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Abstract

Introduction

As SARS-CoV-2 disproportionately affects adults, the COVID-19 pandemic vaccine response will rely on adult immunisation infrastructures.

Aim

To assess adult immunisation programmes in World Health Organization (WHO) Member States.

Methods

We evaluated country reports from 2018 on adult immunisation programmes sent to WHO and UNICEF. We described existing programmes and used multivariable regression to identify independent factors associated with having them.

Results

Of 194 WHO Member States, 120 (62%) reported having at least one adult immunisation programme. The Americas and Europe had the highest proportions of adult immunisation programmes, most commonly for hepatitis B and influenza vaccines (> 47% and > 91% of countries, respectively), while Africa and South-East Asia had the lowest proportions, with < 11% of countries reporting adult immunisation programmes for hepatitis B or influenza vaccines, and none for pneumococcal vaccines. In bivariate analyses, high or upper-middle country income, introduction of new or underused vaccines, having achieved paediatric immunisation coverage goals and meeting National Immunisation Technical Advisory Groups basic functional indicators were significantly associated (p < 0.001) with having an adult immunisation programme. In multivariable analyses, the most strongly associated factor was country income, with high- or upper-middle-income countries significantly more likely to report having an adult immunisation programme (adjusted odds ratio: 19.3; 95% confidence interval: 6.5–57.7).

Discussion

Worldwide, 38% of countries lack adult immunisation programmes. COVID-19 vaccine deployment will require national systems for vaccine storage and handling, delivery and waste management to target adult risk groups. There is a need to strengthen immunisation systems to reach adults with COVID-19 vaccines.

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/content/10.2807/1560-7917.ES.2021.26.17.2001195
2021-04-29
2021-05-08
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.17.2001195
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References

  1. World Health Organization (WHO). Guiding principles for immunization activities during the COVID-19 pandemic. Geneva: WHO; 2020. Available from: https://apps.who.int/iris/bitstream/handle/10665/331590/WHO-2019-nCoV-immunization_services-2020.1-eng.pdf
  2. Teresa Aguado M, Barratt J, Beard JR, Blomberg BB, Chen WH, Hickling J, et al. Report on WHO meeting on immunization in older adults: Geneva, Switzerland, 22-23 March 2017. Vaccine. 2018;36(7):921-31.  https://doi.org/10.1016/j.vaccine.2017.12.029  PMID: 29336923 
  3. Okwo-Bele JM, Cherian T. The expanded programme on immunization: a lasting legacy of smallpox eradication. Vaccine. 2011;29(Suppl 4):D74-9.  https://doi.org/10.1016/j.vaccine.2012.01.080  PMID: 22486980 
  4. World Health Organization (WHO). Table 1: Summary of WHO Position Papers - Recommendations for Routine Immunization. Geneva: WHO; 2019. Available from: https://www.who.int/immunization/policy/Immunization_routine_table1.pdf
  5. World Health Organization (WHO). Tetanus vaccines: WHO position paper – February 2017. Wkly Epidemiol Rec. 2017;92(6):53-76. PMID: 28185446 
  6. World Health Organization (WHO). Human papillomavirus vaccines: WHO position paper, May 2017. Wkly Epidemiol Rec. 2017;92(19):241-68. PMID: 28530369 
  7. World Health Organization (WHO). WHO/UNICEF Joint Reporting Process. Geneva: WHO; 2013. Available from: https://www.who.int/immunization/monitoring_surveillance/routine/reporting/reporting/en/
  8. Ortiz JR, Perut M, Dumolard L, Wijesinghe PR, Jorgensen P, Ropero AM, et al. A global review of national influenza immunization policies: Analysis of the 2014 WHO/UNICEF Joint Reporting Form on immunization. Vaccine. 2016;34(45):5400-5.  https://doi.org/10.1016/j.vaccine.2016.07.045  PMID: 27646030 
  9. World Health Organization (WHO). Global Vaccine Action Plan 2011-2020. Geneva: WHO; 2013. Available from: https://www.who.int/teams/immunization-vaccines-and-biologicals/strategies/global-vaccine-action-plan/GVAP_doc_2011_2020/en/
  10. Burton A, Monasch R, Lautenbach B, Gacic-Dobo M, Neill M, Karimov R, et al. WHO and UNICEF estimates of national infant immunization coverage: methods and processes. Bull World Health Organ. 2009;87(7):535-41.  https://doi.org/10.2471/BLT.08.053819  PMID: 19649368 
  11. Blau J, Sadr-Azodi N, Clementz M, Abeysinghe N, Cakmak N, Duclos P, et al. Indicators to assess National Immunization Technical Advisory Groups (NITAGs). Vaccine. 2013;31(23):2653-7.  https://doi.org/10.1016/j.vaccine.2013.01.047  PMID: 23398930 
  12. European Centre for Disease Prevention and Control (ECDC). Vaccine schedules in all countries of the European Union. Stockholm: ECDC; 2019. Available from: https://vaccine-schedule.ecdc.europa.eu/
  13. Gavi the Vaccine Alliance. Eligibility. Geneva: Gavi; 2019. Available from: https://www.gavi.org/types-support/sustainability/eligibility
  14. The World Bank. World Bank Country and Lending Groups. Washington DC: The World Bank; 2019. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519
  15. The World Bank. World Development Indicators. Washington DC: The World Bank; 2019. Available from: https://databank.worldbank.org/home
  16. Institute for Health Metrics and Evaluation (IHME). Global Burden of Disease Study 2017 (GBD 2017) Population Estimates 1950-2017. Seattle: IHME; 2019. Available from: http://ghdx.healthdata.org/record/ihme-data/gbd-2017-population-estimates-1950-2017
  17. Leidner AJ, Murthy N, Chesson HW, Biggerstaff M, Stoecker C, Harris AM, et al. Cost-effectiveness of adult vaccinations: A systematic review. Vaccine. 2019;37(2):226-34.  https://doi.org/10.1016/j.vaccine.2018.11.056  PMID: 30527660 
  18. Fleming JA, Munthali A, Ngwira B, Kadzandira J, Jamili-Phiri M, Ortiz JR, et al. Maternal immunization in Malawi: A mixed methods study of community perceptions, programmatic considerations, and recommendations for future planning. Vaccine. 2019;37(32):4568-75.  https://doi.org/10.1016/j.vaccine.2019.06.020  PMID: 31319932 
  19. Porter RM, Goldin S, Lafond KE, Hedman L, Ungkuldee M, Kurzum J, et al. Does having a seasonal influenza program facilitate pandemic preparedness? An analysis of vaccine deployment during the 2009 pandemic. Vaccine. 2020;38(5):1152-9.  https://doi.org/10.1016/j.vaccine.2019.11.025  PMID: 31839465 
  20. Cherian T, Morales KF, Mantel C, Lambach P, Al Awaidy S, Bresee JS, et al. Factors and considerations for establishing and improving seasonal influenza vaccination of health workers: Report from a WHO meeting, January 16-17, Berlin, Germany. Vaccine. 2019;37(43):6255-61.  https://doi.org/10.1016/j.vaccine.2019.07.079  PMID: 31500965 
  21. Godoy P, Castilla J, Mayoral JM, Martín V, Astray J, Torner N, et al. Influenza vaccination of primary healthcare physicians may be associated with vaccination in their patients: a vaccination coverage study. BMC Fam Pract. 2015;16(1):44.  https://doi.org/10.1186/s12875-015-0259-0  PMID: 25880501 
  22. Palache A, Abelin A, Hollingsworth R, Cracknell W, Jacobs C, Tsai T, et al. Survey of distribution of seasonal influenza vaccine doses in 201 countries (2004-2015): The 2003 World Health Assembly resolution on seasonal influenza vaccination coverage and the 2009 influenza pandemic have had very little impact on improving influenza control and pandemic preparedness. Vaccine. 2017;35(36):4681-6.  https://doi.org/10.1016/j.vaccine.2017.07.053  PMID: 28754488 
  23. World Health Organization (WHO). WHO Concept for fair access and equitable allocation of COVID-19 health products 2020. Geneva: WHO; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/who-covid19-vaccine-allocation-final-working-version-9sept.pdf
  24. Our World in Data. Coronavirus (COVID-19) Vaccinations. Oxford: Oxford University; 2021. Available from: https://ourworldindata.org/covid-vaccinations
  25. Publication WHO. Hepatitis B vaccines: WHO position paper--recommendations. Vaccine. 2010;28(3):589-90.  https://doi.org/10.1016/j.vaccine.2009.10.110  PMID: 19896455 
  26. World Health Organization (WHO). Varicella and herpes zoster vaccines: WHO position paper, June 2014. Wkly Epidemiol Rec. 2014;89(25):265-87. PMID: 24983077 
  27. World Health Organization (WHO). Vaccines against influenza WHO position paper – November 2012. Wkly Epidemiol Rec. 2012;87(47):461-76. PMID: 23210147 
  28. World Health Organization (WHO). Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper –February 2019. Wkly Epidemiol Rec. 2019;94:85-103. Available from: https://apps.who.int/iris/handle/10665/310970
  29. World Health Organization. 23-valent pneumococcal polysaccharide vaccine. WHO position paper. Wkly Epidemiol Rec. 2008;83(42):373-84. PMID: 18927997 
  30. Troeger C, Blacker B, Khalil IA, Rao PC, Cao J, Zimsen SRM, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018;18(11):1191-210.  https://doi.org/10.1016/S1473-3099(18)30310-4  PMID: 30243584 
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