Immunization, Vaccines and Biologicals

Immunization highlights: 2011

Supporting countries in evidence-based decision-making

Vaccine and immunization policy-making

SAGE members discussing during the meeting
C. Scudamore

Evidence-based immunization policy recommendations are formulated through the regular consultation of experts from around the world. SAGE ― established in 1999 by the WHO Director-General ― is the principal advisory group to WHO for vaccines and immunization. It is charged with advising WHO on overall global policies and strategies, ranging from vaccine technology and research and development, to delivery of immunization and its linkages with other health interventions. SAGE is concerned with vaccines and immunization for all age groups.

In 2011, two SAGE meetings were held. At the April meeting, a cross-cutting concern emerged that weak primary health care services, particularly in Africa, are impeding the ability of countries to deliver on immunization strategies. Health systems strengthening, and the creation of a grassroots advocacy movement at global, national and community levels in support of access to vaccines, will be needed if we are to achieve the global immunization targets that have been set.

At the November meeting, the strategy to eradicate the remaining strains of wild poliovirus was discussed at length. SAGE stated unequivocally that the risk of failure to finish global polio eradication constitutes a programmatic emergency of global proportions for public health and is not acceptable under any circumstances.

Three new WHO position papers on vaccines published

Screen shot of the pertussis vaccines position paper published in 2010

Three new or updated position papers were published in the WHO Weekly Epidemiological Record — on tick-borne encephalitis, rubella and meningococcal. As with all WHO position papers on vaccines, prior to publication, the papers were reviewed by experts within and outside WHO and follow the recommendations of SAGE on immunization.

Substantive supporting material — a summary, grading tables of scientific evidence on which the paper is based, key references and presentation slides — is posted with all new and updated position papers.

WHO recommendations for routine immunization

Immunization is no longer limited to the classic six vaccines for children. New products, including for adolescents, adults and seniors, are available to prevent disease, disability and death. To assist countries in creating optimal immunization schedules, WHO has produced tables summarizing its current recommendations on routine immunization. Details on the recommended timing of routine immunization of children are also included. In addition, a short orientation guide has been developed as a companion piece to facilitate the use of the WHO summary tables. By consolidating its many recommendations into summary tables, WHO hopes to provide easy access to its policy advice and support national immunization programmes to critically examine, and possibly modify, their schedules.

Progress in establishing and strengthening National Immunization Technical Advisory Groups

In partnership with the Supporting National Independent Immunization and Vaccine Advisory Committees Initiative and other partners, WHO continued its efforts to assist countries in establishing and strengthening their National Immunization Technical Advisory Groups (NITAGs). NITAGs advise governments, policy-makers and programme managers on technical issues related to national immunization programmes and on the formulation of national immunization policies and strategies.

NITAG specific indicators are now included in the WHO/UNICEF joint reporting form. By the end of 2010, 50% of countries reported the existence of an NITAG with a legislative or administrative basis which represents a 10% increase since 2008. In addition, an increasing number of countries confirmed that their NITAGs have established formal terms of reference and a requirement for members to disclose their interests. This is crucial as the main advantage of a NITAG is the transparency and credibility that its independent expert members bring to the decision-making process, the national immunization programme and the government at large.