EYE Newsletter May 2020

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Date: 27 May 2020
 
Gavi, UNICEF and WHO call for joint effort to deliver immunization and proceed with campaigns safely
To address the growing impact of COVID-19 on immunization service delivery, Gavi, UNICEF and WHO leadership highlighted the importance of maintaining efforts to  safely deliver routine immunization (RI) and proceed with preventive mass vaccination campaigns (PMVCs) against deadly vaccine-preventable diseases (VPDs) such as yellow fever (YF) via a joint press conference on 22 May. Read more here.

Many countries have temporarily and justifiably suspended PMVCs against diseases such as YF due to the possibility that PMVCs may increase COVID-19 transmission among health workers and the community. Three countries with YF outbreaks have experienced delays in implementing reactive campaigns (Ethiopia, South Sudan and Uganda), while 3 countries have postponed their PMVCs to later this year (DRC, Ghana and Nigeria) and 2 countries have postponed vaccination campaigns in the Americas (Bolivia and Colombia).

In late March, concerned that mass gatherings for vaccination campaigns would enflame COVID-19 transmission WHO recommended countries to temporarily suspend preventive campaigns while assessments of risk, and effective measures for reducing SARS-CoV-2 transmission were established.

WHO has carefully monitored the situation and has now issued advice to help countries determine how and when to resume mass vaccination campaigns. This guidance notes that countries will need to make specific risk assessments based on the local dynamics of COVID-19 transmission, health system capacities, and the public health benefit of conducting preventive and outbreak response vaccination campaigns.

Based on this guidance, and following growing concerns about increasing transmission of YF, the Eliminate Yellow Fever Epidemics (EYE) Strategy continues supporting YF high-risk countries and advising them to start planning for the safe resumption of YF immunization campaigns.
 
Successful Gavi application submissions for 3 countries:
Nigeria (PMVC), Sudan (catch-up) & Uganda (PMVC, RI intro)
As a country at high-risk for YF, Uganda demonstrated its commitment to eliminate the risk of outbreaks by submitting applications for YF vaccination support from Gavi, the Vaccine Alliance. Despite the complexity of operations in the COVID-19 context, Uganda completed preparation of the application documents and received Inter-Agency Coordination Committee (ICC) endorsement in support of introduction of YF vaccination into RI and completion of nation-wide PMVCs. This meeting resulted in the clearance and successful submission of its application to Gavi. The Ugandan health ministry and related agencies are to be congratulated for their commitment to ensure protection of their populations against YF.

EYE partners including the US Centers for Disease Control and Prevention (CDC), Gavi, UNICEF, WHO regional offices and headquarters actively provided support to the process. The EYE Risk Analysis Working Group (RAWG), under the leadership of the CDC's Division of Vector-Borne Diseases (DVBD), Arboviral Diseases Branch was instrumental in supporting Uganda with risk analysis to guide the application.

Sudan submitted their application for a YF catch up campaign intended to ensure that all children in the country have equitable access to protection against YF.

Nigeria also submitted an application for additional phases to complete nation-wide PMVCs on an accelerated schedule. The application writing team was supported with inputs from partners (Bill & Melinda Gates Foundation, Gavi and WHO).
 
EYE informational update to YF vaccine manufacturers
Vaccination against YF is the single most important measure for YF prevention, with a single dose being capable of providing life-long immunity. Ensuring adequate vaccine supply for all at-risk populations remains critically important in the COVID-19 context.
 
YF vaccines are currently manufactured by 4 WHO-prequalified suppliers (Bio-Manguinhos, Chumakov, Sanofi, Institut Pasteur Dakar) and through the EYE partnership, over a billion YF vaccine doses are expected to be delivered to countries with high YF risk by 2026.
 
As part of its coordination role, the EYE programme management group (PMG) provides a quarterly informational update to the four global producers of the YF vaccine. During the most recent update in May, the EYE PMG highlighted the continued commitment to EYE at all levels despite COVID-19, the anticipated vaccination activities through 2022 and options for contingency plans if challenges to implement are encountered.
 
This session provided an interactive forum with a clear representation of the actions being taken by the countries and by the partnership towards successful campaign planning and implementation, while acknowledging risks beyond the control of the partnership (political, insecurity, epidemic evolution) and options to mitigate any adverse impact.
 
Published and anticipated guidance documents
To support decision-making processes during the COVID-19 pandemic, WHO and partners have published country and technical guidance documents. WHO’s country and technical guidance documents are accessible via its publications hub, containing documents such as:

Framework for decision-making: implementation of mass vaccination campaigns in the context of COVID-19, which describes the principles to consider when deliberating the implementation of mass vaccination campaigns for prevention of vaccine-preventable diseases and high impact diseases (VPD/HID), and when assessing risks and benefits of conducting outbreak-response vaccination campaigns to respond to VPD/HID outbreaks. This framework builds on the previously published resources for immunization in COVID-19 context, including:
At the  regional level, PAHO has developed The Immunization Program in the Context of the COVID-19 which contains recommendations on vaccination and epidemiological surveillance for VPDs in the Americas region.

Anticipated: WHO will soon issue new advice to countries on maintaining essential services during the pandemic, including recommendations on how to provide immunizations safely.
 

110 million people

Protected against yellow fever in Africa since EYE inception.
 
We are all partners. We all have a role to play.
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