Title: Immunization: The Bold and the New, The Tried and the True
1Immunization The Bold and the New,The Tried
and the True
- Rebecca Fields, IMMUNIZATIONbasics
- Youssef Tawfik, USAID/Global/HIDN
- October 27, 2006, USAID Mini-University
2Immunization 101 Vaccines usually included in
national immunization programs
- BCG against Tb
- DTP - diphtheria, tetanus,
- pertussis (whooping cough)
- Polio
- Measles
- Hepatitis B
- Yellow fever
- Haemophilus influenzae type b (Hib)
3Routine Immunization Schedule
4Global Immunization Goalsas per Global
Immunization Vision and Strategy (GIVS)
- By 2010 or earlier
- Increase coverage to gt 90 at national level and
gt 80 in every district - Reduce measles mortality by 90 compared to 2000.
- By 2015 or earlier
- Sustain coverage. The vaccination coverage goal
reached in 2010 will have been sustained. - Reduce morbidity and mortality. Global childhood
cases and deaths due to vaccine-preventable
diseases will be reduced by gt two thirds
compared to 2000 levels.
5Global and regional trends in immunization
coverage (DTP3)
6UNICEF Expenditures on Immunization, 1990-1998
7Reported DPT3 Coverage African Region, 2003 - 2005
2003
2004
Nov. 2005
EMRO
gt 80
Source 2003-2004 JRF 2005 EPI
Monthly report
50 - 79
lt50
8Coverage varies within country Example
Madagascar, 2003
9Comparing Vaccination Coverage Rates from Routine
Data and Surveys
10Full Immunization Rates by Socio-economic Status
11Immunization coverage is not enough !
Was potent vaccine administered safely and
efficiently in a timely manner before exposure to
disease?
12Cost Profile of Immunization Programs
13(No Transcript)
14Planning vaccination services
15(No Transcript)
16Quality of ServicesSafety of injections
- 12 billion injections annually in developing
countries - Over 50 unsafe ? HIV, Hepatitis B, Hepatitis C
- Immunization accounts for 10 of total but led
push for safe injection
17Disease Control Initiatives Supplemental
Immunization
- Polio eradication
- Measles mortality reduction/measles elimination
- Maternal and neonatal tetanus elimination
18Features common to all disease control initiatives
- Campaigns to give EXTRA doses above beyond
routine doses - Increased disease surveillance
- A strong base of routine immunization
19Polio Eradication
- WHA resolution 1988 to eradicate polio
- Huge decrease in cases, from 350,000 to 1500 so
far in 2006 - Great majority in a few endemic countries
Afghanistan, India, Nigeria, Pakistan - Exportation to other countries a major issue
20(No Transcript)
21Projected Impact of Different Measles
Vaccination Strategies on Measles Mortality in
Africa, 2001-2025
Constant routine
Catch-up Constant routine
Strengthen routine only
Strengthen routine catch-up follow-ups
Note routine strengthening assumes 5 annual
improvement in routine immunization coverage
until 95
22(No Transcript)
23Global Estimated Deaths Occurring and Prevented,
2000Measles, Neonatal Tetanus and Pertussis
24Immunization is a good investment
- In high mortality environments, immunization of
each 1000 infants prevents - 30 deaths from measles
- 10 deaths from pertussis
- 5 cases of lifelong disability from polio
- Immunization of each 1000 women prevents
- 5 deaths from neonatal tetanus
25Vaccines could save as many as 17 million
lives/year
26New Vaccines against Vaccine- Preventable
Diseases
27Global Alliance for Vaccines and Immunization
(GAVI Alliance)
- Improve access to sustainable immunization
services - Expand use of all existing cost-effective
vaccines - Accelerate RD and introduction of new vaccines
- Assure injection safety for immunization
28Categories of funding available to countries
through GAVI
- Immunization Services Support cash support at
20/child immunized with DTP3 - New and under-utilized vaccines
- Hib, Hep B, Yellow Fever
- Injection safety 5 year limit
- Health System Support new, to address broad
obstacles in the health system
29Results Reaching More Children
Cumulative Number of Children Reached in
GAVI-Supported Countries
Source WHO/UNICEF
projected
Source WHO/UNICEF
30Prices of Newer Vaccines Increase Vaccine Costs
Exponentially for Under-ones
31An ounce of prevention is worth a pound of
cureThe first cost-benefit ratio (116)