Vaccines: The Week in Review 27 October 2012

Editor’s Notes:

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World Polio Day – 24 October 2012: Statements/Media Releases

World Polio Day – 24 October 2012: Statements/Media Releases

– GAVI Statement:

– GAVI Commentary: Building on India’s Success on Polio  by Seth Berkley [see Wall Street Journal in Media Watch below]

– UNICEF: Vaccine suppliers integral to achieving polio free world
COPENHAGEN, 24 October 2012 – On World Polio Day, UNICEF has commended the continued contribution of industry to global polio eradication efforts, particularly in helping meet a 410 million dose gap in 2012 and preventing a 300 million dose gap in 2013.

“This year has proven challenging in terms of oral polio vaccine (OPV) supply due to shortfalls from a few suppliers,” Shanelle Hall, Director UNICEF Supply, said.

Offers received from manufacturers in response to the UNICEF-issued OPV tender for the period covering 2013-2017 identified a gap of approximately 300 million doses for the first half of 2013, which would have seriously affected planned polio campaigns.

“The 2013 supply shortfall has been actively addressed through collaborative efforts by industry to increase or fast-track availability, and coordination with global partners to accelerate WHO prequalification of new products and adjust activity schedules. Sufficient OPV will now be available to meet programmatic requirements for the period,” Ms. Hall added.

UNICEF has also welcomed manufacturer’s contribution to affordable vaccine pricing. Through efforts by multiple manufacturers, cost savings equivalent to nearly 100 million doses are expected over the next five years.

“In times of increasing financial constraint and uncertainty, these savings will have significant impact as we make the final push towards eradicating this disease from the world. Vaccine suppliers, including BioFarma, GlaxoSmithKline, Haffkine, Novartis, Sanofi Pasteur, and the Serum Institute of India, are key partners to the Global Polio Eradication Initiative (GPEI),” said Ms. Hall.

The OPV market is complex and changing, and requires close management and coordination with countries and global programme partners, as well as with industry in order to achieve a polio-free world.

“As global efforts edge closer to realizing this goal, UNICEF remains committed to working with industry to secure OPV at affordable prices, and to ensure potential supply-related challenges are minimised,” she said…

GPEI Update: Polio this week – As of 24 Oct 2012

Update: Polio this week – As of 24 Oct 2012
Global Polio Eradication Initiative

[Editor’s Extract]
– World Polio Day, October 24: Polio eradication partners around the world are marking the first World Polio Day since India was removed from the list of countries with active transmission of wild poliovirus. This development opened up a historic opportunity to complete polio eradication in the remaining endemic countries, powered by the World Health Assembly declaration of an ‘emergency for global public health’ and implemented through national emergency programmes run by the governments of Afghanistan, Nigeria and Pakistan.

– Since World Polio Day last year, the number of new cases of polio has declined by 64% (from 489 at this time last year to 175 this year).

– The next Independent Monitoring Board (IMB) meeting will take place next week in London, United Kingdom. During its deliberations, the IMB will review the latest status of the global polio eradication effort and progress and challenges with implementing national polio emergency action plans. The IMB’s meeting report is anticipated to be finalized in November.

– One new WPV case was reported in the past week (WPV1 from Kandahar), bringing the total number of cases for 2012 to 26. The most recent case had onset of paralysis on 1 October (WPV1 from Paktya).
– The ‘Ending Polio Is My Responsibility’ social mobilization and media campaign continues to be rolled out, with public service announcements airing on TV and radio, and billboards set up around the country.

– Two new WPV cases were reported in the past week (WPV1s from Katsina), bringing the total number of cases for 2012 to 97. One of the newly-reported cases is the most recent case in the country, and had onset of paralysis on 23 September.

– Three new WPV cases were reported in the past week (two WPV1s from Khyber Pakhtunkhwa – KP – and one WPV1 from Balochistan), bringing the total number of cases for 2012 to 47. The newly-reported case from Balochistan is the most recent in the country, and had onset of paralysis on 2 October.
– Additionally, one new cVDPV2 case was reported, in Balochistan, from September.

Horn of Africa
– Outbreak response is ongoing in Kenya and parts of Somalia, following recent confirmation of a cVDPV2 outbreak in a Somali refugee camp in Dadaab, Kenya, and Kismayo, south-central Somalia.

WHO: Fact Sheet – Poliomyelitis October 2012

WHO: Fact Sheet – Poliomyelitis
Fact sheet N°114
October 2012

Key facts [Excerpt]
– Polio (poliomyelitis) mainly affects children under five years of age.

– One in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.

– Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 650 reported cases in 2011. The reduction is the result of the global effort to eradicate the disease.

– In 2012, only three countries (Afghanistan, Nigeria and Pakistan) remain polio-endemic, down from more than 125 in 1988.

– As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200 000 new cases every year, within 10 years, all over the world.

– In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems…

Weekly Epidemiological Record (WER) for 26 October 2012

The Weekly Epidemiological Record (WER) for 26 October 2012, vol. 87, 43 (pp. 413–420) includes:
– Outbreak news
. Dengue fever in Madeira, Portugal
. Marburg haemorrhagic fever, Uganda
– Progress towards poliomyelitis eradication in Chad, January 2011–August 2012
– Monthly report on dracunculiasis cases, January–August 2012

ACIP Meeting Update: 24 October 2012

ACIP Meeting Update: 24 October 2012

CDC Advisory Committee on Immunization Practices Recommends HibMenCY for Infants at Increased Risk for Meningococcal Disease
The Advisory Committee for Immunization Practices voted today 13 to 1, with 1 abstention, to recommend that infants at increased risk for meningococcal disease should be vaccinated with 4 doses of HibMenCY at 2, 4, 6, and 12 through 15 months.  These include infants with recognized persistent complement pathway deficiencies and infants who have anatomic or functional asplenia including sickle cell disease. HibMenCY can be used in infants ages 2 through 18 months who are in communities with serogroup C and Y meningococcal disease outbreaks…

CDC Advisory Committee for Immunization Practices Recommends Tdap Immunization for Pregnant Women
The Advisory Committee for Immunization Practices voted today 14 to 0, with one abstention, to recommend that providers of prenatal care implement a Tdap immunization program for all pregnant women.  Health-care personnel should administer a dose of Tdap during each pregnancy irrespective of the patient’s prior history of receiving Tdap.  If not administered during pregnancy, Tdap should be administered immediately postpartum.

This builds upon a previous recommendation made by ACIP in June 2011 to administer Tdap during pregnancy only to women who have not previously received Tdap. By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. Tdap will also protect the mother at time of delivery, making her less likely to transmit pertussis to her infant. If not vaccinated during pregnancy, Tdap should be given immediately postpartum, before leaving the hospital or birthing center.

The U.S. remains on track to have the most reported pertussis cases since 1959, with more than 32,000 cases already reported along with 16 deaths, the majority of which are in infants…

PAHO: Recommendation Calls for Exploring Collaboration between Public Vaccine Producers in the Americas

PAHO: Recommendation Calls for Exploring Collaboration between Public Vaccine Producers in the Americas

PAHO’s Technical Advisory Group (TAG) on Vaccine-preventable Diseases “…recommended that opportunities for collaboration between public vaccine producers in the Americas be explored with a view to incentivizing regional production in order to meet local needs. This recommendation arises from the challenges currently being faced to guarantee a steady supply of priority vaccines and maintain the achievements to date in controlling and eradicating such diseases as poliomyelitis, measles, and rubella.” The Technical Advisory Group recommended that PAHO/WHO convene a working group, bringing together representatives of public vaccine producers in Latin America and the Caribbean, “to identify common areas of activity and draft a regional strategy for vaccine research, development, and production.”

The announcement noted that there are 40 vaccine providers in the world, 15 of which produce 95% of the total output, and 70% of vaccine production takes place in developing countries. In the Americas there are six public sector vaccine manufacturers, located in Argentina, Brazil, Colombia, Cuba, Mexico, and Venezuela. In addition, “the supply of traditional vaccines against polio, yellow fever, and whooping cough (also called pertussis), diphtheria, and tetanus continues to be erratic and often falls short of meeting the needs of the countries in the Region, which acquire them at an affordable price through the PAHO Revolving Fund. These vaccines are still essential.” However, TAG noted in the conclusions of its meeting that “they are no longer of commercial interest to the pharmaceutical companies, which in many cases have ceased to produce them or else have turned their interest toward the preparation of new combined vaccines.”

According to the conclusions of the meeting, “the establishment of agreements for technology transfer between the transnational pharmaceutical industry and producers in the Region has not yet been translated into improved local capacity to produce new vaccines. Hence, there is need for more in-depth analysis of the role that regional producers can play in meeting the needs of the countries of the Americas for high-quality, safe, and effective vaccines.” The PAHO/WHO Technical Advisory Group on Vaccine-preventable Diseases met from October 17 to 19 in Washington, D.C., to examine current issues and make recommendations on vaccination against polio, rotavirus, whooping cough, measles, rubella, and cholera, as well as to consider prospects for ramping up regional vaccine production capacity.