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Key Factors to Consider When Introducing a New Vaccine in Low-Income Settings: Lessons from Malawi expanded program on immunization

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World Journal of Vaccines 2024年第1期14卷 1-23页

作者： Samuel Mpinganjira Kimberly Konono Joseph Mwaka Adidja Amani Habtamu Anteneh Michael Ngigi Boston Zimba Atupele Kapito Institute for Global Health Santa Chiara Lab Universita degli Studi di Siena Siena Italy School of Public and Global Health Kamuzu University of Health Sciences Blantyre Malawi Faculty of Medicine and Biomedical Sciences of the University of Yaound 1 Yaound Cameroon Department of Public Health University of Glasgow Glasgow UK

Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented d

关键词： Vaccine Introduction Implementation expanded program on immunization Low-Income Stakeholders

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Seroprotection after hepatitis B vaccination amongst infants aged between 12 and 24 months in Ho Chi Minh City, Vietnam

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Asian Pacific Journal of Tropical Medicine 2020年第7期13卷 295-300页

作者： Giao Huynh Quang Vinh Bui Ngoc Lan Nguyen Le An Pham Faculty of Public Health University of Medicine and Pharmacy at Ho Chi Minh CityVietnam Department of Pediatrics University of Medicine and Pharmacy at Ho Chi Minh CityVietnam Department of Microbiology and Parasitology University of Medicine and Pharmacy at Ho Chi Minh CityVietnam Center for training of Family Medicine University of Medicine and Pharmacy at Ho Chi Minh City Vietnam

Objective:To assess levels of HBs Ab amongst infants who received hepatitis B vaccine in the expanded program on immunization in ***:A cross-sectional study was carried out at 16 community health centers from February 2016 to July *** infants were tested for HBs Ab and HBs *** questionnaires were used to collect relevant information about the demographics of the parents/caregivers and their infants after physical ***:A total of 199 eligible infants were selected with a mean age of(17.3±4.5)*** antibody levels with HBs Ab≥10 m IU/m L were detected in 68.3%of *** these,antibody levels from 10 to 99 m IU/m L were 48.5%of those tested and antibody levels≥100 ml U/m L were recorded as 51.5%.No cases were recorded of being infected with hepatitis B *** rate of positive HBs Ab level in those who were not wasting and≥18 months old was less than that among those who were<18 months old(OR 0.49,95%CI:0.26-0.92,P<0.05)while the infants with wasting and<18 months were less likely to be positive HBs Ab than those who were not wasting and of the same age group(OR 0.15,95%CI:0.04-0.55,P<0.05).Conclusions:Seroprotection against hepatitis B virus was low in the infants tested(at 68.3%),which suggests that the hepatitis B vaccine should be administered with one additional dose for infants between 12 and 24 months of age,particularly those with wasting.

关键词： Hepatitis B virus Hepatitis B Vaccine Vaccination expanded program on immunization

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Seroconversion of Hepatitis B Vaccine in Young Bangladeshi Children: A Tertiary Centre Experience

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World Journal of Vaccines 2021年第2期11卷 7-18页

作者： Salahuddin Mahmud Jahida Gulshan Farhana Tasneem Syed Shafi Ahmed Department of Pediatric Gastroenterology Hepatology & Nutrition Bangladesh Institute of Child Health Dhaka Shishu(Children) Hospital Dhaka Bangladesh Institute of Statistical Research and Training University of Dhaka Dhaka Bangladesh Department of Pediatrics BIHS General Hospital Diabetic Association of Bangladesh Dhaka Bangladesh

Background: Hepatitis B virus (HBV) infection is one of the most important global health problems and active immunization is the single most important and effective preventive measure against HBV infection. Several studied show that HBV carrier rate is between 2% - 7% in Bangladesh. Bangladesh introduced hepatitis B vaccination in children through expanded program on immunization (EPI) in 2005 that includes 3 doses which starts from six weeks after birth. Currently booster vaccination is not recommended any more. However, many studies on different countries observed a declined level of HBs-antibody over a period of 3 - 6 years that may even reach to non-protective levels. Objective: To evaluate the status of seroconversion and seroprotection along with non-responders of EPI vaccinated children against HBV and to measure their antibody levels in different age groups. Methods: A cross sectional descriptive study was done in the department of Pediatric Gastroenterology, Hepatology & Nutrition, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh on 120 cases of EPI vaccinated children enrolled from January-December 2019 while attending the inpatient department without any liver problem. The development of Anti-HBs titre greater than or equal to 10 mIU/mL is considered as protective immunity and any titre less than 10 mIU/mL as non-protective following HBV vaccination. Results: Age of the children was 1 - 12 years with mean age of 5.6 ± 1.7 years and male: female ratio was 1.1:1. Among the children, 56 (46.6%) were from 1 - 5 years age, 36 (30.1%) children from 6 - 10 years age group and 27 (23.3%) children from 11 - 12 years age group. Out of 120 children, presence of Anti-HBs protective titre was in 63 (52.5%) children and non-protective level in 57 (47.5%) children. Among protective level, 34 (60.7%) children were in 1 - 5 years age group, 18 (50.0%) children in 6 - 10 years age group and 11 (39.3%) c

关键词： Hepatitis B Virus expanded program on immunization Immune Response Antibody Titre

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