A Review of the Evidence to Support Influenza Vaccine Introduction in Countries and Areas of WHO's Western Pacific Region

Gina Samaan,Michelle Mcpherson,Jeffrey Partridge,Jianqing Xu

doi:10.1371/journal.pone.0070003

Abstract

BackgroundImmunization against influenza is considered an essential public health intervention to control both seasonal epidemics and pandemic influenza. According to the World Health Organization (WHO), there are five key policy and three key programmatic issues that decision-makers should consider before introducing a vaccine. These are (a) public health priority, (b) disease burden, (c) efficacy, quality and safety of the vaccine, (d) other inventions, (e) economic and financial issues, (f) vaccine presentation, (g) supply availability and (h) programmatic strength. We analyzed the body of evidence currently available on these eight issues in the WHO Western Pacific Region.Methodology/Principal FindingsStudies indexed in PubMed and published in English between 1 January 2000 and 31 December 2010 from the 37 countries and areas of the Western Pacific Region were screened for keywords pertaining to the five policy and three programmatic issues. Studies were grouped according to country income level and vaccine target group. There were 133 articles that met the selection criteria, with most (90%) coming from high-income countries. Disease burden (n = 34), vaccine efficacy, quality and safety (n = 27) and public health priority (n = 27) were most frequently addressed by studies conducted in the Region. Many studies assessed influenza vaccine policy and programmatic issues in the general population (42%), in the elderly (24%) and in children (17%). Few studies (2%) addressed the eight issues relating to pregnant women.Conclusions/SignificanceThe evidence for vaccine introduction in countries and areas in this Region remains limited, particularly in low- and middle-income countries that do not currently have influenza vaccination programmes. Surveillance activities and specialized studies can be used to assess the eight issues including disease burden among vaccine target groups and the cost-effectiveness of influenza vaccine. Multi-country studies should be considered to maximize resource utilization for cross-cutting issues such as vaccine presentation and other inventions.

Highlights

The Western Pacific Region of the World Health Organization (WHO) comprises 37 countries and areas, spanning from China in the north and west, to New Zealand in the south, and to French Polynesia in the east [1]
Studies included in the final analysis were categorized, summarized and appraised according to the relevant key policy or programmatic issues [3] and were reported by the income level of the country or area and by the five target groups recommended by the WHO position paper for influenza vaccination as well as studies that focus on the general population [4]
Twenty-seven studies focused on the prioritization of influenza vaccination within various target groups, of which 96% (n = 26) were from high-income countries (Table 2)

Summary

Introduction

The Western Pacific Region of the World Health Organization (WHO) comprises 37 countries and areas, spanning from China in the north and west, to New Zealand in the south, and to French Polynesia in the east [1]. To assist countries with the development of vaccine policy, WHO published the Vaccine Introduction Guidelines in 2005 [3] These guidelines highlight five key policy issues and three key programmatic issues that decision-makers should consider before introducing a vaccine (Figure 1). According to the World Health Organization (WHO), there are five key policy and three key programmatic issues that decision-makers should consider before introducing a vaccine. These are (a) public health priority, (b) disease burden, (c) efficacy, quality and safety of the vaccine, (d) other inventions, (e) economic and financial issues, (f) vaccine presentation, (g) supply availability and (h) programmatic strength.

Methods

Results

Conclusion