Vaccination Week in the Americas: An Ongoing Initiative to Strengthen and Sustain Measles and Rubella Elimination in the Region.

Vaccination Week in the Americas (VWA) is a yearly regional initiative that promotes the benefits of vaccination to all persons in the region. In its 22-year history, more than 1.15 billion people have been reached under the framework of VWA across more than 40 countries and territories. This review examines multiple PAHO and WHO data points, documents and reports related to measles/rubella vaccination coverage and VWA since its inception. Its goal is to document the impact that the VWA has had in maintaining and accelerating measles and rubella disease elimination, in the context of PAHO's Disease Elimination Initiative. The results suggest that VWA's contributions to measles and rubella elimination have been substantial. Every year, VWA promotes (a) renewed political commitment to the immunization program from the highest political authorities of Member States; (b) vaccination operations to close immunity gaps, recover under-vaccinated persons, and reach chronically underserved populations; and (c) the dissemination of messages on the benefits of vaccination through regional and national communications campaigns. VWA will continue to be an important contributor to disease elimination efforts in the Americas, even as new targets are set in response to the evolving epidemiological landscape.

The evolution of Vaccination Week in the Americas

[ABSTRACT]. This report covers the background and evolution of Vaccination Week in the Americas (VWA), an initiative that started as a coordinated response to a 2002 measles outbreak in Colombia and Venezuela, and evolved into the model for other regions and World Immunization Week (WIW). VWA focuses on the work of national immunization programs, with special efforts to reach the unreached. This paper offers examples of how countries have leveraged VWA to implement a diverse array of vaccination activities, strengthening overall health services by integrating with other preventive health interventions, and bolstering “Pan-Americanism” and health diplomacy. The opportunities offered by this global initiative were clearly demonstrated in April 2016 when the successful global switch from the trivalent oral polio vaccine to the bivalent vaccine was synchronized with WIW. Going forward, VWA and WIW can help close the gaps in access to immunization and other health services, contributing to achieve universal health coverage.

[RESUMEN]. Este informe incluye los antecedentes y la evolución de la Semana de Vacunación en las Américas, una iniciativa que comenzó como una respuesta coordinada a un brote de sarampión en Colombia y Venezuela en el 2002, y evolucionó hasta convertirse en modelo para otras regiones y para la Semana Mundial de la Inmunización. La Semana de Vacunación en las Américas se centra en el trabajo de los programas nacionales de inmunización, con esfuerzos especiales para llegar a las personas que todavía no estén cubiertas. En el presente trabajo se dan ejemplos de cómo los países han aprovechado la Semana de Vacunación para realizar diversas actividades relacionadas con la vacunación, fortalecer los servicios de salud en general mediante la integración con otras intervenciones preventivas y fomentar el “panamericanismo” y la diplomacia en torno a la salud. Las oportunidades que ofrece esta iniciativa mundial quedaron claramente evidenciadas en abril del 2016 con el éxito obtenido en la sustitución de la vacuna oral trivalente contra la poliomielitis por la vacuna bivalente, sincronizada con la Semana Mundial de la Inmunización. En el futuro, la Semana de Vacunación en las Américas y la Semana Mundial de Inmunización pueden ayudar a subsanar la brecha en el acceso a la inmunización y otros servicios de salud, y contribuir a alcanzar la cobertura universal de salud.

[RESUMO]. Este artigo narra os antecedentes e a evolução da Semana de Vacinação nas Américas (SVA), uma iniciativa que nasceu da resposta coordenada ao surto de sarampo na Colômbia e na Venezuela em 2002 e evoluiu como um modelo para as outras regiões e para a Semana Mundial da Imunização. A SVA põe ênfase no trabalho dos programas nacionais de vacinação e, principalmente, nos esforços para se alcançar quem ainda está inalcançado. São ilustrados exemplos de como os países têm aproveitado a SVA para implementar várias atividades de vacinação, fortalecendo os serviços de saúde em geral ao integrá-la a outras intervenções preventivas e reforçando o pan-americanismo e a diplomacia da saúde. As oportunidades criadas por esta iniciativa global ficaram bem evidentes em abril de 2016 com a bem-sucedida transição em nível mundial da vacina oral contra poliomielite trivalente à bivalente, em sincronia com a Semana Mundial da Imunização. Prosseguindo adiante, a SVA e a Semana Mundial da Imunização podem contribuir para sanar as lacunas no acesso à imunização e a outros serviços de saúde e alcançar a cobertura universal de saúde.

The evolution of Vaccination Week in the Americas.

This report covers the background and evolution of Vaccination Week in the Americas (VWA), an initiative that started as a coordinated response to a 2002 measles outbreak in Colombia and Venezuela, and evolved into the model for other regions and World Immunization Week (WIW). VWA focuses on the work of national immunization programs, with special efforts to reach the unreached. This paper offers examples of how countries have leveraged VWA to implement a diverse array of vaccination activities, strengthening overall health services by integrating with other preventive health interventions, and bolstering "Pan-Americanism" and health diplomacy. The opportunities offered by this global initiative were clearly demonstrated in April 2016 when the successful global switch from the trivalent oral polio vaccine to the bivalent vaccine was synchronized with WIW. Going forward, VWA and WIW can help close the gaps in access to immunization and other health services, contributing to achieve universal health coverage.

Este informe incluye los antecedentes y la evolución de la Semana de Vacunación en las Américas, una iniciativa que comenzó como una respuesta coordinada a un brote de sarampión en Colombia y Venezuela en el 2002, y evolucionó hasta convertirse en modelo para otras regiones y para la Semana Mundial de la Inmunización.La Semana de Vacunación en las Américas se centra en el trabajo de los programas nacionales de inmunización, con esfuerzos especiales para llegar a las personas que todavía no estén cubiertas. En el presente trabajo se dan ejemplos de cómo los países han aprovechado la Semana de Vacunación para realizar diversas actividades relacionadas con la vacunación, fortalecer los servicios de salud en general mediante la integración con otras intervenciones preventivas y fomentar el "panamericanismo" y la diplomacia en torno a la salud.Las oportunidades que ofrece esta iniciativa mundial quedaron claramente evidenciadas en abril del 2016 con el éxito obtenido en la sustitución de la vacuna oral trivalente contra la poliomielitis por la vacuna bivalente, sincronizada con la Semana Mundial de la Inmunización. En el futuro, la Semana de Vacunación en las Américas y la Semana Mundial de Inmunización pueden ayudar a subsanar la brecha en el acceso a la inmunización y otros servicios de salud, y contribuir a alcanzar la cobertura universal de salud.

Este artigo narra os antecedentes e a evolução da Semana de Vacinação nas Américas (SVA), uma iniciativa que nasceu da resposta coordenada ao surto de sarampo na Colômbia e na Venezuela em 2002 e evoluiu como um modelo para as outras regiões e para a Semana Mundial da Imunização.A SVA põe ênfase no trabalho dos programas nacionais de vacinação e, principalmente, nos esforços para sealcançar quem ainda está inalcançado. São ilustrados exemplos de como os países têm aproveitado a SVA para implementar várias atividades de vacinação, fortalecendo os serviços de saúde em geral ao integrá-la a outras intervenções preventivas e reforçando o pan-americanismo e a diplomacia da saúde.As oportunidades criadas por esta iniciativa global ficaram bem evidentes em abril de 2016 com a bem-sucedida transição em nível mundial da vacina oral contra poliomielite trivalente à bivalente, em sincronia com a Semana Mundial da Imunização. Prosseguindo adiante, a SVA e a Semana Mundial da Imunização podem contribuir para sanar as lacunas no acesso à imunização e a outros serviços de saúde e alcançar a cobertura universal de saúde.

The evolution of Vaccination Week in the Americas / La evolución de la Semana de Vacunación en las Américas / Evolução da Semana de Vacinação nas Américas

ABSTRACT This report covers the background and evolution of Vaccination Week in the Americas (VWA), an initiative that started as a coordinated response to a 2002 measles outbreak in Colombia and Venezuela, and evolved into the model for other regions and World Immunization Week (WIW). VWA focuses on the work of national immunization programs, with special efforts to reach the unreached. This paper offers examples of how countries have leveraged VWA to implement a diverse array of vaccination activities, strengthening overall health services by integrating with other preventive health interventions, and bolstering "Pan-Americanism" and health diplomacy. The opportunities offered by this global initiative were clearly demonstrated in April 2016 when the successful global switch from the trivalent oral polio vaccine to the bivalent vaccine was synchronized with WIW. Going forward, VWA and WIW can help close the gaps in access to immunization and other health services, contributing to achieve universal health coverage.(AU)

RESUMEN Este informe incluye los antecedentes y la evolución de la Semana de Vacunación en las Américas, una iniciativa que comenzó como una respuesta coordinada a un brote de sarampión en Colombia y Venezuela en el 2002, y evolucionó hasta convertirse en modelo para otras regiones y para la Semana Mundial de la Inmunización. La Semana de Vacunación en las Américas se centra en el trabajo de los programas nacionales de inmunización, con esfuerzos especiales para llegar a las personas que todavía no estén cubiertas. En el presente trabajo se dan ejemplos de cómo los países han aprovechado la Semana de Vacunación para realizar diversas actividades relacionadas con la vacunación, fortalecer los servicios de salud en general mediante la integración con otras intervenciones preventivas y fomentar el "panamericanismo" y la diplomacia en torno a la salud. Las oportunidades que ofrece esta iniciativa mundial quedaron claramente evidenciadas en abril del 2016 con el éxito obtenido en la sustitución de la vacuna oral trivalente contra la poliomielitis por la vacuna bivalente, sincronizada con la Semana Mundial de la Inmunización. En el futuro, la Semana de Vacunación en las Américas y la Semana Mundial de Inmunización pueden ayudar a subsanar la brecha en el acceso a la inmunización y otros servicios de salud, y contribui(AU)

RESUMO Este artigo narra os antecedentes e a evolução da Semana de Vacinação nas Américas (SVA), uma iniciativa que nasceu da resposta coordenada ao surto de sarampo na Colômbia e na Venezuela em 2002 e evoluiu como um modelo para as outras regiões e para a Semana Mundial da Imunização. A SVA põe ênfase no trabalho dos programas nacionais de vacinação e, principalmente, nos esforços para se alcançar quem ainda está inalcançado. São ilustrados exemplos de como os países têm aproveitado a SVA para implementar várias atividades de vacinação, fortalecendo os serviços de saúde em geral ao integrá-la a outras intervenções preventivas e reforçando o pan-americanismo e a diplomacia da saúde. As oportunidades criadas por esta iniciativa global ficaram bem evidentes em abril de 2016 com a bem-sucedida transição em nível mundial da vacina oral contra poliomielite trivalente à bivalente, em sincronia com a Semana Mundial da Imunização. Prosseguindo adiante, a SVA e a Semana Mundial da Imunização podem contribuir para sanar as lacunas no acesso à imunização e a outros serviços de saúde e alcançar a cobertura universal de saúde.(AU)

Influenza vaccination in the Americas: Progress and challenges after the 2009 A(H1N1) influenza pandemic.

BACKGROUND: There has been considerable uptake of seasonal influenza vaccines in the Americas compared to other regions. We describe the current influenza vaccination target groups, recent progress in vaccine uptake and in generating evidence on influenza seasonality and vaccine effectiveness for immunization programs. We also discuss persistent challenges, 5 years after the A(H1N1) 2009 influenza pandemic. METHODS: We compiled and summarized data annually reported by countries to the Pan American Health Organization/World Health Organization (PAHO/WHO) through the WHO/UNICEF joint report form on immunization, information obtained through PAHO's Revolving Fund for Vaccine Procurement and communications with managers of national Expanded Programs on Immunization (EPI). RESULTS: Since 2008, 25 countries/territories in the Americas have introduced new target groups for vaccination or expanded the age ranges of existing target groups. As of 2014, 40 (89%) out of 45 countries/territories have policies established for seasonal influenza vaccination. Currently, 29 (64%) countries/territories target pregnant women for vaccination, the highest priority group according to WHO´s Stategic Advisory Group of Experts and PAHO/WHO's Technical Advisory Group on Vaccine-preventable Diseases, compared to only 7 (16%) in 2008. Among 23 countries reporting coverage data, on average, 75% of adults ≥60 years, 45% of children aged 6-23 months, 32% of children aged 5-2 years, 59% of pregnant women, 78% of healthcare workers, and 90% of individuals with chronic conditions were vaccinated during the 2013-14 Northern Hemisphere or 2014 Southern Hemisphere influenza vaccination activities. Difficulties however persist in the estimation of vaccination coverage, especially for pregnant women and persons with chronic conditions. Since 2007, 6 tropical countries have changed their vaccine formulation from the Northern to the Southern Hemisphere formulation and the timing of their campaigns to April-May following the review of national evidence. LAC countries have also established an official network dedicated to evaluating influenza vaccines effectiveness and impact. CONCLUSION: Following the A(H1N1)2009 influenza pandemic, countries of the Americas have continued their efforts to sustain or increase seasonal influenza vaccine uptake among high risk groups, especially among pregnant women. Countries also continued strengthening influenza surveillance, immunization platforms and information systems, indirectly improving preparedness for future pandemics. Influenza vaccination is particularly challenging compared to other vaccines included in EPI schedules, due to the need for annual, optimally timed vaccination, the wide spectrum of target groups, and the limitations of the available vaccines. Countries should continue to monitor influenza vaccination coverage, generate evidence for vaccination programs and implement social communication strategies addressing existing gaps.

Vaccination Week in the Americas, 2011: an opportunity to assess the routine vaccination program in the Bolivarian Republic of Venezuela.

BACKGROUND: Vaccination Week in the Americas (VWA) is an annual initiative in countries and territories of the Americas every April to highlight the work of national expanded programs on immunization (EPI) and increase access to vaccination services for high-risk population groups. In 2011, as part of VWA, Venezuela targeted children aged less than 6 years in 25 priority border municipalities using social mobilization to increase institution-based vaccination. Implementation of social communication activities was decentralized to the local level. We conducted a survey in one border municipality of Venezuela to evaluate the outcome of VWA 2011 and provide a snapshot of the overall performance of the routine EPI at that level. METHODS: We conducted a coverage survey, using stratified cluster sampling, in the Venezuelan municipality of Bolivar (bordering Colombia) in August 2011. We collected information for children aged <6 years through caregiver interviews and transcription of vaccination card data. We estimated each child's eligibility to receive a specific vaccine dose during VWA 2011 and whether or not they were actually vaccinated during VWA activities. We also estimated baseline vaccination coverage, timeliness and 95% confidence intervals (CI), and used chi-square tests to compare coverage across age cohorts, taking into account the sampling design. RESULTS: We surveyed 839 children from 698 households; 93% of children had a vaccination card. Among households surveyed, 216 (31%) caregivers reported having heard about a vaccination activity during April or May 2011. Of the 528 children eligible to receive a vaccine during VWA, 24% received at least one dose, while 13% received all doses due. Overall, baseline coverage with routine vaccines, as measured by the survey, was >85%, with a few exceptions. CONCLUSION: Low levels of VWA awareness among caregivers probably contributed to the limited vaccination of eligible children during the VWA activities in Bolivar in 2011. However, vaccine coverage for most EPI vaccines was high. Additionally, high vaccination card availability and high participation in VWA among those caregivers aware of it in 2011 suggest public trust in the EPI program in the municipality. Health authorities have used survey findings to inform changes to the routine EPI and better VWA implementation in subsequent years.

Vaccination Week in the Americas: an opportunity to integrate other health services with immunization.

Vaccination Week in the Americas (VWA) is an initiative of the countries and territories of the Americas that works to advance equity and access to vaccination. The initiative focuses on reaching populations with limited access to regular health services and promotes solidarity among countries. As the Expanded Program on Immunization is one of the world's best-established health programs, integrating other interventions with immunization services has been highly promoted. Using data available from the Pan American Health Organization, we explored the extent of integration of other interventions with immunization in Latin American and Caribbean (LAC) countries as part of VWA. At least 14 countries or territories have integrated other interventions with immunization during VWA. The most common integrated intervention is vitamin A supplementation, followed by deworming. However, a variety of other interventions have been integrated, such as educational activities, supplementation with vitamins and minerals, and provision of health services. Data on coverage of integrated interventions are limited. Integration of other interventions with immunization in LAC countries is widespread, and its impact and lessons learned merit further examination.

Pandemic influenza vaccination: lessons learned from Latin America and the Caribbean.

In April 2009, the World Health Organization (WHO) reported the emergence of a new influenza (H1N1) virus which led to the first pandemic declaration of the 21st century. Most countries in Latin America and the Caribbean (LAC) had a national preparedness plan in place at this time; however, the vaccination component of such plans was largely undeveloped. Nevertheless, countries were able to capitalize on the infrastructure of their immunization programs and widespread experience utilizing the seasonal influenza vaccine to prepare rapidly, developing H1N1 vaccination plans targeting individuals with chronic disease, pregnant women and health care workers, among others. In LAC vaccine was acquired through three mechanisms: the Pan American Health Organization's Revolving Fund, direct manufacturer purchase, and WHO donations. Vaccine access was not equitable both in quantity of vaccine available and timeless of vaccine availability. As of December 2010, an estimated 145 million doses had been administered in LAC. Despite high regional coverage, there were large variations in coverage at the national level; pregnant women had the lowest coverage, despite their high risk for morbidity and mortality. The number of severe adverse events reported in LAC was similar to those expected with the seasonal influenza vaccine. Risk communication was one of the key challenges countries faced, mainly due to concerns and misinformation spread regarding vaccine safety. Countries and the international community need to learn from the experiences gained during H1N1 vaccination in order to be better prepared for the next pandemic.

Expansion of seasonal influenza vaccination in the Americas.

BACKGROUND: Seasonal influenza is a viral disease whose annual epidemics are estimated to cause three to five million cases of severe illness and 250,000 to 500,000 deaths worldwide. Vaccination is the main strategy for primary prevention. METHODS: To assess the status of influenza vaccination in the Americas, influenza vaccination data reported to the Pan American Health Organization (PAHO) through 2008 were analyzed. RESULTS: Thirty-five countries and territories administered influenza vaccine in their public health sector, compared to 13 countries in 2004. Targeted risk groups varied. Sixteen countries reported coverage among older adults, ranging from 21% to 100%; coverage data were not available for most countries and targeted populations. Some tropical countries used the Northern Hemisphere vaccine formulation and others used the Southern Hemisphere vaccine formulation. In 2008, approximately 166.3 million doses of seasonal influenza vaccine were purchased in the Americas; 30 of 35 countries procured their vaccine through PAHO's Revolving Fund. CONCLUSION: Since 2004 there has been rapid uptake of seasonal influenza vaccine in the Americas. Challenges to fully implement influenza vaccination remain, including difficulties measuring coverage rates, variable vaccine uptake, and limited surveillance and effectiveness data to guide decisions regarding vaccine formulation and timing, especially in tropical countries.