Global Alliance For Vaccines And Immunization Research Articles

Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017

ObjectivesThe designing of contextually tailored sustainable plans to finance the procurement of vaccines and the running of appropriate immunisation programmes are necessary to address the high burden of vaccine-preventable diseases...

A Mathematical Model to Study the Potential Hepatitis B Virus Infections and Effects of Vaccination Strategies in China.

Hepatitis B is a potentially life-threatening infectious disease caused by the hepatitis B virus (HBV). Approximately 390,000 people in China die from HBV-related diseases each year. Around 86 million individuals suffer from infections of the hepatitis B virus, accounting for about 6% of the total population in the region. There are approximately 30 million chronic infections. From 2002 to 2007, China's government took part in "The Global Alliance for Vaccines and Immunization (GAVI)" initiative, which helped reduce cases of chronic HBV infections among children. However, incidences of hepatitis B remain persistently high in China. Accurately estimating the number of potential HBV infections is crucial for preventing and controlling the transmission of the hepatitis B virus. Up until now, there were no studies of potentially infectious hepatitis B virus infections. this study was based on data from the National Bureau of Statistics of China from 2003 to 2021; a dynamic model was built, which included a compartment for potentially infectious hepatitis B virus infections. The parameters in the model were fitted using a combination of nonlinear least-squares and genetic algorithm methods. the calculated reproduction number for hepatitis B virus transmission within the population is Rc = 1.741. Considering the existing vaccine inefficiency rate of 0.1, the model estimates there are 449,535 (95%CI [415,651, 483,420]) potentially infectious hepatitis B virus infections, constituting 30.49% of total hepatitis B cases. Date fitting using MATLAB reveals that increasing the rate of hepatitis B vaccinations can effectively reduce the number of infections. the results reveal that the number of potential infectious hepatitis B virus infections is so high that the number of hepatitis B patients persistently rises in China. To better control the transmission of the hepatitis B virus, an optional prevention and control strategy is needed to increase the vaccination of different age groups, and it is necessary to help the public correctly understand the transmission of hepatitis B and ensure adequate protection.

COVID-19 vaccine wastage and distribution disparities in Pakistan: an editorial

COVID-19 vaccine wastage and distribution disparities in Pakistan: an editorial

The Role of International Organizations in Handling Covid-19 Pandemic

Introduction: The spread of the Covid-19 virus after being designated as a pandemic by the WHO (World Health Organization) in early 2020 had a negative impact on the sustainability of life in the world. The hampering of activities due to lockdown policies to break the chain of transmission of the virus, paralyzed the movement of the world economy.Purposes of the Research: This study aims to find out the development of handling the Covid-19 virus as a pandemic and the role of WHO as an international health organization in equalizing vaccine availability.Methods of the Research: Normative juridical approach method with a statute approach, a historical approach and an analytical approach.Results of the Research: That as an effort to address inequality of access and distribution of Covid-19 vaccines between poor and rich countries, WHO formed a cooperation forum with the Global Alliance for Vaccines and Immunizations (GAVI), Vaccine Alliance, Coalition for Epidemic Preparedness Innovations (CEPI), and UNICEF namely Covid-19 Vaccines Global Access (COVAX) which has set up a pricing mechanism for rich countries to pay a requisite fees as a form of subsidize to poor countries.

Saving children's lives through interventions: a quasi-experimental analysis of GAVI.

This study evaluates the impact of the Global Alliance for Vaccines and Immunization (GAVI) on children's health outcomes in developing countries. Using a difference-in-differences identification strategy, we find that GAVI has reduced neonatal, infant and under-five mortality rates. The impact of GAVI on children's health outcomes is larger in countries with lower per capita income. Our findings underscore the relevance of health interventions in improving children's health outcomes in developing economies.

Factors Related To The Provision Of Complete Basic Immunization To Ballta In Puskesmas Sukajadi District The Year 2022

Based on data obtained from The Global Alliance for Vaccines and Immunization (GAVI), the World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) it is stated that at least 80 million children aged less than 1 year are at risk for suffering from Diphtheria, Measles. and Polio due to disruption of routine immunization services in the midst of the Covid-19 pandemic. This study aims to determine the relationship between knowledge, attitudes and husband's support simultaneously with the completeness of basic immunization for infants at the Sukajadi Health Center, Banyuasin Regency in 2022. The method in this study used a cross sectional with a population of 45 respondents and a sample of 45 respondents using accidental sampling technique. Data analysis used chi square statistical test with p value value (0.05). The results of this study were from 15 respondents who had good knowledge, 11 people (73.3%) gave complete basic immunization with p value = 0.02, from 23 respondents who had a positive attitude as many as 15 people (65.2%) who gave basic immunization complete p value = 0.02, meanwhile, from 21 respondents who received husband's support as many as 16 people (76.2%) p value = 0.001. From this study, we can conclude that there is a simultaneous relationship between knowledge, attitude and husband's support for the completeness of basic immunization for children under five at the Sukajadi Public Health Center, Banyuasin Regency in 2022

Trends of expenditure on Immunization in Pakistan since 2000.

World health organization started Expanded Program on Immunization in 1974. At that time only 5% of the children were covered globally in the first year on pro-gram. In Pakistan 16.34% of the total population is under five years’ children. In 2000 Global Alliance for Vaccines and Immunizations (GAVI) was introduced in Paki-stan. Since 2000 by the finance and HR support from GAVI, additional 370 million children have been vaccinated from deadly disease. It has been noticed that the expenditure on immunization remained inconsistent over the time period. Since 2000 the massive change is seen in the pattern of expenditure on immunization both routine and campaigns to meet the goals. In Pakistan, expenditure on immun-ization has reached to $240 million annually but still the fully immunized children are between 43-62% of all the under-five population of the country. Immunization services needed to be on time and efficiently provided to the communities. The growth in fiscal gap and need for expenditure competition in financing, has subju-gated policymaking. There is a need for reviewing the current policies for budgeting immunization program and needful risk assessment will support future financial crisis.Key Words: Immunization, Global Alliance for Vaccines and Immunization,Extended Program of Immunization,

An Update on Cholera Immunity and Current and Future Cholera Vaccines

Individual resistance to cholera infection and disease depends on both innate host factors and adaptive immunity acquired by a previous infection or vaccination. Locally produced, intestinal-mucosal secretory IgA (SIgA) antibodies against bacterial surface lipopolysaccharide (LPS) O antigens and/or secreted cholera toxins are responsible for the protective adaptive immunity, in conjunction with an effective mucosal immunologic memory that can elicit a rapid anamnestic SIgA antibody response upon re-exposure to the antigen/pathogen even many years later. Oral cholera vaccines (OCVs), based on inactivated Vibrio cholerae whole-cell components, either together with the cholera toxin B subunit (Dukoral™) or administered alone (Shanchol™/Euvichol-Plus™) were shown to be consistently safe and effective in large field trials in all settings. These OCVs are recommended by the World Health Organisation (WHO) for the control of both endemic cholera and epidemic cholera outbreaks. OCVs are now a cornerstone in WHO’s global strategy found in “Ending Cholera: A Global Roadmap to 2030.” However, the forecasted global demands for OCV, estimated by the Global Alliance for Vaccines and Immunization (GAVI) to 1.5 billion doses for the period 2020–2029, markedly exceed the existing manufacturing capacity. This calls for an increased production capacity of existing OCVs, as well as the rapid introduction of additional and improved vaccines under development.

Introduction of typhoid vaccine in the expanded immunization program of Pakistan

ABSTRACT Worldwide, typhoid infects 11–20 million people each year. In Pakistan, the first extensively drug-resistant (XDR) typhoid was reported in 2016 resulting in an epidemic. To curb this battle of typhoid, the Expanded Program for Immunization (EPI) of Pakistan requested Global Alliance for Vaccines and Immunization (GAVI) for financial assistance. Hence becoming the first country to administer the vaccination against typhoid in children through EPI. To address the possible risk of endemic, it is needed that WHO and the United Nations should recommend all south Asian countries to avail of this golden opportunity provided by GAVI. Finally, the addition of typhoid vaccine in routine immunization will reduce mortalities, morbidities, health expenditure, and increase life expectancy in all low- and middle-income countries.

The COVID-19 Pandemic: Global Asymmetries and Challenges for the Future of Health.

The coronavirus disease 2019 (COVID-19) pandemic reveals economic, social, and environmental trends that have been present since the last two decades, and it is characterized as a new phenomenon that qualitatively alters contemporary global and national dilemmas — not only because it was caused by a hitherto unknown virus, but by the magnitude of the crisis and the transformations that shape the lifeworld It marks a disruptive and threatening historical period in the face of the foundations of modern sociability built during the post-war period Social and economic inequality between countries, territories, and population groups has increased during the pandemic Its impacts are unevenly distributed, revealing the interface between the biological, economic, and social worlds There is a threat of a humanitarian crisis due to the concrete differences between those who have full access to products, services, and health and those who can be left behind In Latin America alone, the income of more than 30 million people has fallen below the poverty threshold less than a year after the arrival of the pandemic to the continent (1) In terms of international relations, the pandemic highlights the tension between a vision of global health and the interests of the nation states and regional blocs Vulnerability is observed even in developed countries, manifested in the lack of fundamental health items such as ventilators, essential medicines used in treatment, and even more basic items such as masks and personal protective equipment for health providers Within the scope of the relationship between the nation states, the dispute over health products, with the imposition of trade barriers by more developed countries that could lead a solidarity action in health, has resulted in a limitation of access, generating global inequity At present, limiting the supply of vaccines to less developed countries and vulnerable populations undermines the impact of essential mechanisms, such as the COVAX Facility [the initiative led by World Health Organization (WHO), Global Alliance for Vaccines and Immunization (GAVI) and the Coalition for Epidemic Preparedness Innovations (CEPI)], which is aimed at ensuring equal access to immunization

Global Perspectives: The COVID-19 Pandemic in 2020-2021 and Beyond.

While coronavirus disease 2019 (COVID-19) cases have reached 100 million across the globe with more than 2 million deaths as at January 26, 2021, over 50 countries have initiated vaccinations against the disease Vaccinations began within a year from January 12, 2020, when the China CDC shared the new virus genomic sequence with the World Health Organization (WHO) and globally, following the first complete genome sequencing of the novel β genus coronavirus on January 3 (1) This must be the most remarkable achievement in vaccine research and development since the English physician Edward Jenner pioneered the concept of smallpox vaccination in the 18th century It truly is an outcome of joint efforts between interconnected scientific communities, the leading roles played by the WHO, Global Alliance for Vaccines and Immunisation (GAVI), and Coalition for Epidemic Preparedness Innovations (CEPI), and the contributions of many global health partners In 2015, in the aftermaths of the Ebola and Middle East respiratory syndrome (MERS) outbreaks, the WHO created a dedicated research team under the name “the R&D Blueprint to Prevent Epidemics ” The intended aim was to facilitate research and development activity during the time of any outbreak The R&D Blueprint organized the First Global Research and Innovation Forum on February 11–12, 2020, less than a fortnight after the declaration of a Public Health Emergency of International Concern (PHEIC) by the WHO Director General, which happened on January 30, 2020 This testifies to the WHO’s strong commitment to play a coordinator role in research and development The First Forum resulted in a coordinated global research roadmap for COVID-19, which was published on March 12, 2020 This roadmap proposes an immediate goal of accelerating research to contain the COVID-19 epidemic and a mid- to long-term goal of supporting research priorities that can lead to the development of a global research platform to better prepare for future epidemics and pandemics There is no doubt that the research and development preparedness coordinated by the WHO R&D Blueprint network has facilitated the development of COVID-19 vaccines in 2020

Allocating a COVID-19 Vaccine: Balancing National and International Responsibilities.

Policy Points In this paper we propose a middle-ground policy for the distribution of an effective COVID-19 vaccine, between a cosmopolitan approach that rejects entirely nation-state priority and unbridled vaccine nationalism that disregards obligations to promote an equitable global allocation of an effective vaccine over time. Features of the COVAX partnership, a collaboration among the Global Alliance for Vaccines and Immunizations (GAVI), the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Health Organization (WHO) to develop and distribute COVID-19 vaccines make it an appropriate framework for a middle-ground policy.

Current Trends of Yellow Fever in Nigeria: Challenges and Prospects

Yellow fever is a viral infection caused by yellow fever virus and is spread by the bite of an infected female mosquito (Aedes and Haemogogus species). The evolutionary origin of yellow fever lies in Africa, with transmission of the disease from nonhuman primates to human. Yellow fever remains a disease of significant public health importance. The earliest outbreak of yellow fever in Nigeria was reported in Lagos in 1864 with subsequent regular outbreaks reported until 1996 following which Nigeria has been responding to successive outbreaks. Since 15th September 2017, when the Nigeria Centre for Disease Control (NCDC) officially notified a confirmed case of yellow fever in Kwara state to WHO as per the International Health Regulations (2005). Currently the country has been responding to successive yellow fever outbreaks over a wide geographic area. As such, four-year (2018-2021) national yellow fever Preventive Mass Vaccination Campaign (PMVC) plan, supported by the Global Alliance for Vaccines and Immunization (GAVI) and partners, is currently being implemented to cover all states in the country. By 2025, it is anticipated that all states in Nigeria will have conducted PMVC activities to protect at-risk populations against yellow fever.

Attitude and Use of Pentavent Vaccine among Pregnant Women Attending Antenatal Care in Plateau State Specialist Hospital, Jos, Nigeria

Background: The World Health Organization (WHO) and the Global Alliance for Vaccines and Immunizations (GAVI) recommended the use of Pentavelent vaccines in Nigeria and other developing countries to replace the DPT (Diphtheria, pertusis and tetanus) vaccine. This was done to increase the uptake of the hepatitis B (HB) and Haemophilus influenza type b (Hib) vaccines in these countries by capitalising on the uptake of DPT vaccine. Objective: This study aims to assess the attitude and use of pentavalent vaccine in pregnant women attending antenatal care in a Tertiary Hospital in Jos, Plateau State. Methods: The study was carried out among pregnant women receiving antenatal care in Plateau Specialist hospital, Jos using a descriptive cross sectional study design. The study was done over a period of four (4) months (August 2018 to December 2018). Simple Random Sampling was used to select 397 women who participated in the study. Results: Respondents were predominantly Christians 283 (71.3%) while Muslims represent about 114 (28.7%) of respondents. About 373 (94%) respondents were married, While 24 (6.0%) percent of the respondents were single parents. Also 213 (53.7%) were business women, Only 48 (12.1%) were civil servants while 85 (21.4%) of the respondents had no form of employment. Majority 257(97.0%) of them had a positive attitude towards the vaccine while only a few 8(3.0%) had a negative attitude.Eighty eight (32.2%) felt pentavalent vaccines were not important. A similar proportion 88 (3.2%) also stated that they would not give their child the vaccine. Most women 252 (95.1%) agreed that mothers should be encouraged to attend immunization regularly. Side effect experienced by children were fever 69 (87.3%), swelling at injection site 21 (26.6%), rash 6 (7.6%). Conclusion and recommendations: All most all pregnant women had a positive attitude towards the vaccine while only a few had a negative attitude. Nine in ten women had children who had received pentavalent vaccine.Health workers should improve efforts at health education on immunization especially on adverse effects following immunization (AEFI), reasons for missed opportunities, coverage of hard to reach areas or distant areas via special immunization or home visiting to administer vaccine.

Combating infectious disease epidemics through China's Belt and Road Initiative.

Combating infectious disease epidemics through China's Belt and Road Initiative.

Prevention of Cervical Cancer in Sub-Saharan Africa: The Advantages and Challenges of HPV Vaccination.

Cervical cancer is a critical public health issue in sub-Saharan Africa (SSA), where it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical, and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach for primary prevention of cervical cancer and presents an opportunity to reduce the burden from cervical cancer in SSA. With a number of SSA countries now eligible for Global Alliance for Vaccines and Immunization (GAVI) support for vaccine introduction, it is timely to consider the factors that impede and facilitate implementation of vaccine programs in SSA. This article describes epidemiological features of cervical cancer in SSA and the current status of HPV vaccine implementation in SSA countries. Rwanda’s experience of achieving high vaccination coverage in their national HPV immunization program is used as a case study to explore effective approaches to the design and implementation of HPV vaccination programs in SSA. Key factors in Rwanda’s successful implementation included government ownership and support for the program, school-based delivery, social mobilization, and strategies for reaching out-of-school girls. These findings might usefully be applied to other SSA countries planning for HPV vaccination.

Adverse events following immunization with pentavalent vaccine in a tertiary care hospital

Background: Immunizations currently save 3 million lives per year throughout the world and is one of the most cost-effective health interventions. The Global Alliance for Vaccines and Immunizations (GAVI) and WHO recommended the use of pentavalent to replace the DPT vaccine in developing countries. Vaccines related most side effects are mild and non-serious. Surveillance of adverse events following immunization will enable us to monitor the safety of immunization programs and thereby contribute to validating the immunization program. The main aim of this study is to analyze all suspected adverse events in children reported for pentavalent vaccination.Methods:A prospective, observational epidemiological study was conducted in the department of Paediatrics OPD at tertiary care teaching institute during October 2016 to December 2016. The study was conducted amongst 190 children attending the department of Paediatrics OPD for the second or third dose of pentavalent vaccine.Results: The study shows the following adverse effects after pentavalent injection 127 (66.8%) children had pain at the site of injection, 103(54.2%) mild fever, Swelling at injection site 84(44.2%) and 55(28.9%) children held their leg back due to pain. In majority 85 (44.7%) of children antipyretic and in 65 (34.2%) children analgesic was given was given to relieve the symptoms. The parents were very positive for completing their children’s immunization schedule even though they have faced few symptoms.Conclusions:It can be concluded that all the adverse events reported were mild and could be managed easily without any complications.

Charting the evolution of approaches employed by the Global Alliance for Vaccines and Immunizations (GAVI) to address inequities in access to immunization: a systematic qualitative review of GAVI policies, strategies and resource allocation mechanisms through an equity lens (1999-2014).

BackgroundGAVI’s focus on reducing inequities in access to vaccines, immunization, and GAVI funds, − both between and within countries - has changed over time. This paper charts that evolution.MethodsA systematic qualitative review was conducted by searching PubMed, Google Scholar and direct review of available GAVI Board papers, policies, and program guidelines. Documents were included if they described or evaluated GAVI policies, strategies, or programs and discussed equity of access to vaccines, utilization of immunization services, or GAVI funds in countries currently or previously eligible for GAVI support. Findings were grouped thematically, categorized into time periods covering GAVI’s phases of operations, and assessed depending on whether the approaches mediated equity of opportunity or equity of outcomes between or within countries.ResultsSerches yielded 2816 documents for assessment. After pre-screening and removal of duplicates, 552 documents underwent detailed evaluation and pertinent information was extracted from 188 unique documents. As a global funding mechanism, GAVI responded rationally to a semi-fixed funding constraint by focusing on between-country equity in allocation of resources. GAVI’s predominant focus and documented successes have been in addressing between-country inequities in access to vaccines comparing lower income (GAVI-eligible) countries with higher income (ineligible) countries. GAVI has had mixed results at addressing between-country inequities in utilization of immunization services, and has only more recently put greater emphasis and resources towards addressing within-country inequities in utilization to immunization services. Over time, GAVI has progressively added vaccines to its portfolio. This expansion should have addressed inter-country, inter-regional, inter-generational and gender inequities in disease burden, however, evidence is scant with respect to final outcomes.ConclusionIn its next phase of operations, the Alliance can continue to demonstrate its strength as a highly effective multi-partner enterprise, capable of learning and innovating in a world that has changed much since its inception. By building on its successes, developing more coherent and consistent approaches to address inequities between and within countries and by monitoring progress and outcomes, GAVI is well-positioned to bring the benefits of vaccination to previously unreached and underserved communities towards provision of universal health coverage.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2521-8) contains supplementary material, which is available to authorized users.

Delivering vaccines to the people who need them most.

Thanks to the Global Alliance for Vaccines and Immunization (GAVI), the Vaccine Fund and the Bill & Melinda Gates Foundation, the global health community has made enormous progress in providing already existing vaccines to developing countries. However, there still exists a gap to develop vaccines for which there is no market in the Western world, owing to low economic incentives for the private sector to justify the investments necessary for vaccine development. In many cases, industry has the technologies, but lacks the impetus to direct resources to develop these vaccine products. The present emergency with the Ebola vaccine provides us an excellent example where a vaccine was feasible several years ago, but the global health community waited for a humanitarian disaster to direct efforts and resources to develop this vaccine. In the beginning of 2015, the first large-scale trials of two experimental vaccines against Ebola virus disease have begun in West Africa. During the past few years, several institutions have dedicated efforts to the development of vaccines against diseases present only in low-income countries. These include the International Vaccine Institute, the Novartis Vaccines Institute for Global Health, the Hilleman Institute, the Sabin Vaccine Institute and the Infectious Disease Research Institute. Nevertheless, solving this problem requires a more significant global effort than that currently invested. These efforts include a clear policy, global coordination of funds dedicated to the development of neglected disease and an agreement on regulatory strategies and incentives for the private sector.

Cost-effectiveness of pneumococcal conjugate vaccination in Georgia

ObjectiveFinancial support from the Global Alliance for Vaccines and Immunization (GAVI) to introduce the 10-valent pneumococcal conjugate vaccine (PCV10) into the routine childhood immunization schedule in Georgia is ending in 2015. As a result, the Interagency Coordination Committee (ICC) decided to carry out a cost-effectiveness analysis to gather additional evidence to advocate for an appropriate evidence-based decision after GAVI support is over. The study also aimed to strengthen national capacity to conduct cost-effectiveness studies, and to introduce economic evaluations into Georgia's decision-making process. MethodologyA multidisciplinary team of national experts led by a member of the ICC carried out the analysis that compared two scenarios: introducing PCV10 vs no vaccination. The TRIVAC model was used to evaluate 10 cohorts of children over the period 2014–2023. National data was used to inform demographics, disease burden, vaccine coverage, health service utilization, and costs. Evidence from clinical trials and the scientific literature was used to estimate the impact of the vaccine. A 3+0 schedule and a vaccine price increasing to US$ 3.50 per dose was assumed for the base-case scenario. Alternative univariate and multivariate scenarios were evaluated. ResultsOver the 10-year period, PCV10 was estimated to prevent 7170 (8288 undiscounted) outpatient visits due to all-cause acute otitis media, 5325 (6154 undiscounted) admissions due to all-cause pneumonia, 87 (100 undiscounted) admissions due to pneumococcal meningitis, and 508 (588 undiscounted) admissions due to pneumococcal non-pneumonia and non-meningitis (NPNM). In addition, the vaccine was estimated to prevent 41 (48 undiscounted) deaths. This is equivalent to approximately 5 deaths and 700 admissions prevented each year in Georgia. Over the 10-year period, PCV10 would cost the government approximately US$ 4.4 million ($440,000 per year). However, about half of this would be offset by the treatment costs prevented. The discounted cost-effectiveness ratio was estimated to be US$ 1599 per DALY averted with scenarios ranging from US$ 286 to US$ 7787. DiscussionThis study led to better multi-sectoral collaboration and improved national capacity to perform economic evaluations. Routine infant vaccination against Streptococcus pneumoniae would be highly cost-effective in Georgia. The decision to introduce PCV10 was already made some time before the study was initiated but it provided important economic evidence in support of that decision. There are several uncertainties around many of the parameters used, but a multivariate scenario analysis with several conservative assumptions (including no herd effect in older individuals) shows that this recommendation is robust. This study supports the decision to introduce PCV10 in Georgia.