WHO's revised position on rabies vaccines, published today in the Weekly Epidemiological Record, emphasizes the need to replace nerve tissue rabies vaccines by effacacious, safer vaccines developed through cell culture. Intradermal immunization of cell culture vaccines is an acceptable alternative to standard intramuscular administration, and should be considered in settings constrained by cost and supply issues. Periodic booster injections of rabies vaccine for persons whose occupation puts them at high risk are advised. Rabies is a zoonotic, viral disease which is transmitted through close contact with saliva from infected animals. An estimated 55 000 people die from rabies each year, mainly in Asia and Africa. Without vaccination, the disease is virtually always fatal in persons who have developed symptoms.

WHO position paper on rabies vaccines [pdf 312kb]

The World Health Organization (WHO) is today releasing a new comprehensive approach to tackle the challenges in immunization monitoring and disease surveillance. The Global Framework for Immunization Monitoring and Surveillance was developed by WHO and the United States Centers for Disease Control and Prevention. It responds to the need for timely and valid epidemiological and programme information which is crucial in measuring progress towards immunization goals and controlling vaccine-preventable diseases.

Global Framework for Immunization Monitoring and Surveillance [pdf 1.8MB]
WHO Bulletin

Measles deaths in Africa fell by 91% during the period 2000 through 2006, from an estimated 396 000 to 36 000, reaching the United Nations 2010 goal to cut measles deaths by 90% four years early. The gains achieved in Africa helped generate a strong decline in global measles deaths, which fell 68% worldwide - from an estimated 757 000 to 242 000 - during this period. "This is a major public health success and a tribute to the commitment of countries in the African region," said Dr Margaret Chan, Director-General, World Health Organization.

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The Strategic Advisory Group of Experts (SAGE) on immunization will meet in Geneva on 6-9 November 2007. Twice a year, the Group provides evidence-based, strategic advice to WHO on global immunization-related policies and strategies. SAGE serves as a rallying point for experts in vaccines and immunization from all over the world. The Group will focus, in this session, on uses of an H5N1 vaccine stockpile, efforts to complete polio eradication, the target product profile for Advance Market Commitment-eligible pneumococcal vaccines, and the use of typhoid fever vaccines in vulnerable populations living in high risk regions. SAGE will also be updated on activities, priorities and implementation issues in the Regions of the Americas, Europe and the Western Pacific, as well as on the work of the GAVI Alliance.

InfoVac web site
More information on the VSN

The web site InfoVac, which provides information for health-care professionals, the general public and the media on vaccines recommended in Switzerland, has become the latest site to join the Vaccine Safety Net, WHO's network of web sites providing information on vaccine safety. The web site, through its experts in infectious diseases and vaccination, provides answers in French and German to many commonly-asked questions on vaccine safety. The Vaccine Safety Net was initiated by WHO in 2003 with the aim of facilitating access to reliable information on vaccine safety. In order to join the network, web sites must clearly indicate their purpose, disclose their ownership and information sources, reveal their sponsors, provide contact information, have a data protection policy, and provide quality information in sufficient quantity. The network includes web sites in Dutch, English, French, German, Italian, and Spanish.

InfoVac web site
More information on the VSN

The new publication "WHO: working to ensure quality, safety and standards in immunization" provides information on the activities undertaken by WHO to assist countries in ensuring that vaccines and immunization equipment meet international norms and standards. The booklet covers the standard-setting process, national regulatory authority strengthening, prequalification of vaccines and immunization equipment, and response to vaccine safety issues of global concern.

Full text [pdf 740kb]
More information on immunization standards

The projected supply of pandemic influenza vaccine has greatly increased and will continue to rise in the near future, thanks to scientific advances and increased demand for and production of seasonal influenza vaccines. This progress comes one year after eight new strategies to increase pandemic influenza vaccine were identified and published in the World Health Organization Global pandemic influenza action plan to increase vaccine supply. It was announced at the first meeting of the Global Action Plan Advisory Group at WHO 's Geneva headquarters on 19 October. In 2007, maximum production capacity has reached, according to the International Federation of Pharmaceutical Manufacturers & Associations, an estimated 565 million doses of trivalent (i.e. includes three viral strains) seasonal influenza vaccines, compared to around 350 million doses effectively produced in 2006. According to experts working in this field, the production capacity for seasonal influenza vaccine is expected to rise to 1 billion doses in 2010, provided corresponding demand exists. This constitutes significant progress, but is still far short of the 6.7 billion immunization courses that would be needed within half a year to protect the global population from pandemic influenza.

Press release
WHO Global pandemic influenza action plan to increase vaccine supply

New results of a candidate malaria vaccine clinical trial undertaken to determine the vaccine's safety, immunogenicity and efficacy, show promise. The trial, in which 214 Mozambican infants were enrolled, measured a reduced risk of 65% in contracting new malaria infections in infants who received RTS,S/AS02D, the candidate malaria vaccine. This is the first time the possibility of protecting young infants against malaria has ever been demonstrated in a malaria vaccine trial. In addition, the vaccine was found to be safe and well-tolerated. Published yesterday in The Lancet 's online edition, the news "should encourage all those who are working towards making malaria a vaccine-preventable disease," said Dr Zarifah Reed, Scientific Officer, WHO Initiative for Vaccine Research. "These preliminary results represent an important step in the direction of the goal envisioned by the Malaria Vaccine Technology Roadmap: the development of a vaccine by 2025 that would have a protective efficacy of more than 80% against clinical disease. The Lancet study authors urged caution in interpreting the efficacy results in view of the brief follow-up period and the intensity of malaria surveillance. Larger trials, planned for 2008 in sub-Saharan Africa, are needed to confirm these promising findings.

The Lancet article
Malaria Vaccine Technology Roadmap
WHO Statement (2004) on related trial [pdf 1.07Mb]

Routine measles vaccination coverage reached its highest level ever, an estimated 80% in 2006, and an unprecedented number of children were vaccinated against measles through supplementary immunization activities. This was among the good news that came out of the Measles Initiative partners meeting held on 24-25 September in Geneva. To achieve the goal to reduce measles mortality by 90% in the period 2000-2010, the partners agreed that countries need to sustain the gains made to date and to accelerate efforts in India as well as in countries experiencing conflict, where large pockets of the population are unimmunized against measles. There is also an urgent need to secure funding for measles immunization activities for 2009-2010.

WHO measles information
Measles Initiative

Maternal and neonatal tetanus are set to be validated as eliminated in all but seven countries in Africa and four countries in Asia in 2009, according to an article co-authored by WHO and published today in The Lancet. Vaccination with tetanus toxoid (US $1.20 for three doses) to induce immunity in both mother and newborn is the most reliable way to prevent this disease, though hygienic deliveries and umbilical cord care are also important. The elimination strategy, which aims to reduce the burden of the disease to less than one case per 1000 live births in every district in every country, particularly targets high risk areas through supplemental immunization activities. An estimated 180 000 deaths due to neonatal tetanus occur worldwide each year (based on 2002 data), usually among poor, remote and disenfranchised communities. Good progress is being made against this very painful, life-threatening disease: the number of annual deaths has declined by about 80% since the late 1980s. However, as of early 2007, 48 developing countries had not yet eliminated the disease, about 15% less than in the year 2000. The rejuvenated worldwide commitment to improvement of maternal and child health, as well as the application of effective strategies to vaccinate hard-to-reach, underserved populations will help achieve the elimination goal embodied in a 1989 World Health Assembly resolution.

The Lancet article [pdf 388kb]
Lancet web site
WHO tetanus page

WHO published today, in the Weekly Epidemiological Record, its revised position on rotavirus vaccines. The article provides information on the safety, efficacy and use of the two new live, oral, attenuated vaccines against the disease, licensed in 2006: the monovalent human rotavirus vaccine (Rotarix®) and the pentavalent bovine-human, reassortant vaccine (RotaTeq®). It recommends the inclusion of rotavirus vaccination into the national immunization programmes of regions and countries where vaccine efficacy data suggest a significant public health impact and where appropriate infrastructure and financing mechanisms can sustain vaccine utilization. Rotaviruses are the most common cause of severe diarrhoeal disease in infants and young children worldwide.

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The Committee, meeting on 12-13 June in Geneva, Switzerland, considered a number of issues, including the safety of human papillomavirus (HPV) and rotavirus vaccines.
Current evidence on the safety of HPV vaccines is reassuring. As with the introduction of any new vaccine, it will be important to conduct surveillance to identify possible, rare, unexpected events, especially as good quality information on the baseline rates of diseases common in the target age group for HPV vaccination (9-26 years) is generally lacking. With regard to rotavirus vaccines, data were presented on the Merck vaccine RotaTeq® and the GSK vaccine Rotarix® . The Committee concluded that the data regarding intussusception are reassuring, but noted that most data currently relate to developed countries. The Committee was established in 1999 to respond promptly, efficiently, and with scientific rigour to vaccine safety issues of potential global importance.

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From 2 to 18 July, an estimated 1.5 million children aged 9 months to 13 years will be vaccinated against measles in eight districts in the western province of Balochistan. This is part of a nationwide drive which began in March 2007 to protect more than 63 million children against measles by March 2008 and will be a significant step toward reaching the global goal of reducing measles deaths by 90% by 2010.

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The Meningitis Vaccine Project (MVP) today released new data on the performance of a meningitis vaccine in West African children, suggesting that the new vaccine - expected to sell initially for 40 US cents a dose – will be much more effective in protecting African children and their communities than any vaccine currently on the market in the region. "This important study brings real hope that the lives of thousands of children, teenagers and young adults will be saved by immunization and that widespread suffering, sickness and socioeconomic disruption can be avoided", said Dr. Margaret Chan, Director-General, WHO.

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The Immunization Department's stand at the 60th World Health Assembly focuses on measles mortality during three key years, and the increasing number of lives saved due to outstanding progress in measles control. While 2400 people died as a result of measles every day in 1999, in 2010, deaths per day are expected to number about 220. The next ambitious measles goal--a 90% reduction of measles deaths in 2010 (compared to 2000)--will require strong political commitment and continuing support from international partners. Nearly US$ 230 million has been raised, but approximately US$ 250 million is still needed to reach this realistic goal. During the World Heatlh Assembly, 14-23 May, a progress report on reducing global measles mortality will be discussed by delegates.

IVB measles page
Progress reports on technical and health matters [pdf 201kb]

A new joint policy statement has been announced on 3 May by WHO and UNICEF concerning the role of vaccine vial monitors (VVMs) in improving access to immunization. Statement was released in conjunction with the 10-year anniversary of successful introduction of VVMs in immunization programmes. The new joint policy statement will call upon all vaccine self-procuring Member States to include the VVM among the minimum requirements for vaccine purchase agreements.

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Countries and vaccine manufacturers meeting at World Health Organization headquarters on 25 April agreed that creating a stockpile of H5N1 vaccine before an influenza pandemic occurs may be feasible. This followed a recommendation last week to the Director-General by the Strategic Advisory Group of Experts on Immunization that there was sufficient scientific evidence for WHO to create an international H5N1 vaccine stockpile, including indications that some of the current H5 prototype vaccines may offer cross-protection against related, but different, viruses. WHO will now set up expert groups to determine how the stockpile will be created, funded, maintained and used.

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Six developing countries – Brazil, India, Indonesia, Mexico, Thailand, and Viet Nam – will get funding from the governments of the US and Japan to establish in-country manufacturing capacity for influenza vaccine as a part of the Global pandemic influenza action plan to increase vaccine supply.

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Forty-five countries and territories are participating in the fifth Vaccination Week in the Americas whose aim is to immunize 55 million persons. Vaccination campaigns against diseases such as influenza, measles, rotavirus and yellow fever are being combined with other health activities and social communication to increase awareness of the importance of immunization. The Week, which takes place 21-28 April, focuses on improving low immunization coverage, immunizing indigenous communities and promoting the use of new and existing vaccines.

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The Strategic Advisory Group of Experts meeting in Geneva on 17-18 April 2007 will discuss stockpiling of pandemic influenza vaccines, immunization financing and vaccine safety issues, and the status of human papillomavirus vaccines. The group of experts will also be updated on progress and priorities in the African, Eastern Mediterranean and South-East Asia Regions and the work of the GAVI Alliance.

In mid-March, a technical team from WHO's South-East Asia Regional Office, along with UNICEF, assisted national authorities in the planning and implementation of the first phase of a large measles immunization drive in the Democratic People's Republic of Korea (DPRK). More than 6 million North Korean children aged six months to 15 years were successfully vaccinated. The campaign is in response to 3500 reported cases of measles and four deaths.

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The inclusion of the 7-valent pneumococcal conjugate vaccine (PCV7) in national immunization programmes is a priority, particularly in countries with under-five mortality greater than 50 per 1000 live births, more than 50 000 child deaths annually or those with a high HIV/AIDS burden. Pneumococcal disease is the leading vaccine- preventable cause of child deaths worldwide. The full text of the updated position paper containing this new WHO recommendation can be found at:

http://www.who.int/immunization/documents/positionpapers

On 15-16 February 2007, WHO held a meeting in Geneva on the evaluation of pandemic influenza prototype vaccines in clinical trials. This was the third such meeting in two years, but for the first time, results presented at the meeting have convincingly demonstrated that vaccination with newly developed avian influenza vaccines can bring about a potentially protective immune response against H5N1 virus. Some of the vaccines work with low doses of antigen, which means that significantly more vaccine doses can be available in case of a pandemic.

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The goal to reduce global measles deaths by half between 1999 and 2005 has not only been achieved but exceeded. Measles deaths worldwide plunged by more than 60% from 1999 to 2005. This achievement became possible thanks to major success in the African region where measles deaths fell by 75%. "This is a historic victory for global public health, for the power of partnership and commitment by countries to fight a terrible disease," said Dr Margaret Chan, Director-General, World Health Organization.

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