WHO Optimizing Immunization Schedules Project
Request For Proposals for the WHO Optimizing Immunization Schedules Project, 2012
Introduction and Background
This request for proposals (RFP) is made by the WHO Initiative for Vaccine Research (IVR) . IVR seeks proposals for the rigorous systematic review and meta-analysis of all available data from published and unpublished clinical trials data, as well as post-marketing data collected through registries, case control studies, cohort studies, surveillance systems or spontaneous case reports relevant to immunization schedules of selected childhood vaccines. The methodology will include a systematic review of data available. IVR encourages proposals that include collaboration between institutions/groups in industrialized countries and institutions/groups in low and middle income countries.
In 2006, SAGE recognized the importance and timeliness of reviewing the scientific and operational basis for the choice of the optimal schedule for childhood immunization . More than 20 years have passed since the “EPI schedule” of 6, 10 and 14 weeks for DTP-OPV and 9 months for measles vaccine was introduced, and much information has accrued, together with the development of improved techniques for assessing immune responses. There was recognition that immunization schedules in use today vary greatly around the world, and it is unlikely that a single, uniform immunization schedule would suit all countries.
WHO should aim to provide countries with advice on the parameters to be considered when they select a schedule. There was unanimous support for a new review of the evidence base, and agreement that changes in schedule are not appropriate without strong evidence to demonstrate benefit. It has also been stressed that it is difficult to design one schedule for all countries as there are differences in epidemiology, health infrastructure and resources. In developed countries these discussions take place at national level based on local data, but low resource countries often rely on decisions made by others.
The Optimizing Immunization Schedules project aims to develop a standard tool to review evidence supporting immunization schedules and their appropriateness in different epidemiological settings. The project entails:
- reviewing local epidemiological data;
- conducting systematic reviews of the effectiveness of different vaccination schedules;
- modelling the impact and cost-effectiveness of immunization schedules in different epidemiological scenarios; and
- conducting evidence-based assessments of the trade-offs made by selecting a particular schedule in the context of local operational and health-system realities .