Vaccines and Global Health: The Week in Review :: 21 December 2019

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

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

Vaccines and Global Health: The Week in Review will resume publication on 4 January 2020 after an end-of-year holidays break.

Drop in cholera cases worldwide, as key endemic countries report gains in cholera control

Milestones :: Perspectives :: Research


Drop in cholera cases worldwide, as key endemic countries report gains in cholera control
19 December 2019 WHO News release
The number of cholera cases decreased globally by 60% in 2018, the World Health Organization (WHO) announced in a report that points to an encouraging trend in cholera prevention and control in the world’s major cholera hotspots, including Haiti, Somalia and the Democratic Republic of the Congo.

“The decrease we are seeing in several major cholera-endemic countries demonstrates the increased engagement of countries in global efforts to slow and prevent cholera outbreaks and shows the vital role of mass cholera vaccination campaigns,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We continue to emphasize, however, that the long-term solution for ending cholera lies in increasing access to clean drinking water and providing adequate sanitation and hygiene.”

There were 499,447 cases of cholera and 2990 deaths in 2018, according to reports from 34 countries. While outbreaks are still ongoing in various countries, the case load represents a significant downward trend in cholera transmission that has continued into 2019, according to data collected by WHO.

“The global decrease in case numbers we are observing appears to be linked to large-scale vaccination campaigns and countries beginning to adopt the Global Roadmap to 2030 strategy in their national cholera action plans,” said Dr Dominique Legros, who heads WHO’s cholera programme in Geneva. “We must continue to strengthen our efforts to engage all cholera-endemic countries in this global strategy to eliminate cholera.”

Nearly 18 million doses of Oral Cholera Vaccine (OCV) were shipped to 11 countries in 2018. Since the OCV stockpile was created in 2013, almost 60 million doses have been shipped worldwide. Gavi, the Vaccine Alliance, has provided funding for purchase of the vaccine and financial support for the global vaccination drives….

New pneumococcal vaccine from Serum Institute of India achieves WHO prequalification

Milestones :: Perspectives :: Research


New pneumococcal vaccine from Serum Institute of India achieves WHO prequalification
December 19, 2019 by Lauren Newhouse
This milestone marks a key step toward improving pneumococcal conjugate vaccine affordability and enabling sustainable access for low- and middle-income countries
Pune, India and Seattle, United States, December 19, 2019—PNEUMOSIL®, a vaccine against a leading cause of deadly childhood pneumonia—the pneumococcus bacterium—has achieved prequalification by the World Health Organization (WHO). Developed though a collaboration spanning over a decade between Serum Institute of India, Pvt., Ltd. (SIIPL) and PATH and with funding from the Bill & Melinda Gates Foundation, the vaccine is expected to provide protection for children on par with other pneumococcal conjugate vaccines at a price that is more affordable for low- and middle-income countries…

Global Vaccine Action Plan review and Lessons Learned Report

Milestones :: Perspectives :: Research


Global Vaccine Action Plan review and Lessons Learned Report
WHO/IVB/19.07 2019 :: 44 pages
Strategic Advisory Group of Experts on Immunization. The Global Vaccine Action Plan 2011-2020.
Report PDF:
Preface [excerpt]
…This report expands on the annual assessment reports prepared by the SAGE Decade of Vaccines Working Group. It considers the entire decade, drawing on a review of progress toward GVAP’s goals and objectives as well as the perceptions of stakeholders captured through three surveys, which elicited 310 responses from immunization stakeholders, and two sets of semi-structured interviews with 80 stakeholders undertaken in 2017–2019. It also incorporates valuable insights from Working Group members and the representatives of partner organizations and WHO regional offices who have made important contributions to annual
assessments. Annex 3 provides links to the full body of evidence used to generate this report.
This document reflects on the lessons learned from GVAP, and makes recommendations for the development, content and implementation of the next global immunization strategy.


A post-2020 global immunization strategy should:
1. Build on GVAP’s lessons learned, ensuring more timely and comprehensive implementation at global, regional and national levels

2. Have a key focus on countries:
2a. Place countries at the centre of strategy development and implementation to ensure context specificity and relevance
2b. Strengthen country-led evidence-based decision-making
2c. Encourage the sourcing and sharing of innovations to improve programme performance
2d. Promote use of research by countries to accelerate uptake of vaccines and vaccine technologies and to improve programme performance

3. Maintain the momentum towards GVAP’s goals:
3a. Incorporate key elements of GVAP, recognizing its comprehensiveness and the need to
sustain immunization’s successes each and every year
3b. Add a specific focus on humanitarian emergencies, displacement and migration, and chronic fragility
3c. Encourage stronger integration between disease-elimination initiatives and national immunization programmes 3d. Encourage greater collaboration and integration within and beyond the health sector

4. Establish a governance model better able to turn strategy into action:
4a. Create a robust and flexible governance structure and operational model based on closer collaboration between partners at all levels
4b. Incorporate the flexibility to detect and respond to emerging issues
4c. Develop and maintain a strong communications and advocacy strategy

5. Promote long-term planning for the development and implementation of novel vaccine and other preventive innovations, to ensure populations benefit as rapidly as possible

6. Promote use of data to stimulate and guide action and to inform decision-making

7. Strengthen monitoring and evaluation at the national and sub-national level to promote greater accountability

Highest-Ever Funding Allocations Announced to Fight AIDS, TB and Malaria – Global Fund

Milestones :: Perspectives :: Research


Highest-Ever Funding Allocations Announced to Fight AIDS, TB and Malaria – Global Fund
18 December 2019
GENEVA − Following a record-breaking Replenishment in October 2019, the Global Fund today announced its largest-ever funding allocations for eligible countries to fight AIDS, tuberculosis and malaria and build systems for health over the next three years.

The allocations include US$12.71 billion for country allocations and US$890 million for catalytic investments for the period beginning 1 January 2020 – 23% more than for the previous three-year period. The funds will help save 16 million lives, cut the mortality rate for the three diseases in half and get the world back on track to end the epidemics of AIDS, tuberculosis and malaria by 2030.

“World leaders came together at our Replenishment and made commitments to step up the fight to end these epidemics by 2030,” said Peter Sands, Executive Director of the Global Fund. “Now the real work begins. Our allocations will allow partners to expand programs that work, and to find innovative solutions for new challenges. In addition to more money, we need better collaboration and more effective programs.”…

Biocompatible near-infrared quantum dots delivered to the skin by microneedle patches record vaccination

Featured Journal Content


Science Translational Medicine
18 December 2019 Vol 11, Issue 523
Research Articles
Biocompatible near-infrared quantum dots delivered to the skin by microneedle patches record vaccination
By Kevin J. McHugh, Lihong Jing, Sean Y. Severt, Mache Cruz, Morteza Sarmadi, Hapuarachchige Surangi N. Jayawardena, Collin F. Perkinson, Fridrik Larusson, Sviatlana Rose, Stephanie Tomasic, Tyler Graf, Stephany Y. Tzeng, James L. Sugarman, Daniel Vlasic, Matthew Peters, Nels Peterson, Lowell Wood, Wen Tang, Jihyeon Yeom, Joe Collins, Philip A. Welkhoff, Ari Karchin, Megan Tse, Mingyuan Gao, Moungi G. Bawendi, Robert Langer, Ana Jaklenec
Science Translational Medicine18 Dec 2019 Full Access
On the record
Vaccines prevent disease and save lives; however, lack of standardized immunization recordkeeping makes it challenging to track vaccine coverage across the world. McHugh et al. developed dissolvable microneedles that deliver patterns of near-infrared light-emitting microparticles to the skin. Particle patterns are invisible to the eye but can be imaged using modified smartphones. By codelivering a vaccine, the pattern of particles in the skin could serve as an on-person vaccination record. Patterns were detected 9 months after intradermal delivery of microparticles in rats, and codelivery of inactivated poliovirus led to protective antibody production. Discrete microneedle-delivered microparticle patterns in porcine and pigmented human skin were identifiable using semiautomated machine learning. These results demonstrate proof of concept for intradermal on-person vaccination recordkeeping.
Accurate medical recordkeeping is a major challenge in many low-resource settings where well-maintained centralized databases do not exist, contributing to 1.5 million vaccine-preventable deaths annually. Here, we present an approach to encode medical history on a patient using the spatial distribution of biocompatible, near-infrared quantum dots (NIR QDs) in the dermis. QDs are invisible to the naked eye yet detectable when exposed to NIR light. QDs with a copper indium selenide core and aluminum-doped zinc sulfide shell were tuned to emit in the NIR spectrum by controlling stoichiometry and shelling time. The formulation showing the greatest resistance to photobleaching after simulated sunlight exposure (5-year equivalence) through pigmented human skin was encapsulated in microparticles for use in vivo. In parallel, microneedle geometry was optimized in silico and validated ex vivo using porcine and synthetic human skin. QD-containing microparticles were then embedded in dissolvable microneedles and administered to rats with or without a vaccine. Longitudinal in vivo imaging using a smartphone adapted to detect NIR light demonstrated that microneedle-delivered QD patterns remained bright and could be accurately identified using a machine learning algorithm 9 months after application. In addition, codelivery with inactivated poliovirus vaccine produced neutralizing antibody titers above the threshold considered protective. These findings suggest that intradermal QDs can be used to reliably encode information and can be delivered with a vaccine, which may be particularly valuable in the developing world and open up new avenues for decentralized data storage and biosensing.