Dear all I encountered operational challege were during SIA, specifically OBR using mOPV2 antigen. I observed that the fixed post team were given only bOPV which is the right antigen for routine while ignoring the purpose of the campaign (mOPV2 not given). They were intructed to give both mOPV2 and bOPV concurrently in other to ensure children received RI and SIA doses. When we reffered to the stakeholders it was revealed that guideline stipulated that, child should receive only mOPV2 and resheduled for bOPV next contact. i have little imformation that needs clarification from immunzation experts and/or refference materials for capacity building in support of the guideline. 1. What is the possible consequence of given mOPV2 and bOPV at same time? any scientific justification. 2. Weighing the risk of missed oppurtunities and combining both antigens at same, which one should i prioritised? Thanks alot waiting for your input.

The SAGE October 2016 meeting report has been published in the WHO Weekly Epidemiological Record. SAGE reviewed relevant data and evidence, advised and made recommendations on various complex and critical issues including: Global Vaccine Action Plan: 2016 mid-term review of progress and recommendations Maternal and neonatal tetanus elimination (MNTE) and broader tetanus prevention Measles and rubella elimination Hepatitis B vaccination Schedules and strategies for human papillomavirus (HPV) immunization Yellow fever Polio eradication The meeting report can be downloaded at http://apps.who.int/iris/bitstream/10665/251810/1/WER9148.pdf?ua=1

Every year, the Decade of Vaccines secretariat[1] prepares a report which summarizes the progress against each of the GVAP goals (coverage, disease elimination, vaccine prices, NITAGs…). This report is the best source of information available to have a clear picture of the situation in all the areas of work of the Immunization world (research, procurement, logistic, delivery, demand…). This year, the GVAP Secretariat report 2016 is composed of several pieces: 1) The usual GVAP secretariat report (all Goals and Strategic Goals indicators) 2) Six regional progress reports 3) Seven priority countries progress reports 4) The Score Cards for Immunization summarizing the immunization coverage for all antigens and for all countries from 2000 to 2015 All those documents serve as the basis for the independent review conducted by the Strategic Advisory Group of Experts on immunization (SAGE). SAGE GVAP Assessment report will be published soon and will then be discussed at the World Health Assembly. The SAGE Decade of Vaccines (DoV) Secretariat Report 2016 and the National Immunization Coverage Scorecards estimates 2016 are now available and can be accessed from the WHO GVAP web page To facilitate the exploration of the data, some data visualizations that measure progress against the goals and strategic objectives of the GVAP have been made available on the TechNet-21.org website. We encourage you to share your opinions or ask questions about these visualizations on the TechNet-21.org forum. For further information on the Decade of Vaccines and the Global Vaccine Action Plan please see the GVAP webpage or email the DoV Secretariat (dovsecretariat@who.int). [1] The Decade of Vaccines secretariat comprises the Bill & Melinda Gates Foundation, Gavi the Vaccine Alliance, UNICEF, the US National Institute of Allergy and Infectious Diseases and the World Health Organization (WHO).

The SAGE April 2016 meeting report has been published today in the WHO Weekly Epidemiological Record. SAGE reviewed relevant data and evidence, advised and made recommendations on various complex and critical issues including the:

Use of dengue vaccine;
Progress towards polio eradication;
Implementation of immunization in the context of Health Systems Strengthening and Universal Health Coverage;
Second-year-of-life immunization platform;
Missed opportunities for vaccination; and
Pre-empting and responding to vaccine supply shortages.

You can download the meeting report at http://www.who.int/wer/2016/wer9121/en/.

We are pleased to inform you that several publications featuring the Decade of Vaccines Global Vaccine Action Plan (GVAP) Assessment report 2014 are now available for dissemination. - WHO Executive Board 136 report on GVAP: http://apps.who.int/gb/e/e_eb136.html The document (EB 136/25) will be discussed at the upcoming Executive Board meeting in January 2015 and is available in all 6 official languages. - The Strategic Advisory Group of Experts (SAGE) on immunization October 2014 meeting report is now available in the Weekly Epidemiological Record (WER): http://www.who.int/wer/2014/wer8950.pdf. The report includes a summary of the GVAP session. - The SAGE GVAP Assessment Report 2014: http://www.who.int/immunization/global_vaccine_action_plan/en/ The 2014 report is available for download in English, French, Russian and Spanish languages. Hard copies will be disseminated to Member States. Please feel free to share these materials with your networks. Let us know what you think about the report! Kamel Senouci

The meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization took place in Geneva from the 21-23 October 2014. The full SAGE meeting summary is available online at: http://www.who.int/immunization/sage/meetings/2014/october/summary_meeting_oct2014 For more information on SAGE, a short video is available by following the link below. During this 7-minute video, Professor Helen Rees, former Chair of WHO's Strategic Advisory Group of Experts (SAGE) on Immunization, describes WHO's advisory framework for immunization policy, with a focus on SAGE. http://www.who.int/immunization/sage/what_is_SAGE

The Strategic Advisory Group of Experts (SAGE) on Immunization was established by the Director-General of the World Health Organization in 1999. It is the principal advisory group to WHO for vaccines and immunization and is concerned not just with childhood vaccines and immunization, but all vaccine-preventable diseases.

The Group met in Geneva from 9 April to 11 April 2013. The topics listed below were discussed. Please read the WHO Weekly Epidemiological Report for a detailed description of the discussion and recommendations.


Report from the WHO Department of Immunization, Vaccines and Biologicals
The report focused on: (i) the Global Vaccine Action Plan (GVAP) roll-out; (ii) the strengthening of routine immunization and efforts to integrate immunization and other child health interventions; and (iii) the changing epidemiology of measles.

Report from the GAVI Alliance
The report provided an update on: (i) the processes and timelines for developing the next Vaccine Investment Strategy (for the period 2015–2020) beyond existing commitments, (ii) the preliminary Board discussions regarding GAVI’s potential role in supporting the GPEI, including supporting inactivated polio vaccine (IPV)introduction and potential innovative financing instruments for mobilizing resources, and (iii) the preparations for the next GAVI replenishment round in 2014.

Report from the Global Advisory Committee on Vaccine Safety (GACVS)
A report of the December 2012 GACVS meeting was presented. SAGE acknowledged the detailed review and the recommendations of GACVS on the safety profile of varicella vaccines, risk of narcolepsy and Guillain-Barré syndrome with influenza vaccines, and the safety of dengue vaccines.

Report from the Immunization Practice Advisory Committee (IPAC)
A report of the April 2013 IPAC meeting was presented. SAGE endorsed IPAC’s ongoing contributions to the development of the “Reaching Every Community” toolkit and to the immunization session checklist. SAGE supported these additional tools and validated IPAC’s proposal to pilot test the tools before wide-spread implementation.

Dengue vaccines
... There are unique challenges for dengue vaccine development, including a lack of animal disease models, absence of immunological correlates of protection, and a potential immunopathological component in severe disease, as previous infection with dengue is a risk factor for severe disease upon secondary infection by a heterologous dengue virus. There are currently 5 vaccine candidates in human trials, all of which are tetravalent vaccines designed to protect against all 4 dengue serotypes; 3 are chimeric live attenuated vaccines and 2 are inactivated or subunit vaccines. Several other vaccine candidates are in the preclinical stage of development. SAGE reviewed the results of the Phase IIb trial of the lead vaccine candidate, a tetravalent live attenuated vaccine.

Polio eradication
SAGE commended the GPEI on remarkable continued progress made towards decreasing wild poliovirus transmission in the remaining endemic areas, especially in view of significant difficulties. The programme has also intensified systematic preparations for the withdrawal of oral polio vaccine type 2 (OPV2) along several key workstreams. SAGE recognised that the need to introduce IPV in up to 130 countries that use OPV over a relatively short period of time represented a major and unprecedented challenge.

Yellow fever vaccination
Based on currently available surveillance data, SAGE concluded that vaccine failures are extremely rare and do not cluster as time increases after immunization. A single dose of YF vaccine is sufficient to confer sustained immunity and life-long protection against yellow fever disease and a booster dose of YF vaccine is not needed. Surveillance in endemic countries and clinical studies may possibly identify specific risk groups (such as infants or HIV-infected patients) that could benefit from a second primary or booster dose. SAGE requested WHO to revisit the IHR provisions relating to the period of validity for international certificates for vaccination against YF.

Non-specific effects of vaccines on mortality
SAGE previously requested that WHO review the evidence concerning the possible non-specific mortality effects of vaccines included in the routine infant immunization schedule. SAGE has now established a working group to review data on non-specific effects and consider whether current evidence is sufficient to merit adjustments in policy recommendations, or may warrant further scientific investigation and if so, to outline a path towards obtaining unequivocal evidence that would inform future robust, evidence-based adjustments in immunization policies, if warranted. SAGE recognized that there have been previous reviews on this topic by WHO committees, including reviews by the GACVS between 2000 and 2008.

SAGE was asked to review the protocols for 2 systematic reviews to assess the possible non-specific effects of vaccines: one regarding the epidemiological mortality studies and the other on human immunological studies of non-specific effects of vaccine on mortality in children

Many thanks to Simona Zipursky for sharing this with TechNet21 readers. Please note that the full report of the November 2010 meeting of WHO's Strategic Advisory Group of Experts (SAGE) on Immunization was published in English and French in the WHO Weekly Epidemiological Record (WER) today and can be accessed through http://www.who.int/immunization/newsroom/newsstory_sage_report_jan2011/en/index.html (direct link: http://www.who.int/wer/2011/wer8601_02.pdf ) The Arabic, Chinese, Russian and Spanish translations of the report will be posted on the appropriate language pages (click on tabs at top right of page) of http://www.who.int/immunization/sage_conclusions/en/index.html in due course. A summary of some of the key issues covered in the report is below. Kind regards. Alison Mrs Alison Brunier, MBA Communications Officer Immunization, Vaccines and Biologicals World Health Organization Measles efforts to focus on strengthening routine immunization SAGE concluded that measles can and should be eradicated but proposed that demonstration of sufficient progress towards regional measles elimination targets be made a precursor to establishing a target date for global eradication. Furthermore, all efforts should be carried out in the context of strengthening routine immunization programmes. Recognizing the fragility of gains in measles mortality reduction, apparent through outbreaks affecting 28 countries in the African Region since 2009, the Group highlighted the growing risk that the contribution of the reduction in measles mortality to achieving Millennium Development Goal 4 (approximately 25% of the overall reduction) will be lost because of declining political and financial commitment to measles control. SAGE members welcomed the news that India has begun implementing strategies to provide a second opportunity for measles immunization and encouraged the South-East Asia Region to establish a target date for measles elimination. Timely establishment and implementation of corrective action plans key to polio eradication SAGE recognized the considerable progress made towards eradicating polio since its April meeting but noted with deep concern that some countries had either missed their relevant milestone in the new Strategic Plan or were at very high risk of doing so. SAGE emphasized the importance of strengthening surveillance in critical areas at the subnational level. The Group strongly supports the role of the Independent Monitoring Board established in October 2010 to monitor progress in meeting the goals of the Strategic Plan, noting that its most critical contribution will be to suggest urgent plans for corrective action in close coordination with ministries of health and country and regional-level technical advisory groups. Gender as a determinant of immunization status SAGE noted that there is no evidence to suggest a significant difference between the coverage of routine immunization in boys and girls at the global level. However, in some countries, such differences have been reported at the subnational level. Local surveys clearly provide valid data that can be used to address local barriers to immunization, including gender. SAGE also noted that in some settings, the low status of women prevents them from accessing immunization services for their children. Supporting lower-middle-income countries SAGE was presented with the outcome of a study on the adoption of new vaccines by lower-middle-income countries not eligible for support from the GAVI Alliance. SAGE noted that price continues to be a major barrier. The Group encouraged continuation and expansion of data collection activities and asked WHO to facilitate further work to support countries in this income bracket. Also discussed were influenza and typhoid vaccination, optimization of immunization schedules, and improving the accessibility of affordable vaccines.