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  2. European Immunization Week, 23–29 April 2018

    European Immunization Week, 23–29 April 2018
  3. On 23–29 April 2018, the WHO European Region celebrates European Immunization Week (EIW), to raise awareness of the importance of immunization for people’s health and well-being. Since its inception in 2005, EIW has grown into a widely recognized event carried out predominately by the Region’s Member States and involving WHO country offices and partners, health ministries, professional and parent organizations, local health facilities, politicians and more. The initiative’s aim is to help sustain public demand and political support for immunization through advocacy and targeted communication and educational activities. In this, the Immunize Europe Forum has been a key tool during EIW in the past years and continues to do so in 2018. The European Region continues to enjoy overall high childhood immunization coverage and is progressing towards the goals of the European Vaccine Action Plan, including elimination of measles and rubella. Unfortunately, the benefits of vaccines are spread unevenly in the Region, with far too many children missing the protection they deserve. In 2016, 1 in 15 infants in the Region missed their first measles-containing vaccine and 1 in 21 did not receive all recommended doses of vaccines against diphtheria, tetanus and mumps. Such gaps in coverage have led to avoidable disease outbreaks in the Region. Focus of this year’s campaign To help close immunization gaps, EIW 2018 will focus on immunization as an individual right and shared responsibility. Vaccines provide individual protection from dangerous diseases. But the benefits do not stop there. When all eligible individuals in a community are vaccinated, not enough susceptible people are left to sustain transmission of a contagious disease. Together they protect those who are most vulnerable, including babies. Every person deserves to be immunized and shares the social responsibility to protect those who cannot protect themselves. Immunization keeps us protected together In conjunction with other regional initiatives and World Immunization Week, the European Region will utilize EIW 2018 as an opportunity to highlight how vaccines work to protect individuals and their communities and to further progress towards the global Sustainable Development Goals.
  4. Congratulations Pernille and colleagues. Vaccines Today also highlighted your project last year. Perhaps it will inspire some positive copycats around Europe! https://www.vaccinestoday.eu/stories/kaunas-lithuanian-city-women-begun-embracing-flu-vaccination-pregnancy/
  5. Applications are being accepted for internships at the WHO Regional Office for Europe with the Vaccine-preventable Diseases and Immunization programme https://tl-int.vcdp.who.int/careersection/ex/jobdetail.ftl?job=1800022&tz=GMT%2B01%3A00 and the Web Communication team https://tl-int.vcdp.who.int/careersection/ex/jobdetail.ftl?job=1800020&tz=GMT%2B01%3A00 Deadline for submissions is 26 January 2018.
  6. National surveys on seasonal influenza vaccination programmes, 2008/2009 to 2014/2015 revealed among other findings that most countries recommended vaccination for older persons, individuals with chronic disease, healthcare workers, and pregnant women. Children were included in < 50% of national policies and only one country of 49 in the WHO Europpean Region reached 75% coverage in older persons (2014/2015). A number of countries reported declining vaccination uptake. For more results see the full article in Vaccine: http://www.sciencedirect.com/science/article/pii/S0264410X17317620
  7. Excellent initiative and great team! Congratulations!
  8. WHO recommends seasonal influenza vaccination of pregnant women to protect them and their newborn babies from infection, and to reduce the risk of influenza-related complications and hospitalization. Evidence shows that inactivated influenza vaccines are safe for both pregnant mothers and fetuses during all trimesters of pregnancy, and for breastfeeding women. However, maternal influenza vaccination uptake remains low in most of the WHO European Region, despite widespread national policies. http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/publications/2017/tailoring-immunization-programmes-for-seasonal-influenza-tip-flu-a-guide-for-increasing-pregnant-womens-uptake-of-seasonal-influenza-vaccination-2017
  9. Congratulations to Kristina Rudžinskaitė at the Ministry of Health of the Kaunas Department of Communicable Diseases for receiving the "Annual Public Health Leader" award. Dr Rudžinskaitė received the award for her exceptional work on successfully promoting influenza vaccination coverage among pregnant women, not only in Kaunas, but also in other counties of Lithuania. Read more on: https://nvsc.lrv.lt/lt/naujienos/konkurso-metu-visuomenes-sveikatos-lyderis-2017-laimetojas-kaune This project was initially started in 2015 using the Tailoring Immunization Programmes (TIP) approach and is described in the guide "TIP FLU - A guide for increasing pregnant women’s uptake of seasonal influenza vaccination", which can be downloaded at: http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/publications/2017/tailoring-immunization-programmes-for-seasonal-influenza-tip-flu-a-guide-for-increasing-pregnant-womens-uptake-of-seasonal-influenza-vaccination-2017
  10. Measles outbreaks continue to occur in a number of EU/EEA countries, and there is a risk of spread and sustained transmission in areas with susceptible populations. Since the beginning of 2016, 48 deaths due to measles were reported in the EU. New data published today by ECDC in the Communicable Disease Threat Report (CDTR) show that the highest number of measles cases in 2017 were reported in Romania (7 977), Italy (4 854) and Germany (904). Greece is currently experiencing a measles outbreak, with 690 cases including two deaths, reported since May 2017; most cases were unvaccinated or incompletely vaccinated. The monthly measles and rubella surveillance monitoring report is also published today and provides more in-depth analysis of the situation. The spread of measles across Europe is due to suboptimal vaccination coverage in many EU/EEA countries: of all measles cases reported during the one-year period 1 November 2016‒31 October 2017 with known vaccination status, 87% were not vaccinated. Measles increasingly affects all age groups across Europe and in 2017, 45% of measles cases with known age were aged 15 years or older. Romania, Italy, Germany and Greece were the countries most affected by measles during 2016 and 2017 and each shows different trends: Romania saw a sharp increase in cases from October 2016, and the trend has continued throughout 2017; in Italy, the increasing trend started in January 2017, while in Germany it began in February 2017; Greece has seen a measles outbreak starting in the second half of 2017, with 167 cases reported in October. This data is based on analysis of the cases notified to ECDC and included in the monthly and biannual monitoring reports. The latest available figures on vaccination coverage collected by WHO (2016) show that the vaccination coverage for the first dose of measles was below 95% in 18 of 30 EU/EEA countries; for the second dose of measles, it was below 95% in 20 of 27 EU/EEA countries reporting second dose coverage data. In order to achieve the measles elimination goal, the vaccination coverage rates for children targeted by routine vaccination programmes should increase in a number of countries, as the vaccination coverage of the second dose must be at least 95% to interrupt measles circulation and achieve herd immunity. This is particularly important to protect children below one year of age, who are particularly vulnerable to complications of measles but are too young to have received the first dose of vaccine. Read more ECDC collects measles data on a monthly basis via The European Surveillance System (TESSy). In addition, ECDC monitors measles and rubella epidemiology and outbreaks via epidemic intelligence. For a complete overview of data regarding measles outbreaks in the EU/EEA in 2016 and 2017, the following outputs are available and regularly updated: Communicable Disease Threat Report “Measles and Rubella, Monitoring European and worldwide outbreaks” (Epidemic intelligence data) Monthly measles and rubella monitoring report (a concise report with TESSy data from 1 November 2016 – 31 October 2017) Bi-annual measles and rubella monitoring report (an extensive report, TESSy and epidemic intelligence data presented, with data from 1 January 2016 – 30 June 2017) ECDC Atlas of Infectious Diseases (TESSy data) Monthly-Measles-Rubella-monitoring-report-December-2017_0.pdf
  11. Flu campaign in Kyrgyzstan underway

    Kyrgyzstan is gearing up for the flu season. Over the past few weeks 100+ healthcare workers across Kyrgyzstan have been trained to store and administer multidose vials of flu vaccine. WHO also facilitated donation of 105,000 doses of the vaccine. For more on the campaign see: http://www.euro.who.int/en/countries/kyrgyzstan/news/news/2017/11/105-000-doses-of-vaccine-flown-into-kyrgyzstan-to-kick-start-influenza-immunization-campaign) Did you know that you can follow the flu season week by week through the joint WHO/ECDC Flu News Europe bulletin? The site gives weekly and seasonal updates, virus characteristics and country data in tables and maps and you can sign up for email alerts: https://flunewseurope.org/
  12. Social Media Consultancy

    WHO social media project: exploratory phase Background Social media is playing an increasingly significant role in information dissemination and in the formation and expression of public opinion and concerns related to immunization and thus have the power to both damage and support immunization programmes. National immunization programmes would like to explore the opportunities and potential pitfalls of actively engaging in social media, including the options to optimize the considerable potential of this effort and the resources and best practice process steps needed for this work. Monitoring of social media is another activity offering potentially a rich source of information that may guide programme planning. Lastly, with anti-vaccination voices being vocal in many Member States and effectively using social media in their effort to gain influence on people’s vaccination decisions, immunization programme managers are seeking ways to counteract this, if at all possible. See attached notice. Concept note(1).pdf
  13. Containment is forever!

    The hard work on containment is already underway and to find out more about how such a prolific virus will be rounded up and stored safely, read this interview with WHO scientist Dr Eugene Gavrilin. http://www.euro.who.int/en/health-topics/communicable-diseases/poliomyelitis/news/news/2017/10/15th-anniversary-of-polio-free-certification-in-the-european-region-but-the-hard-work-to-prevent-future-cases-is-not-over/a-place-for-polio-containment-is-forever
  14. 15 years certified polio free in Europe

    As we wave goodbye and good riddance to polio, it’s important to remember that just three things stand between us and a return of the virus that used to devastate so many young lives. The first is high vaccination coverage and although a great many countries have hit the magic 95% coverage, and achieved herd immunity, this target has eluded many. Secondly, surveillance efforts must be sustained so that any cases or containment breaches are detected immediately. Thirdly all samples of the virus must be logged and properly contained. In this article Professor David Salisbury, Chair of the Global Certification Commission and European Regional Certification Commission for Poliomyelitis Eradication, gives his view of the current situation. http://www.euro.who.int/en/health-topics/communicable-diseases/poliomyelitis/news/news/2017/10/15th-anniversary-of-polio-free-certification-in-the-european-region-but-the-hard-work-to-prevent-future-cases-is-not-over
  15. WHO’s Vaccine Safety Net (VSN) project is calling for volunteers to assist the VSN secretariat in reviewing candidate websites against criteria for good information practices as defined by the Global Advisory Committee on Vaccine Safety (GACVS). Qualifications Qualified candidates will be students, academics or professionals in a related field, such as medicine, immunology, or virology , with native language skills in the language of a candidate website. Languages of particular interest include but are not limited to: Arabic, Bulgarian, Chinese, Czech, Dutch, Farsi, German, Hungarian, Italian, Japanese, Polish, Portuguese, Spanish, Swedish, Thai and Turkish. Review process Interested candidates will be placed on a roster of reviewers and asked to review a website in the relevant language as the need arises. The reviewing task will be based on a detailed reviewers’ guide and is expected to take approximately 3 hours per website. The reviewer will report his or her findings and recommendations to the VSN secretariat, which will then decide whether to invite the website to become a member of the network or suggest required changes as a prerequisite for joining. Benefits for the reviewer As token of appreciation, each reviewer will receive a letter of appreciation from the VSN coordinator, acknowledging his or her contribution to this WHO project. About VSN Due to the success of immunization worldwide, several vaccine-preventable diseases have been contained and are no longer perceived by many as a threat. However, certain groups have questioned the utility of vaccines in spite of their proven success in controlling diseases. Moreover, a number of websites have been established providing misleading and alarming vaccine-safety information, causing undue fears, particularly among parents. The Vaccine Safety Net (VSN) was established in 2003 by the World Health Organization, following the request from governments, non-governmental organizations and UNICEF to promote balanced and science-based information about vaccine safety. VSN is continually evolving and currently comprises member-websites from 30 countries providing information in 15 different languages. The websites are run by governmental agencies, grassroots organizations, academic institutions, professional organizations, private non-profit entities as well as specific information repositories/platforms. VSN aims to facilitate easy access to reliable, understandable, evidence-based information on the safety of vaccines for internet users, regardless of their geographic location and language and to foster international collaboration among stakeholders to: increase awareness about vaccines, reduce vaccine hesitancy and strengthen confidence in vaccines by seeking to better understand internet users’ needs, behaviours and preferences; provide reliable information tailored to users’ needs; and communicate vaccine safety information through a diversity of digital channels. If you are interested in volunteering your time to this important project, please send your CV and contact details to: gvsi(at)who.int
  16. Frontline health care workers (HCWs) are more likely to be infected with influenza viruses compared with other working adults and are recommended to be vaccinated against influenza. Yet, in Serbia, seasonal influenza vaccination uptake among HCWs has declined in recent years. In 2017, a project was set up to increase influenza vaccination rates among HCWs in Serbia during the 2017/2018 influenza season in two pilot sites in Belgrade with the involvement of a number of stakeholders; from health care staff to national policy- and decision-makers. The aim of the project was to gain in-depth insight into attitudes and behaviours of frontline health care staff towards influenza vaccination and, based on this, to develop tailored interventions that would encourage doctors and nurses to get their influenza vaccination. The behavioural insights analysis highlighted that a large proportion of staff were unsure about the safety and effectiveness of the vaccine and felt that they didn’t have time to arrange to get it. However, staff also highlighted that they strongly felt that it was everyone’s duty to protect patients, friends and family from preventable diseases. A range of communication tools and tactics was subsequently identified to help promote uptake of seasonal influenza vaccination in the 2017/2018 season, including improved access to vaccines, postcards and posters with clear simple messages on benefits of influenza vaccination and “myth busting”, and staff emails and bulletins to engage and update HCWs with latest news, data and campaign information. Dr Verica Jovanovic, director of the Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, who is a key partner in the implementation of this project, stated that the results from this campaign will serve as a baseline for the future activities at the national level. Moreover, this project initiated the launch of another project that will identify drivers and barriers to the vaccination of children in 2018 using the same methodology. The pilot project will be completed in December 2017 with evaluation in early 2018 to assess the impact, identify areas for improvement, and provide insight and learning for future activities.
  17. This project was completed during August 2008 so there have been organisational changes but I hope you don't mind me sharing, I feel it offers a little insight into how alternative venues for childhood vaccination can be used. For this project, we conducted a pilot immunisation session at a local shopping centre. This venue was selected due to its central location, easy access using public transport and close proximity to the surgery where patients being invited to the immunisation session were registered. The session ran from 9am – 6pm with PCT immunisers and nursery nurses working three hour slots. The immunisation co-ordinator was present throughout the day and a children’s entertainer attended for part of the day. In total, 286 children were invited to the session and 67 attended (24%). 5 children who had not been invited were brought in to the session and immunised as required (Pre school booster or MMR only) on a drop in basis. Children requiring further vaccines to bring them up to date with the current schedule were referred back to their Health Visitor / GP. 68% of children attended the session between the hours of 11am and 4pm and 139 vaccines were administered, of these, 70 were MMR, 58 were pre-school boosters and 11 were pre-school boosters with Hib booster. The total cost for this session was approximately £650. (Immunisers were working within their contracted hours). Although this event was not formally evaluated from a parents perspective, comments from parents attending the pilot session were positive. Children who did not attend for this appointment receive further appointments to attend their GP for outstanding vaccines Following this, a further four sessions were delivered, 2 sessions in the same shopping centre, and two sessions in community clinic buildings. Risk assessments were completed following discussion with the Ambulance Service and Infection Control, vaccine storage and supply issues were addressed, a staffing rota was developed and equipment requested as necessary (e.g. chairs, desks and children’s toys etc) The team for each session consisted of 4 immunisers per 3 hour slot; 2 nursery nurses; Clerical support; the PCT Immunisation Trainer; the PCT Immunisation co-ordinator and a Children’s entertainer To promote the pre-school childhood immunisation programme, postcards with a reminder about ensuring pre-school vaccines were up to date were developed and distributed locally, methods of distribution included the local shop selling school uniforms adding a card to carrier bags when items of school uniform were purchased, local hairdressers displaying cards in waiting areas and the local Library inserting a postcard in all children’s books borrowed. The postcards were also displayed at customer services desks in the shopping centre. Messages used on the card were taken from Department of Health immunisation publications to ensure consistency of information for parents. Parents were invited to attend the appointment by Child Health Computer Services and were allocated to a 1 hour time band during which they could attend. On arrival at the venue, parents were asked for their invite letter and personal child health record (red book). The clerical officer would mark them as attended on the clinic list and the parent was then given a ticket with a number on to ensure children were seen in the order they arrived in. The child’s personal child health record (Red book) and appointment letter were given to the immunisation trainer / immunisation co-ordinator to ensure their correct immunisation history was recorded. The vaccine controller allocated vaccines to immunisers to ensure strict control of storage conditions and stock. Children were immunised following normal consent and pre-vaccination procedures A children’s entertainer was present at all the sessions and children were able to participate in various activities such as Plate spinning and balloon modelling. Approximately 300 children were invited to each of the four sessions (total 1,025) and a total of 398 attended (approx 100 per session), this represented a 39% attendance rate. Children attending were registered with 12 different GP practices in the PCT which demonstrated that parents are willing to travel to alternative venues if they are accessible and convenient. The majority of parents brought their children between 11am – 3pm and a total of 728 vaccines were administered: 339 MMR; 255 Pre-school boosters; 53 Hib/MenC and 81 PCV (Prevenar). There were no adverse events during the sessions. One child felt faint following vaccination and recovered following a biscuit and orange juice. Parents views were very positive: "Really good idea, I am up here anyway doing the shopping so only needed to drop in" "They know there is something wrong when you take them to the Doctors" "Less stressful" "More convenient" "More child friendly" "Excellent way of doing it" Overall Outcome for five immunisation sessions 465 children were brought up to date with their immunisations 867 vaccines were administered: (409 MMR, 324 PSB, 53 Hib/MenC, 81 PCV)
  18. Robb Butler, WHO, on HPV vaccine

  19. Press release Copenhagen, 26 September 2017 In the WHO European Region, 42 of 53 countries have interrupted endemic transmission of measles, and 37 countries have interrupted endemic transmission of rubella as of the end of 2016. This was determined by the European Regional Verification Commission for Measles and Rubella Elimination (RVC) at its 6th meeting in June 2017. Full press release
  20. Europe Immunization Programme Managers Meeting

    WHO/Europe Immunization Programme Managers Meeting (PMM), 24-26 October 2017, Budva, Montenegro (link: http://www.euro.who.int/en/media-centre/events/events/2017/10/regional-meeting-of-national-immunization-programme-managers)
  21. Flu Awareness Campaign

    See more at: http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/flu-awareness-campaign
  22. World Polio Day

    See more at: https://www.endpolio.org/world-polio-day
  23. Vaccination can benefit all age groups, but is especially important for people at higher risk of serious influenza complications. Specific population groups may be targeted for vaccination depending on the objectives of the national vaccination programme, documented vaccine effectiveness, access to vaccine, and the ability to implement vaccination campaigns in the target groups. http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/publications/2017/who-regional-office-for-europe-recommendations-on-influenza-vaccination-during-the-20172018-winter-season-september-2017
  24. Migration and vaccination: Protecting Syrian refugee children in Turkey “I learned in Syria that vaccinations are important,” says a Syrian refugee mother waiting in the lobby of a clinic in southeastern Turkey. Holding her baby boy, she explains that she is here to have him immunized. “I got the first two rounds of the vaccination at a Turkish hospital and health centre,” says another Syrian mother in her native Arabic. Turkish and Arabic are very different languages and use different alphabets, so Syrian patients and parents can encounter problems understanding when they go to Turkish medical facilities. “It was a little difficult with the language,” she continues. “It’s good that there are Syrian doctors here.” The mothers are at one of Turkey’s clinics for Syrian refugees, staffed by both Turkish doctors and WHO-trained Syrian doctors and nurses who are themselves refugees. Since the brutal conflict in Syria began, 3 million Syrians have poured into neighbouring Turkey. Although the Turkish Ministry of Health has worked hard to provide for their needs, the strain on Turkey’s health system has been immense. In addition, experienced Syrian doctors and nurses had earlier been unable to practice medicine in Turkey due to accreditation issues. With help from WHO, these Syrian health professionals are being screened and then trained to adapt to Turkey’s health care system. When they successfully complete classroom work and six weeks of on-the-job training, they can be employed legally in Turkey’s public clinics and provide care to their fellow refugees. Vaccination is an important part of this care, especially because the conflict caused many Syrian children to miss out on vaccines in their home country. “I remember one child about 3 years old,” says Selam, a Syrian nurse trained as part of the WHO programme. “The parents didn’t want to get the vaccination because of the language barrier.” Refugee children visit a vaccination centre in southeastern Turkey. Photo: WHO/Sheahen “The Turkish government has been encouraging and providing vaccination, but some people didn’t want to,” continues Selam. Immunizing all children in Turkey is urgently important. As the Syrian conflict has decimated vaccination efforts, there have been outbreaks of polio and measles across the border in Syria, just a few hours’ drive away from cities in southeastern Turkey. Now that refugee parents in Turkey can talk to Syrian doctors in their own language at the clinics, there is less confusion and concern. Dr Dalal Kouryani, who escaped Syria with her husband, took the training, which included information on Turkish acronyms for vaccines and the Turkish vaccination schedule. “We like this training because we’re helping Syrians,” she says. The WHO programme also trains bilingual Turkish-Arabic speakers in understanding medical terminology, including words related to immunization. Earlier, “There were lots of translators, but sometimes they can’t bridge the gap, they don’t know the terms,” says Selam. Now, hundreds of WHO-trained Syrian staff have been hired by Turkey’s clinics for refugees. WHO Turkey is also helping to build, equip, and cover operating costs of several refugee health centres where basic primary care, including vaccinations, is free. Arabic-language brochure from Turkey's Ministry of Health about vaccinations for refugee children. WHO also helps Turkey’s Ministry of Health spread the word about vaccination campaigns that specially target refugee children. In 2017, these campaigns reached more than 360 000 refugee children in Turkey to prevent diseases including measles and polio, using the same vaccination schedule used for Turkish children. “With outbreaks of polio and measles in nearby Syria, it’s more important than ever to protect children living in Turkey,” says Dr Pavel Ursu, WHO Representative for WHO Turkey. “The strategy of reaching every child through proper and timely immunization is part of the universal health coverage which the Turkish government offers to all Syrian refugees."
  25. The magnitude of refugee and migration movements in recent years in the Region and complexities associated with the migration phenomenon pose significant public health challenges that necessitate a coordinated response. Taking note of this situation, a technical briefing session on “Immunization and Migration” was organized on 11 September 2017 during the Regional Committee Meeting of the WHO European Region in Budapest, Hungary. The European Vaccine action plan 2015-2020 outlines the need for an equitable access to vaccination of all vulnerable populations including refugees and migrants. The session brought together the Member States, development partners, and other relevant stakeholders to better understand the provision and implementation of immunization services for the refugees and migrants. I joined Mr Robb Butler, Programme Manager Vaccine-Preventable diseases and Immunization (VPI), WHO European Region who co-hosted the session with Dr Santino Severoni from Migration and Health unit of WHO European Region. Listening to the experiences from Germany, Greece, Italy, Sweden and Turkey including the other Member States and partners in the audience on their experiences in providing immunization services to the migrants and refugees was an immense learning for me. Local innovations, coordination between national policy planners and subnational implementers, necessary changes in legislation and regulations, and using local data by the technical advisory groups for decision-making were the key highlights of the discussion. A brief synopsis of the session is available here; http://www.euro.who.int/en/about-us/governance/regional-committee-for-europe/67th-session/news/news/2017/09/day-1-highlights-rc67-opens WHO Europe is developing a Health Evidence Network (HEN) synthesis report which will assimilate the available evidence on equitable delivery, access, and utilization of immunization services for migrants and refugees in the WHO European Region. I will be glad to share the HEN report once it is finalized and available for sharing. What has been your experience regarding the provision of immunization services to the migrants and refugees in your setting? I am keen to expand my knowledge base on this as I hear the first-hand experiences from everyone.
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