Routine Immunization in the WHO African Region: Progress; Challenges and Way Forward

Tremendous progress has been made in expanding immunization in the African Region over the last four decades. And immunization; together with other primary health care and development interventions; has impacted significantly on the annual number of deaths among children under five. However; an estimated 22 (4.3 million) of the infants globally remaining unimmunized are located in four countries of the African Region (Democratic Republic of the Congo; Ethiopia; Nigeria and South Africa). Challenges remain in reaching an estimated 20-30 of children across the Region. In addition to the traditional vaccines (DTP; measles; polio and tuberculosis) newer ones; such as for PCV and rotavirus; are being rolled out in the Region but uptake and coverage is slow and patchy both within and between countries. The new regional strategic plan for immunization 2014-2020 is intended to provide policy and programmatic guidance to Member States; in line with the 2011- 2020 GVAP; in order to optimize immunization services and assist countries to further strengthen their immunization programmes

Immunization Monitoring and Vaccine-Preventable Diseases Surveillance Data Management in the African Region

Countries in the WHO African Regionhave well-established national immunization programmes and disease control programmes working towards the different goals for the control of vaccine-preventable diseases; and generating coverage and surveillance data. WHO provides technical support to standardize the approaches; methodology; and tools used for data management. The datasets are shared with WHO for purposes of monitoring the coverage and disease trends across the Region. This article reviews the methods WHO employs to build capacity in this field of data management across the Region and the resultant achievements and gaps. Despite the recent improvements in some aspects of data quality; important policy; technical and managerial gaps remain; which need to be addressed in order to ensure that the data coming out of these national programmes are of optimal quality

The performance of routine immunization in selected African countries during the first six months of the COVID-19 pandemic

Introduction: following the declaration of the COVID-19 pandemic on 11 March 2020, countries started implementing strict control measures, health workers were re-deployed and health facilities re-purposed to assist COVID-19 control efforts. These measures, along with the public concerns of getting COVID-19, led to a decline in the utilization of regular health services including immunization.Methods: we reviewed the administrative routine immunization data from 15 African countries for the period from January 2018 to June 2020 to analyze the trends in the monthly number of children vaccinated with specific antigens, and compare the changes in the first three months of the COVID-19 pandemic.Results: thirteen of the 15 countries showed a decline in the monthly average number of vaccine doses provided, with 6 countries having more than 10% decline. Nine countries had a lower monthly mean of recipients of first dose measles vaccination in the second quarter of 2020 as compared to the first quarter. Guinea, Nigeria, Ghana, Angola, Gabon, and South Sudan experienced a drop in the monthly number of children vaccinated for DPT3 and/ or MCV1 of greater than 2 standard deviations at some point in the second quarter of 2020 as compared to the mean for the months January-June of 2018 and 2019.Conclusion: countries with lower immunization coverage in the pre-COVID period experienced larger declines in the number of children vaccinated immediately after the COVID-19 pandemic was declared. Prolonged and significant reduction in the number of children vaccinated poses a serious risk for outbreaks such as measles. Countries should monitor coverage trends at national and subnational levels, and undertake catch-up vaccination activities to ensure that children who have missed scheduled vaccines receive them at the earliest possible time