In 2021, the World Health Organization (WHO) collaborated with the Government of Gabon to launch the Intensified Vaccination Activities (IVA) programme. The programme was developed in response to declining immunization coverage, increasing vaccine hesitancy and interruptions to routine immunization due to the COVID-19 pandemic. In October 2021, approximately half of unvaccinated children aged 0 to 11 months received Penta 3, Oral Poliovirus Vaccine type 3 (OPV3), inactivated Polio Vaccine (IPV), Varicella Vaccine (VAR), and Yellow Fever Vaccine (YFV) through the IVA programme. Follow-up rounds conducted monthly resulted in the further administration of Penta 3 and OPV3 vaccinations to more than 2,700 children, 2,371 children receiving IPV, 5,415 children vaccinated with VAR, and 3,139 pregnant women receiving the tetanus vaccine. The implementation of the IVA programme successfully restored immunization coverage for Vaccine Preventable Diseases (VPD), even surpassing pre-pandemic levels. Penta 3 vaccine coverage, which protects against five VPD, rose from 63% in 2020 to 72% by the end of 2021 [1].

 

How did Gabon, with the support of the WHO Secretariat, achieve this?

 

In an effort to ensure high vaccination coverage in all districts, WHO Gabon provided technical support and funding to the Government of Gabon to develop an operational plan based on the Reach Every District (RED) approach. This approach, outlined in the WHO Regional Strategic Plan for Immunization, is designed to ensure equitable access to vaccination. This operational plan was used to advocate for additional funding from partners and donors, and WHO Gabon successfully raised 400,000 USD to cover operational costs for a catch-up immunization campaign.

 

In order to mitigate the disruption caused by the COVID-19 pandemic, WHO provided technical advice to the Ministry of Health (MoH) to adjust the routine vaccine schedule. In September 2021 COVID-19 vaccines were received through the COVAX mechanism, a partnership between the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi the Vaccine Alliance, United Nations Children’s Fund (UNICEF), and WHO. Routine vaccinations were then administered through the IVA programme in three rounds between October and December 2021, integrated with the national COVID-19 vaccination campaign.

 

 WHO Gabon provided comprehensive technical and financial support to the Ministry of Health (MoH) to ensure the effective implementation of the IVA programme. This included training 20 national-level trainers from the MOH and STOP programme consultants on the RED approach and surveillance techniques, financial support to train and deploy 256 health facility staff, including nurses and midwives, for each phase of the IVA, and training and financial assistance to central and regional supervisors to improve management of the campaign and monitor adverse events following immunization (AEFI). It also included technical advice and funding for teams of vaccinators and social mobilizers who visited villages and neighborhoods to actively search for children who had not yet been immunized, and operational support for the transportation of materials and vaccinations [2].

 

WHO Gabon acted as the lead government partner, communicating and coordinating with UNICEF in all regions and with the Red Cross in some regions, to ensure that vaccination activities were conducted effectively and efficiently while protecting staff and patients from COVID-19.

 

WHO and UNICEF worked together to raise awareness of the availability of vaccines in the community, conducting a communication campaign that aimed to build and maintain public confidence in immunization and the health system. WHO provided technical support to create messages for the campaign, which were then distributed throughout the country via multiple channels, such as radio, television, websites, newspapers, SMS messages, and the existing social mobilizer network. In Gabon, social mobilizers, who are funded by the government, are responsible for informing their communities about health matters and initiatives.