Immunization, Vaccines and Biologicals

Health systems strengthening and grassroots advocacy needed if global immunization targets are to be met

An African woman looks on as her young child is vaccinated with a new vaccine to protect against meningitis
WHO/J. Bruyere

At the meeting of 5-7 April 2011 of WHO's Strategic Advisory Group of Experts on Immunization (SAGE), 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.

SAGE emphasized that countries vaccinating their populations against measles, should also be vaccinating against rubella. Countries reaching measles coverage of 80%, either through routine immunization only or through routine immunization and supplementary immunization activities, can introduce rubella-containing vaccine without risk of increasing the incidence of congenital rubella syndrome. While cost-effectiveness for rubella vaccination is clear for high and middle-income countries, SAGE recommended that cost-effectiveness studies for low-income countries be undertaken.

Other topics discussed during the meeting included vaccination against pandemic and seasonal influenza, tick-borne encephalitis and meningococcal meningitis; polio eradication, and ongoing research efforts relating to IPV options for low-income countries in the post-eradication era; and the use of cholera vaccines, particularly in outbreak situations.

The full report of the meeting will be published in the WHO Weekly Epidemological Record on 20 May. Meeting documents, including background material and presentations, will shortly be available at the link below.