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Kahn AL, Steffen CA, Henaff L, MacDonald NE, Morgan C, Faden R, Olayinka F, Desai S. COVID-19 vaccine policy development in a sample of 44 countries - Key findings from a December 2021 survey of National Immunization Technical Advisory Groups (NITAGs). Vaccine 2023; 41:676-683. [PMID: 36494252 PMCID: PMC9671626 DOI: 10.1016/j.vaccine.2022.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
National Immunization Technical Advisory Committees (NITAGs) are tasked with the responsibility of guiding ministries of health and national immunization programmes in their policy development processes. Many NITAGs rely on evidence reviewed by the World Health Organization's (WHO) Strategic Group of Experts(SAGE) on immunization and aim to adapt WHO's recommendations to their respective contexts. This relationship took on exceptional importance since the onset of the COVID-19 pandemic, during which NITAGs have expressed a notable struggle to craft appropriate policies on population prioritization and vaccine utilization in the face of supply constraints and complex programmatic and delivery logistics. This online survey was conducted to assess the usefulness of the SAGE guidance documents for COVID-19 vaccine policies and to examine the persisting needs and challenges facing NITAGs. Results confirmed that SAGE recommendations concerning COVID-19 vaccines are easy to access, understand, and adapt. They have been found to be comprehensive and timely under the data and time constrained circumstances confronting SAGE. The Global NITAG Network (GNN) appears to be the most popular vehicle for addressing questions among high income countries, in contrast to lower income countries who favour WHO Country or Regional Offices. NITAGs place much value on interaction with other NITAGs, which requires facilitation and could benefit from increased opportunities, especially within regions. It is further noted that some NITAGs have had to tackle issues during the pandemic not typically considered by SAGE, such as supply chain logistics and vaccine demand. Learning from the COVID-19 experience offers opportunities to strengthen NITAGs and the pandemic recovery effort through the development of more concrete procedures and consideration of more varied types of data, including implementation effectiveness and uptake data. There is also an opportunity for an increasing involvement of Country Office WHO personnel to support NITAGs, while ensuring information and evidence needs of countries are adequately reflected in SAGE deliberations.
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Affiliation(s)
- Anna-Lea Kahn
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland.
| | - Christoph A. Steffen
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Louise Henaff
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Noni E. MacDonald
- Dept of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Christopher Morgan
- Jhpiego, The Johns Hopkins University Affiliate, Baltimore, MD, USA,Nossal Institute, School of Population and Global Health, University of Melbourne, Melbourne, Australia,Burnet Institute, Melbourne, Australia
| | - Ruth Faden
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Folake Olayinka
- STAR Fellows Department, Public Health Institute, Washington, DC, USA
| | - Shalini Desai
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
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Duclos P, MacDonald NE, Dochez C, Thacker N, Steffen CA, Nohynek H, Lambert PH, Wharton M. Report of the 2nd workshop of the International Collaboration on advanced vaccinology training. Vaccine 2022; 40:6689-6699. [PMID: 36273989 DOI: 10.1016/j.vaccine.2022.09.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
Abstract
At a workshop on 22-24 March 2022, leaders of 33 advanced vaccinology courses were invited to meet with partners to further the aims of the International Collaboration on Advanced Vaccinology Training (ICAVT) initiated in 2018 to assist courses in addressing challenges in priority areas and facilitate interactions and exchange of information. This included: an update to the landscape analysis of advanced vaccinology courses conducted in 2018, sharing experiences and good practices in the implementation of virtual training, reviewing the training needs of target audiences, informing courses of the principles, challenges, and added value of accreditation, discussing course evaluations and measurement of course impact, reviewing principles and support needed for quality cascade training, reviewing COVID-19 impact on training and identifying remaining related training needs, and identifying solutions to facilitate refresher courses and ways to facilitate networking of courses' alumni (particularly for virtual courses). The aims were to identify needs and impediments and implement necessary actions to facilitate sharing of information and resources between courses, to identify need for further developments of the e-Portal of the Collaboration (icavt.org) established to facilitate communication between the different courses and assist future course participants identify the most suitable course for them, and to discuss the formalization of the Collaboration. During the workshop, participants looked at several reports of surveys completed by courses and courses' alumni or partners. The COVID-19 pandemic impacted the delivery of some vaccinology courses leading to postponement, delivery online or hybrid training events. Lack of sustainable funding remained a major constraint for advanced vaccinology training and needs to be addressed. The Collaboration was consolidated with responsibilities and benefits for the members better defined. There was strong support for the Collaboration to continue with the organization of educational sessions at future workshops. The meeting re-enforced the view that there was much enthusiasm and commitment for the Global Collaboration and its core values.
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Affiliation(s)
- Philippe Duclos
- University of Geneva, Centre for Vaccinology, 1 Rue Michel Servet, 1211 Geneva 4, Switzerland.
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada
| | - Carine Dochez
- University of Antwerp, Network for Education and Support in Immunisation, Universiteitsplein 1, 2610 Antwerp, Belgium
| | | | | | - Hanna Nohynek
- National Institute for Health and Welfare Department of Vaccines and Immune Protection, 166 Mannerheimintie, P.O. Box 30, FI-00271 Helsinki, Finland
| | - Paul-Henri Lambert
- University of Geneva, Centre for Vaccinology, 1 Rue Michel Servet, 1211 Geneva 4, Switzerland
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Steffen CA, Henaff L, Durupt A, Omeiri NE, Ndiaye S, Batmunkh N, Liyanage JBL, Hasan Q, Mosina L, Jones I, O'Brien K, Hombach J. Evidence-informed vaccination decision-making in countries: Progress, challenges and opportunities. Vaccine 2021; 39:2146-2152. [PMID: 33712350 DOI: 10.1016/j.vaccine.2021.02.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
Countries face an increasingly complex vaccination landscape. As well as ever-changing infectious disease epidemiology, the number and diversity of vaccine-preventable diseases, vaccine products, and vaccine technologies continue to increase. To ensure that vaccination decision-making is transparent, country-owned and informed by sound scientific evidence, many countries have established national immunization technical advisory groups (NITAGs) to provide independent expert advice. The past decade has seen substantial growth in NITAG numbers and functionality, and there is now a need to consolidate this progress, by further capacity building, to ensure that NITAGs are responsive to the changing face of immunization over the next decade.
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Affiliation(s)
- Christoph A Steffen
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
| | - Louise Henaff
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Antoine Durupt
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Nathalie El Omeiri
- Pan-American Health Organization/Regional Office for the Americas, World Health Organization, Washington, DC, USA
| | - Sidy Ndiaye
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - Nyambat Batmunkh
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | | | - Quamrul Hasan
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Liudmila Mosina
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Ian Jones
- WHO Consultant, Jinja Publishing Ltd., Bishop's Stortford, UK
| | - Katherine O'Brien
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Joachim Hombach
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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MacDonald N, Mohsni E, Al-Mazrou Y, Kim Andrus J, Arora N, Elden S, Madrid MY, Martin R, Mahmoud Mustafa A, Rees H, Salisbury D, Zhao Q, Jones I, Steffen CA, Hombach J, O'Brien KL, Cravioto A. Global vaccine action plan lessons learned I: Recommendations for the next decade. Vaccine 2020; 38:5364-5371. [PMID: 32563607 PMCID: PMC7342005 DOI: 10.1016/j.vaccine.2020.05.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 12/17/2022]
Abstract
The Global Vaccine Action Plan 2011-2020 (GVAP) was developed to realize the ambitions of the Decade of Vaccines - that all individuals and communities enjoy lives free from vaccine-preventable diseases. It included a comprehensive monitoring and evaluation/accountability framework to assess progress towards global targets with recommendations for corrective actions. While many of the GVAP targets are very unlikely to be met by the end of 2020, substantial progress has nevertheless been made, establishing a strong foundation for a successor global immunization strategy, the Immunization Agenda 2030 (IA2030). The Strategic Advisory Group of Experts on immunization has made a series of recommendations to ensure that the lessons learned from GVAP inform the development and implementation of IA2030.
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Affiliation(s)
- Noni MacDonald
- SAGE Decade of Vaccines Working Group; Professor of Paediatrics, Dalhousie University, IWK Health Centre, Canada. Chair of the SAGE Decade of Vaccines Working Group.
| | - Ezzeddine Mohsni
- SAGE Decade of Vaccines Working Group; Senior Technical Adviser in Global Health Development/Eastern Mediterranean Public Health Network
| | - Yagob Al-Mazrou
- SAGE Decade of Vaccines Working Group; Secretary General - Health Services Council of the Kingdom of Saudi Arabia, Saudi Arabia
| | - Jon Kim Andrus
- SAGE Decade of Vaccines Working Group; Adjunct Professor and Director, Division of Vaccines and Immunization, Center for Global Health, University of Colorado, USA
| | - Narendra Arora
- SAGE Decade of Vaccines Working Group; Executive director, International Clinical Epidemiology Network, India
| | - Susan Elden
- SAGE Decade of Vaccines Working Group; Health Adviser, Department for International Development, London, UK
| | - Marie-Yvette Madrid
- SAGE Decade of Vaccines Working Group; Independent Consultant, Geneva, Switzerland
| | - Rebecca Martin
- SAGE Decade of Vaccines Working Group; Director of the Center for Global Health, US CDC, USA
| | - Amani Mahmoud Mustafa
- SAGE Decade of Vaccines Working Group; Project Manager, Sudan Public Health Training Initiative, Carter Center, Sudan
| | - Helen Rees
- SAGE Decade of Vaccines Working Group; Executive Director, Wits Reproductive Health and HIV Institute, Personal Professor, Ob/Gyn Codirector, African Leadership in Vaccinology Excellence, University of Witwatersrand, South Africa
| | - David Salisbury
- SAGE Decade of Vaccines Working Group; Associate Fellow, Centre on Global Health Security, Chatham House, London, UK
| | - Qinjian Zhao
- SAGE Decade of Vaccines Working Group; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ian Jones
- Jinja Publishing Ltd, Bishop's Stortford, UK
| | - Christoph A Steffen
- Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Joachim Hombach
- Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Katherine L O'Brien
- Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Alejandro Cravioto
- Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; Chair, Strategic Advisory Group of Experts on Immunization (SAGE)
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Abstract
The effect of both physiological and pharmacological doses of estradiol on exercise performance and tissue glycogen utilization was determined in oophorectomized estradiol-replaced (ER) rats. Doses of beta-estradiol 3-benzoate (0.02, 0.04, 0.1, 0.2, 1, 2, 4, or 10 micrograms.0.1 ml of sunflower oil-1.100 g body wt-1) were injected 5 days/wk for 4 wk. Controls were sham injected (SI). After treatment, the animals were run to exhaustion on a motorized treadmill. ER animals receiving the 0.02-microgram dose ran significantly longer and completed more total work than the SI group. ER animals receiving doses of greater than or equal to 0.04 microgram ran longer and performed more work than the 0.02-microgram group. At exhaustion, myocardial glycogen content was significantly decreased in animals that were ER with less than or equal to 0.1 microgram, whereas those replaced with doses greater than 0.1 microgram utilized significantly less glycogen. With the 10-micrograms dose no significant decrease in heart glycogen content was observed at exhaustion. A submaximal 2-h run significantly reduced glycogen content in heart, red and white portions of the vastus lateralis, and the livers of SI animals. The latter effect was attenuated in skeletal muscle and liver, and there was no effect in the hearts of the ER animals receiving 2 micrograms. These data indicate that estradiol replacement in oophorectomized rats influenced myocardial glycogen utilization during exhaustive exercise and spared tissue glycogen during submaximal exercise. These glycogen sparing effects may have contributed to the significant improvements in exercise performance observed in this study.
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Affiliation(s)
- Z V Kendrick
- Biokinetics Research Laboratory, College of Health, Physical Education, Recreation, and Dance, Temple University, Philadelphia, Pennsylvania 19122
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