for the Region and a credit to all the Member States and partners that individually, collectively and promptly combated the first and largest outbreak of poliomyelitis the Region has seen since it was declared polio free in 2002. I am also very pleased that the hard work and personal commitments of the presidents, prime ministers and health ministers have produced this success, which shows the importance and value of political commitment and joint action. The WHO Regional Office for Europe will continue to work with Member States so that Europe remains vigilant and the polio-free status of the Region is sustained”. In 2010, four countries, Kazakhstan, the Russian Federation, Tajikistan and Turkmenistan, reported 475 laboratory-confirmed cases of wild poliovirus type 1, with 30 deaths.,-but-constant-vigilance-is-needed

IOM Consensus Report: Adverse Effects of Vaccines

IOM Consensus Report: Adverse Effects of Vaccines: Evidence and Causality

Released: August 25, 2011
Board: Board on Population Health and Public Health Practice

Abstract: Immunizations are a cornerstone of the nation’s efforts to protect people from a host of infectious diseases. Though generally very rare or minor, there are side effects, or “adverse effects,” associated with some vaccines. Importantly, some adverse events following a vaccine may be due to coincidence and are not caused by the vaccine. To make this distinction, researchers use evidence to determine if adverse events following vaccination are causally linked to a specific vaccine; if so, these events are referred to as adverse effects. The Health Resources and Services Administration asked the IOM to review a list of adverse events associated with eight vaccines—varicella zoster, influenza (except 2009 H1N1), hepatitis B, HPV, MMR, hepatitis A, meningococcal, and those that contain tetanus—and evaluate the scientific evidence about the event–vaccine relationship. The IOM committee appointed to this task was not asked to assess the benefits or effectiveness of vaccines but only the risk of specific adverse events.

Using epidemiologic and mechanistic evidence, the committee developed 158 causality conclusions and assigned each relationship between a vaccine and an adverse health problem to one of four categories of causation:
– Evidence convincingly supports a causal relationship
– Evidence favors acceptance of a causal relationship
– Evidence favors rejection of a causal relationship
– Evidence is inadequate to accept or reject a causal relationship

The committee finds that evidence convincingly supports a causal relationship between some vaccines and some adverse events—such as MMR, varicella zoster, influenza, hepatitis B, meningococcal, and tetanus-containing vaccines linked to anaphylaxis. Additionally, evidence favors rejection of five vaccine-adverse event relationships, including MMR vaccine and autism and inactivated influenza vaccine and asthma episodes. However, for the majority of cases (135 vaccine-adverse event pairs), the evidence was inadequate to accept or reject a causal relationship. Overall, the committee concludes that few health problems are caused by or clearly associated with vaccines.

Supporting content:
– Graphic: Strength of Evidence that Determined the Causality Conclusions (PDF, HTML)

– Press Release (HTML)

– Report Brief (PDF, HTML)

– Table: Summary of Causality Conclusions (PDF)

Japan International Cooperation Agency and Gates Foundation announce polio partnership

The Japan International Cooperation Agency (JICA) and the Bill & Melinda Gates Foundation announced “a strategic partnership to ensure continued progress in the fight against polio,” including “an innovative financing agreement to support the polio campaign in Pakistan.”  The financing agreement “represents a significant contribution towards the goal of eradication of polio in Pakistan. Based on the Global Polio Eradication Initiative’s (GPEI) current cost estimates, this 4.9 billion JPY (approximately $65 million) ODA Loan(1) to the government of Pakistan will help ensure that polio eradication activities in Pakistan are financed through 2013.”

Bill Gates commented, “This partnership comes at a critical time for Pakistan and will help us achieve our shared goal of a polio-free world. Japan’s remarkable commitment will benefit generations of children in Pakistan and throughout the world.” The announcement noted that Japan’s ODA loan will provide the country with funds for oral polio vaccine, immunization workers, and vaccination activities across the country and along the Pakistan/Afghanistan border. It will also involve working in partnership with stakeholders such as the World Bank for co-financing as well as the United Nations Children’s Fund (UNICEF) for vaccine procurement and the World Health Organization (WHO) for service delivery of the polio campaign.

The loan is “underpinned by an innovative financing approach referred to as a “Loan Conversion” mechanism. According to this model, the Gates Foundation will repay the credit to JICA on behalf of the Pakistani government if the project is successfully implemented. The aim of this mechanism is to support the government of Pakistan’s commitment to polio eradication without imposing a financial burden.”–melinda-gates-foundation-announce-partnership-on-polio-eradication-127978458.html

HHS: US$137M to states “to strengthen the public health infrastructure”

The U.S. HHS department awarded US$137 million to states to “to strengthen the public health infrastructure and provide jobs in core areas of public health. Awarded in nearly every state, the grants enhance state, tribal, local and territorial efforts to provide tobacco cessation services, strengthen public health laboratory and immunization services, (and) prevent healthcare-associated infections…”   The awards include:

– US$1 million to further enhance the nations’ public health laboratories by hiring and preparing scientists for careers in public health laboratories, providing training for scientists, and supporting public health initiatives related to infectious disease research.

– More than US$42 million to support: improvements to the Immunization Information Systems (registries) and other immunization information technologies; development of systems to improve billing for immunization services; planning and implementation of adult immunization programs; enhancement of vaccination capacity located in schools; and evaluations of the impact on disease of recent vaccine recommendations for children and adolescents.

– US$2.6 million to the Emerging Infections Programs around the country to continue improvement in disease monitoring, professional development and training, information technology development, and laboratory capacity.

– US$9.2 million to eight national non-profit professional public health organizations to assist state, tribal, local, and territorial health departments in adopting effective practices that strengthen their core public health systems and service delivery. They will also enhance the workforce by providing jobs in critical disciplines of epidemiology and informatics, thus attracting new talent to public health.

A full list of grantees is available at:

Saudi Ministry of Health: requirements the Hajj and Umra season

    The Saudi Ministry of Health issued the entry visa requirements and other recommendations for the Hajj and Umra season in 2011, specifying health conditions for travelers to the Kingdom of Saudi Arabia for the pilgrimage to Mecca (Hajj). The Saudi Ministry of Health “plays a critical role in the management of the annual Hajj pilgrimage which occurs over a five-day period during “Dhul-Hijjah,” the final month of the Islamic calendar and is the world’s largest annual mass gathering, attracting 2-3 million pilgrims every year.”

Highlights from the full guidelines [] include:

– Yellow Fever: All travelers arriving from countries or areas at risk of yellow fever must present a valid yellow fever vaccination certificate showing that the person was vaccinated at least 10 days previously and not more than 10 years before arrival at the border.

– Meningococcal Meningitis: Visitors arriving for the purpose of Umra or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and not less than 10 days before arrival in to Saudi Arabia.

– Poliomyelitis: All travelers arriving from polio-endemic countries and re-established transmission countries should receive 1 dose of OPV.

– Seasonal Influenza: International pilgrims should be vaccinated against seasonal influenza before arrival into Saudi Arabia with WHO approved strains specific to the northern or southern hemispheres. In Saudi Arabia, seasonal influenza vaccine is recommended for internal pilgrims, particularly those with pre-existing health conditions, and all staff working in the Hajj premises.

– Health Education: Health authorities in countries of origin are required to provide information to pilgrims on infectious diseases symptoms, methods of transmission, complications, and means of prevention.

– International Outbreaks Responses: Updating immunization against vaccine-preventable diseases in all travelers is strongly recommended.

His Excellency Dr. Abdullah Al Rabeeah, Saudi Minister of Health, stated, “The Department of Preventive Medicine at the Ministry of Health develops and updates these guidelines every year in close coordination with the International Health Regulations Coordination Department at WHO. This is carried out after critical review of the global situation of endemic and emerging communicable diseases, to ensure the establishment of evidence based guidelines to protect and prevent disease transmission among pilgrims and the global community.”

Gates Foundation: Round 8 of Grand Challenges Explorations

   The Bill & Melinda Gates Foundation announced Round 8 of its Grand Challenges Explorations, “a US$100 million grant initiative to encourage innovation in global health and development research.” The initiative “offers scientists, inventors, and entrepreneurs from around the world the opportunity to win $100,000 grants to pursue unconventional ideas that could transform health and agricultural development in the world’s poorest countries.” The topics in this round are:

– Protect Crop Plants from Biotic Stresses From Field to Market

– Explore Nutrition for Healthy Growth of Infants and Children

– Apply Synthetic Biology to Global Health Challenges

– Design New Approaches to Optimize Immunization Systems

– Explore New Solutions in Global Health Priority Areas