Communications, Immunization, and Polio Vaccines: Lessons From a Global Perspective on Generating Political Will, Informing Decision-Making and Planning, and Engaging Local Support

Abstract

The requirements under objective 2 of the Polio Eradication and Endgame Strategic Plan 2013–2018—to introduce at least 1 dose of inactivated poliomyelitis vaccine (IPV); withdraw oral poliomyelitis vaccine (OPV), starting with the type 2 component; and strengthen routine immunization programs—set an ambitious series of targets for countries. Effective implementation of IPV introduction and the switch from trivalent OPV (containing types 1, 2, and 3 poliovirus) to bivalent OPV (containing types 1 and 3 poliovirus) called for intense global communications and coordination on an unprecedented scale from 2014 to 2016, involving global public health technical agencies and donors, vaccine manufacturers, World Health Organization and United Nations Children’s Fund regional offices, and national governments. At the outset, the new program requirements were perceived as challenging to communicate, difficult to understand, unrealistic in terms of timelines, and potentially infeasible for logistical implementation. In this context, a number of core areas of work for communications were established: (1) generating awareness and political commitment via global communications and advocacy; (2) informing national decision-making, planning, and implementation; and (3) in-country program communications and capacity building, to ensure acceptance of IPV and continued uptake of OPV. Central to the communications function in driving progress for objective 2 was its ability to generate a meaningful policy dialogue about polio vaccines and routine immunization at multiple levels. This included efforts to facilitate stakeholder engagement and ownership, strengthen coordination at all levels, and ensure an iterative process of feedback and learning. This article provides an overview of the global efforts and challenges in successfully implementing the communications activities to support objective 2. Lessons from the achievements by countries and partners will likely be drawn upon when all OPVs are completely withdrawn after polio eradication, but also may offer a useful model for other global health initiatives.

Implementation challenges and real-world impacts of switching pediatric vaccines: A global systematic literature review

“…Of 33 included studies, types of vaccine switches are switch of serotype coverage and route of administration (n = 12), 30–35 , 36–40 – 42–44 , 45–48 , 49–57 – 59 switch of serotype coverage only (n = 8), 3–28 , 29–32 – 34–37 – 39 switch of route of administration only (n = 6), 31 , 33 , 43 , 46 , 51 , 54 switch from multiple vaccinations to a combination vaccine (n = 2), 55 , 56 switch of number of doses per vial (n = 1), 50 switch of type of vaccine (n = 1), 47 switch of vaccine schedule only (n = 1), 52 switch of vaccine schedule and serotype coverage (n = 1), 53 and switch to of vaccine strains. 58 Vaccines of interest include poliovirus vaccines (n = 21), 28–37 – 39–42 – 46 , 48 , 49 , 51 , 54 , 57 , 59 PCV (n = 6), 38 , 40 , 41 , 50 , 52 , 53 combination vaccines (n = 2), 55 , 56 pertussis vaccines (n = 1), 47 and Bacillus Calmette – Guérin (BCG) vaccine.…”

“… Vaccine implementation challenge Country/region facing implementation challenge Type of vaccine switches (Type of vaccine) Description of implementation challenge Resource and costs caused by implementation challenge 1. Vaccine availability 1.1 Vaccine supply Ensuring sufficient production scale-up Eastern Mediterranean Region 27 Sri Lanka 28 Global 30 , 31 , 33 , 39 Western Pacific Region 32 India 37 , 38 Region of Americas 42 , 55 Pakistan 43 European Region 54 Switch of route of administration (Polio; from OPV to IPV) 27 – 28-30 – 39-42 – 43-54 – 55 Global shortage of vaccine leading to global disparities in vaccine access 27–30 – 39–42 – 54 Some countries need to use an alternative method of fractional dose of IPV instead of using full-dose IPV 28 , 43 , 55 Opportunity costs of increased risk of infection to children due to missed vaccination 27 …”

A multi-pronged scoping review approach to understanding the evolving implementation of the Smallpox and Polio eradication programs: what can other Global Health initiatives learn?

“…Under engagement and capacity building-related strategies, involving stakeholders-including existing governance mechanisms, communities and other key partners-in the implementation effort was the most common strategy identified in the SEP literature (n = 95, 73%). Within GPEI (n = 289, 53%), this strategy took on additional levels of complexity and variability across contexts as the program worked to adapt implementation approaches and respond to other challenges [55]. These plans included holding stakeholder engagement events in each country within the GPEI; these stakeholders then remained involved through testing of implementation dashboards, monitoring and evaluation plans, and roll-out of the switch itself [56].…”

Experiencia cubana en inmunización, 1962–2016

“…En 2016, se empezó a administrar la IPV por esquema y en las campañas de vacunación se continúa aplicando la vacuna oral (OPV) bivalente (1 y 3) cumpliendo la estrategia para reducir los riesgos asociados con la retirada de la trivalente oral (OPVt). Debe señalarse que la introducción de la IPV requirió difundir información que mantuviera la confianza del personal de salud y de la comunidad en la formulación oral (29).…”