Introducing new vaccines: Challenges of decision making and lessons learned from the recent Hib vaccine introduction experience

Abstract

Adoption of new vaccines in developing countries is critical to reduce child mortality and meeting Millennium Development Goals. However, such introduction has historically suffered from significant delays, that could be attributed to various factors including: lack of recognition of the value of the vaccine (e.g. understanding disease burden, vaccine efficacy, cost-effectiveness and safety; factors related to weak health systems, such as lack of a decision making process, immunizations program factors (vaccine logistics, supply issues), as well as inadequate planning and financing; and policy considerations, such as lack of clear global recommendations and donor commitment. Recently, The Global Alliance for Vaccines and Immunizations (GAVI) supported efforts to accelerate the introduction of Hib vaccines in developing countries, which resulted in significant surge of vaccine adoption in these countries. The experience with Hib vaccines, as well as similar GAVI efforts to support introduction of the newer pneumococcal and rotavirus vaccines, provides a strategy for new vaccine adoption that will be reviewed, providing a useful model to help accelerate the uptake of other life-saving vaccines. This strategy addresses barriers for vaccine adoption by focusing on three major areas: communications to increase awareness about data needs for evidence-based decisions, research activities to answer key questions that will support vaccine introduction and long term program sustainability, and coordination with the various stakeholders at global, regional and country levels to ensure successful program implementation.