Launch of multi-year preventive mass vaccination campaign (PMVC) in Uganda. July 2022.      © WHO Uganda

EYE Strategy July newsletter

Dr Mike Ryan, Executive Director of World Health Organization's (WHO) Health Emergencies Programme speaking at the virtual press conference on global health issues – 5th July 2023

Virtual Press Conference on global health issues – 5th July 2023 

Dr Mike Ryan, Executive Director of World Health Organization's (WHO) Health Emergencies Programme,  discussed yellow fever in the context of the climate crisis in a media briefing on global health issues held on 5th July 2023. We have provided some extracts from the press conference below. To watch the full briefing, click here or on the image above.

"The climate crisis is here, and the health crisis associated with the climate crisis is here, it's now, and we need to start investing in the measures that protect our communities from these diseases. These diseases will just continue to exploit the opportunities provided. We've seen that again and again and again.  

 “The vectors are the conduits of that disease, and we need to deal with them by reducing the presence of the vector but also reducing the impact that that vector has by reducing the susceptibility of the population.  

“A simple thing like yellow fever vaccination can protect you for life. […]. Yellow fever killed hundreds of thousands of people right the way through the last century and the century before. For many people it was known as yellow jack. It was a disease that was absolutely feared and a disease that actually affected the southern part of the United States for many, many years.  

“[…] Vector-borne diseases have affected southern parts of the United States historically and they certainly could return unless we double our efforts both to control those vectors but also to reduce the vulnerability of our populations to the diseases that they cause." 

WHO & UNICEF Estimates of National Immunization Coverage (WUENIC) Data for 2022 

Each year, WHO and UNICEF release estimates of national immunization coverage (WUENIC). Based on country-reported data, WUENIC provides the world’s largest and most comprehensive data set on immunization trends for vaccinations against 13 diseases given through regular health systems.

For 2022, data were provided from 183 countries. Read more below to understand the implications of the latest data.  

Of note, Uganda is included this year for yellow fever for the first time, following the nationwide introduction of the yellow fever vaccine into the routine immunization (RI) schedule in October 2022. Read more about Uganda's introduction into RI here.

Childhood immunization begins recovery after COVID-19 backslide 

Routine immunization vaccinations in Angola © UNICEF 2023

Joint WHO-UNICEF WUENIC Press Release 

New WHO and UNICEF data show promising signs of immunization services rebounding in some countries, but, particularly in low-income countries, coverage still falls short of pre-pandemic levels putting children at grave risk from disease outbreaks. 

Geneva / New York, 18th July 2023 – Global immunization services reached 4 million more children in 2022 compared to the previous year, as countries stepped up efforts to address the historic backsliding in immunization caused by the COVID-19 pandemic. 

According to data published today by WHO and UNICEF in 2022, 20.5 million children missed out on one or more vaccines delivered through routine immunization services, compared to 24.4 million children in 2021.

In spite of this improvement, the number remains higher than the 18.4 million children who missed out in 2019 before pandemic-related disruptions, underscoring the need for ongoing catch-up, recovery and system strengthening efforts. To read more, click here.

Eight things you need to know about the state of global immunisation 

Blog by Gavi, the Vaccine Alliance 

The annual WHO/UNICEF Estimates of National Immunisation Coverage (WUENIC) provide an important window on how many children globally are receiving lifesaving vaccines, and where immunisation efforts are faltering. 

According to the latest data received up to 23rd June 2023, vaccination coverage across 185 WHO and UNICEF member states has made a strong recovery after the disruption of the pandemic, with the number of children receiving no vaccine doses falling by record amounts. However, the state of global immunization remains below pre-pandemic levels. 

What does this mean for the 57 countries supported by Gavi, the Vaccine Alliance? Here are eight key take-aways. To read the full blog post, click here.  

Country updates 

Reactive Vaccination Campaigns (RVCs)   

All RVCs are approved by the International Coordinating Group on Vaccine Provision (ICG) and supported by Gavi, the Vaccine Alliance. 

Central African Republic (CAR) 

Following a confirmed case of yellow fever in a worker in a forest area, an RVC is planned to target ~233,400 people for protection against yellow fever in September 2023. The vaccination campaign will target the resident population and seasonal workers conducting forest activities. The campaign will launch once the country’s referendum is over.

Preventive mass vaccination campaigns (PMVCs) 

Child receives yellow fever vaccination in Borno, Nigeria. July 2023

Nigeria    

All states with planned vaccination campaigns for 2022 have now been completed, including Bayelsa; the implementation for which was completed in early 2023, rather than 2022 due to flooding. 

In Borno state, the implementation of yellow fever PMVC is ongoing. The implementation has been staggered due to security concerns. The yellow fever PMVCs in the state of Jigawa is now complete.

Uganda    

Following last year’s successful introduction of the YF vaccine into Uganda’s RI programme, the country’s multi-year yellow fever PMVC began on 9th June.

Three phases of the PMVC are planned. Phase one in June 2023; phase two is tentatively planned for February 2024, followed by a third phase.

The first phase of the vaccination campaign, covering 51 districts in six regions, (Kabale, Kabarole, Hoima, Lira, Gulu, and Arua) is almost complete. Gaps in vaccination in this phase have been identified and follow-up activities are underway. The campaign has targeted ~13,397,640 people, which amounts to 93% of the population in five of the 51 districts.  

Phase two will target ~16.4 million people in the following regions: Moroto, Mbarara,  Kampala, Masaka and Soroti. While phase three covers the following regions: Mubende, Jinja and Mbale. 

Persons of ages 9 months to 60 years were included in the campaign, as well as the refugee population.

The Democratic Republic of the Congo (DRC)     

Yellow fever vaccination campaigns in Lomami, Kasai and Central Kasai will be combined with measles round 1 for improved efficiency and are due to begin in September 2023. 13.6 million people will be targeted for protection against yellow fever in this campaign.   

Further PMVCs in Kongo Central, Kwango, Kwilu, and Mai Ndombe are due to take place in October 2023. 

Yellow fever risk analysis 

In Africa, 27 countries are classified as being at high risk of yellow fever as per the EYE Strategy. Periodic risk prioritization is needed to optimize vaccine allocation for PMVCs and to maximize their impact. The aim is to reach over 80% of population immunity in all 27 countries within the next few years.  

Based on a standardized approach involving a desktop risk assessment tool, in June the EYE Risk Analysis Working Group (RAWG) assessed all 27 countries.   

The methodology considered changing environmental characteristics; history and recent cases of yellow fever; population density; vector prevalence, and the country’s history of vaccinations.  

With a growing continental population, fast-changing environmental risk factors, and limited resources, this method of prioritization seeks to ensure that those at higher risk are supported at the earliest time. 

The top-ranking countries for risk are as follows: Nigeria, Cameroon, the Democratic Republic of the Congo (DRC), Ghana, and Uganda.  

These are followed by Guinea, Côte D’Ivoire, Ethiopia, Central Africa Republic, Burkina Faso, Kenya, and South Sudan.  

Meet the partners

Recruitment 

Information Management Officer, Brazzaville, Republic of Congo (National UNV)

The EYE Strategy’s Regional Implementation Team in Africa (hosted by WHO AFRO) is recruiting an Information Management Officer (under a National United Nations Volunteer Contract) to support key data and information management activities for yellow fever prevention and control in Africa. The initial contract is envisaged for 3 months but will be extended for at least another 9 months and possibly longer. 

The role involves collating, managing, and analyzing data and information on EYE strategy implementation in Africa. This also includes working with regional counterparts, countries, and other important stakeholders in the EYE partnership to ensure the Strategy’s information needs are met. 

For further information on the role and details on how to apply, click here. The candidate must be a national or legal resident of the Republic of Congo, and the deadline for applications is 13^th September, 2023.

Publications 

Electronic early warning, alert and response system (EWARS) mobile box user guide 

The WHO has launched its EWARS in a box mobile user guide; https://apps.who.int/iris/handle/10665/370282 (ISBN 978-92-4-006674-8). 

EWARS in a box, WHO's electronic early warning, alert, and response system in emergencies, helps detect disease outbreaks early in emergency, fragile, conflict, and vulnerable settings.  

It supports real-time mobile reporting from the most difficult and remote field settings with or without reliable internet or electricity. The web interface helps local epidemiologists and surveillance officers with interactive alert management, data analysis, and visualization.  

The 16 multilingual online training package provides epidemiologists, surveillance officers, and emergency responders with a comprehensive overview of establishing EWARS in a box in the field with the key features and functionalities of the tool. 

Instructions in this guidance complement episodes 14 & 15 of the OpenWHO EWARS in a box training package targeted at strengthening early warning, alert and response systems in emergencies. For the course, click here.