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The Linked Immunisation Action Network is kicking off a year of exciting learning and exchange initiatives to strengthen middle-income countries’ national immunisation programmes.
The first of these initiatives was a Gavi learning forum, with support from Linked, centered on new vaccine introduction that brought together country stakeholders from Angola, Cuba, Eswatini, Kosovo, Indonesia, Philippines, Tunisia, and Uzbekistan. Participants exchanged experiences, challenges, and opportunities around political will and advocacy, decision-making processes, vaccine procurement and pricing, financial sustainability, HPV vaccine introduction, and Gavi support mechanisms. The country posters from the forum can be accessed on the Linked website.
The Linked Network Facilitation Team also hosted the first Steering Committee meeting of 2024, where several new country representatives were welcomed. The Committee reflected on the accomplishments and lessons from 2023, reviewed the learning agenda for 2024, and discussed the new Indonesia subnational learning platform. Highlights from the meeting can be found below in the ‘Network Updates’ section.
Relevant evidence, tools, and country spotlights have recently been published by the global immunisation community to help tackle immunisation programme challenges, including new vaccine introduction, HPV vaccine delivery and cost effectiveness, vaccine communication and uptake, and gender in immunisation. Researchers conducted a systematic review on the costs of HPV vaccine delivery in low- and middle-income countries. A study analyzed the equity impact of HPV vaccination on lifetime projections of cervical cancer burden among cohorts in 84 countries by global, regional, and income levels, 2010–22. An analysis looked at the outcomes and costs of the transition from a paper-based immunisation system to a digital immunisation system in Viet Nam. The Clinton Health Access Initiative (CHAI) developed the Vaccine Procurement Diagnostic Toolkit for country immunisation programmes to help country immunisation programmes address vaccine stock management. Below, you will find all of these fantastic tools and more!
As always, these resources, as well as other relevant and timely news,events, tools, and network updates, can be explored and discussed on the Linked website, as well as our Linked Immunisation Action Network page on LinkedIn. Please be sure to follow us on LinkedIn and share the page with your colleagues!
Warm regards,
Dr. Janis Asuncion Bunoan-Macazo, EPI Manager, Philippines
Network Updates
Gavi-Linked Learning Forum on New Vaccine Introduction
Earlier this month, participants from Angola, Cuba, Eswatini, Kosovo, Indonesia, Jordan Philippines, Tunisia, and Uzbekistan participated in a Gavi learning forum, with support from Linked, to discuss and exchange experiences, challenges, and learning needs for the introduction of three critical vaccines – PCV, HPV, and Rotavirus. Topics discussed during the forum included political will and advocacy, decision-making processes, vaccine procurement and pricing, financial sustainability, HPV vaccine introduction, and Gavi support mechanisms. These new vaccine introduction experiences among MICs countries will be documented and synthesized over the coming weeks. In the meantime, uncover insights from the country posters on the Linked website here.
Highlights from Linked’s First Steering Committee Meeting of 2024
The Linked Steering Committee convened virtually in April for the first meeting of 2024. Firstly, the Steering Committee welcomed two new members: Dr. Oneka Scott, EPI Manager from Guyana, and Dr. Janis Asuncion Bunoan-Macazo, EPI Manager from the Philippines. The addition of these two members increases Linked’s country representation and adds the important perspectives from the Latin America and Caribbean (LAC) region, as well as from a country who has never received Gavi support. Dr. Scott and Dr. Bunoan-Macazo will provide invaluable insights to Linked as we work to effectively support countries in their efforts to improve coverage, sustainability, and equity. We are lucky and delighted to have them officially on board.
At the first meeting of 2024, the Linked Steering Committee reflected on the major achievements and strategic decisions of 2023. The Network Facilitation Team shared the countries and topics selected for the 2024 learning agenda, as well as the desired outcomes for network members. Steering Committee members validated the learning agenda and offered insightful suggestions for opportunities to collaborate with partners. Finally, Network Director, Elizabeth Ohadi, presented the strategy and approach for a Linked subnational peer-to-peer learning platform in Indonesia, which will be piloted later this year.
Featured News & Resources
A systematic review on the costs of HPV vaccine delivery in low- and middle-income countries
The authors of a new study in Vaccine conducted a systematic review of articles on the costing of human papillomavirus (HPV) vaccine delivery in low- and middle-income countries published between 2005 and 2023. Read the full article to find out the vaccine delivery financial costs here.
Ongoing costs and operational context of a routinized HPV vaccination program in Sri Lanka
A study led by PATH provides new evidence on the cost and cost drivers of a routinized HPV vaccination program in Sri Lanka. Results can be used for financial planning purposes in Sri Lanka and may also inform other countries as they consider use of HPV vaccines. Explore the publication here.
Equity impact of HPV vaccination on lifetime projections of cervical cancer burden among cohorts in 84 countries by global, regional, and income levels, 2010–22: a modelling study
While HPV vaccines have been available since 2006, the coverage has varied among countries. The aim of a new modelling study was to analyse the equity impact of HPV vaccination on the lifetime projections of cervical cancer burden among vaccinated cohorts from 2010–22 in 84 countries. The study sheds light on both vaccine coverage and health impact in 84 countries ranging from high-income to low-income. Examine the findings here.
The cost of HPV vaccination delivery at the administrative and health facility levels in the Philippines
The HPV vaccine was introduced in the Philippines in a phased approach in 2015. PATH and the University of the Philippines Manila National Institutes of Health conducted a retrospective, cross-sectional micro-costing study focused on ongoing HPV vaccination delivery and its operational context across all levels of the health system. Review the full paper here.
Is HPV vaccination cost effective?
Cost is one of the biggest considerations countries face when determining whether a vaccine will have sustainable impact. Over the past several years, PATH worked with partners in Mongolia, the Philippines, Mozambique, Kenya, and Burkina Faso to understand the cost-effectiveness of HPV vaccine in their specific countries. Learn more about the individual study findings below:
Outcomes and costs of the transition from a paper-based immunisation system to a digital immunisation system in Viet Nam
The electronic National Immunisation Information System (NIIS) was introduced nationwide in Viet Nam in 2017, and starting in 2018, Hanoi and Son La provinces transitioned to paperless reporting. This study analyzed pre- and post-intervention data to assess changes in NIIS data quality, changes in immunisation programme outcomes and the economic costs of using the NIIS versus the traditional paper system. Review the findings here.
Introduction of the pneumococcal conjugate vaccine in humanitarian and fragile contexts: Perspectives from stakeholders in four African countries
Modeling estimates project that the introduction of PCV in Chad, Guinea, Somalia, and South Sudan could prevent nearly 60,000 deaths between 2024 and 2030. A recent study aimed to understand the factors that would affect introduction and implementation activities for PCV in Gavi-eligible countries with high levels of childhood pneumonia deaths, including Chad, Guinea, Somalia, and South Sudan. Read the stakeholder perspectives here.
Strategies for improving vaccine communication and uptake
Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. This clinical report provides information about the scope and impact of the problem, the facts surrounding common vaccination concerns, and the latest evidence regarding effective communication techniques for the vaccine conversation. Examine the report to learn common causes, determinants, and strategies to address concerns here.
Practical playbook for addressing health misinformation
Misleading rumors, misinformation, and disinformation can make health events more complicated, reduce trust in public health efforts, and lead to negative health impacts. The Practical playbook for addressing health misinformation provides guidance on ways public health and medical professionals can set themselves up for success, make decisions on when they need to act to address misinformation, choose which actions and approaches might be useful to their audiences and information needs, and evaluate how their efforts are working. Explore the content here.
Vaccine Procurement Diagnostic Toolkit for country immunisation programmes
To help address vaccine stock management challenges, the Clinton Health Access Initiative (CHAI) has developed a toolkit based on its work in Cameroon and Uganda from 2019 to 2023. The toolkit utilizes four modules that comprehensively cover the procurement lifecycle to assist countries in identifying and addressing challenges within their vaccine procurement processes. Download the Diagnostic Toolkit here.
Landscaping analysis of immunisation progress and program structures in selected middle income Southeast Asian countries
A study examined the performance and structures of national immunisation programmes in five middle-income Southeast Asian countries – Malaysia, Myanmar, Philippines, Thailand, and Viet Nam– and analyzed how the different structures relate to the difference in program performance to identify effective strategies in the study countries that facilitated good immunisation performance. Uncover the findings here.
Gender and immunisation: opportunities for action
MOMENTUM Routine Immunization Transformation and Equity developed a four-session course entitled “Gender and Immunisation: Opportunities for Action.” The overall goal of the course was to provide national and sub-national participants from low-and middle-income countries with the knowledge, tools, skills, capacity, and confidence to reduce gender barriers to immunisation and document their efforts to advance this nascent and critical technical area. Access the gender course materials here.
Self-evaluation tool for national immunisation technical advisory groups
This self-evaluation tool is intended to be used by national immunisation technical advisory groups (NITAGs) to conduct self-evaluations. It can also be used by NITAG partners to assist NITAGs in conducting the evaluation through semi-structured interviews. The tool addresses a NITAG’s functionality, the quality of work processes and outputs and its integration into the policy process. Download the tool here.
Analysis of the cost of Covid-19 vaccine delivery at selected sites in Bangladesh
ThinkWell conducted a retrospective, bottom-up costing study to estimate the financial and economic costs of delivering COVID-19 vaccines in Bangladesh. The costing analysis was complemented with a qualitative assessment of enabling factors and operational challenges from the implementation of theC19 vaccination effort, as well as a mapping of key funding sources and funding flows. Read the full report here!
Country Spotlights
Kosovo introduces HPV vaccine in immunisation schedule
As of 20 February 2024, all girls aged 12 in Kosovo are eligible to receive the HPV vaccine for lifelong protection from cervical cancer. To comprehensively roll out the vaccine, Pristina health authorities launched a vaccination campaign at schools, as well as door-to-door campaigns, aiming to reach over 12,000 girls in 2024. Read more about the vaccination campaign here.
India resolves to reduce cervical cancer by vaccinating girls
Although the HPV vaccine was introduced in India in 2008, it is yet to be included in the country’s universal immunisation programme. India is now planning a national drive to vaccinate girls between nine and 14 years against the HPV strains that cause cervical cancer. Learn more about their efforts here.
External Events
Why gender matters: Immunisation Agenda 2030
IA2030 envisions a world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being. However, immunisation programmes will only succeed in expanding coverage and equity when gender roles, norms, and relations are understood, analyzed and accounted for as part of service planning and delivery. This series of webinars aims to further improve awareness and understanding of how gender-related barriers impact immunisation. The series will focus on examples and best practices of gender-responsive programming to improve coverage and equity from around the world. All sessions will be in English with simultaneous interpretation in French. Below are the upcoming sessions. You can register for any of them here.
- 9 May: Advance gender equality and improve coverage through integrated services and collaboration across sectors
- 6 June: Apply a gender lens to research and innovation
- 11 July: Implement gender-responsive immunization services in emergency settings