WHO EMRO Weekly Epidemiological Monitor: Volume 12, Issue no 47; 24 November 2019
WHO supports Member States in the region to implement the Pandemic Influenza Preparedness (PIP) Framework and enhance their capacities to detect, prepare for and respond to pandemic influenza. One of the main objectives of PIP framework is to increase the availability and utilization of seasonal influenza vaccine among high-risk groups.
Influenza vaccines are currently the best tool available for prevention of influenza and its complications. A sustainable seasonal influenza vaccine program not only reduces disease burden, but also strengthens health systems and leads to better pandemic preparedness. For example, in the 2009 H1N1 pandemic, countries with vaccination programs (despite the size) were 2.4 times more likely to receive the pandemic influenza vaccine first, as the regulatory and distribution systems were already in place and tested. Five priority groups for countries using or considering introduction of seasonal influenza vaccines have been recommended by the WHO SAGE in 2012.
In the past decade, the capacity of countries in the EMR has greatly increased in surveillance and pandemic planning and at least 14 countries in the Region have introduced the seasonal influenza vaccination. However, the Region remains one of the lowest globally in vaccine utilization. The consultative meeting with EPI managers and influenza focal points of 19 EMR countries, held in Morocco on 16 November, explored the challenges and opportunities countries are facing to increase the utilization and coverage rates.
Most EMR countries face challenges with the perception and acceptance of the vaccine due: lack of knowledge and awareness, low perception of effectiveness, low affordability and poor accessibility. Some other technical challenges in expansion of the programs include: limited knowledge of the disease burden, target groups not being infantfocused, delivery of the program annually, measuring impact, communicating value, matching supply-demand, and integrating into routine immunizations. Additionally, in the EMR, health workers hesitancy towards taking the vaccinations remains high.
Some of those barriers are: perceived low risk of infection/disease, concerns by vaccine effectiveness and safety, lack of recommendations from health provider, inconvenience and out of pocket payments. Despite those challenges, select EMR countries have had successful and notable experiences in increasing uptake rates among health workers. These countries shared some of the strategies they adopted to achieve this (see figure).
In this meeting, solutions to overcoming some of the challenges and maximize available opportunities were explored as well, and ways forward were identified (see list).
WHO urges Member States to continue expanding seasonal influenza prevention and control policies and programs to protect the vulnerable. Creating sustainable, routine, seasonal influenza vaccination programs through the existing immunization infrastructure will save lives in future pandemics. WHO and CDC continue to support countries in seasonal influenza program planning and evaluation, and improving the overall pandemic preparedness.