The partnership for influenza vaccine introduction (PIVI): Supporting influenza vaccine program development in low and middle-income countries through public-private partnerships

Abstract

Influenza vaccination remains the most effective tool for reducing seasonal influenza disease burden. Few Low and Middle-Income Countries (LMICs) have robust, sustainable annual influenza national vaccination programs. The Partnership for Influenza Vaccine Introduction (PIVI) was developed as a public-private partnership to support LMICs to develop and sustain national vaccination programs through time-limited vaccine donations and technical support. We review the first 5 years of experience with PIVI, including the concept, country progress toward sustainability, and lesson learned. Between 2013 and 2018, PIVI worked with Ministries of Health in 17 countries. Eight countries have received donated vaccines and technical support; of these, two have transitioned to sustained national support of influenza vaccination and six are increasing national support of the vaccine programs towards full transition to local vaccine program support by 2023. Nine additional countries have received technical support for building the evidence base for national policy development and/or program evaluation. PIVI has resulted in increased use of vaccines in partner countries, and early countries have demonstrated progress towards sustainability, suggesting that a model of vaccine and technical support can work in LMICs. PIVI expects to add new country partners as current countries transition to self-reliance.

Influenza Virus and Vaccination

“…Vaccinating pregnant women is generally regarded as safe [159][160][161][162][163][164][165]. However, some hesitancy over influenza vaccination is present in this population and the benefit of protecting both the mother and the fetus needs to be conveyed as outweighing the risk of potential side effects [223][224][225][226].…”

The Importance of Vaccinating Children and Pregnant Women against Influenza Virus Infection

“…Vaccinating pregnant women is generally regarded as safe [159][160][161][162][163][164][165]. However, some hesitancy over influenza vaccination is present in this population and the benefit of protecting both the mother and the fetus needs to be conveyed as outweighing the risk of potential side effects [223][224][225][226].…”

“…Increasing vaccination rates in low-and middle-income countries will require additional resources to help offset the cost of development and implementation of vaccination programs [225]. It has been estimated that global supply of influenza virus vaccine is sufficient to cover pregnant women in low-and middle-income countries [241].…”

“…While the Mali study was not sufficiently powered to detect a decrease in ILI, maternal vaccination studies conducted in Bangladesh and South Africa have demonstrated at least partial protection against developing confirmed influenza virus infection [175,180]. Unfortunately, due to the lack of sufficient data for the benefit of developing such programs, the Global Alliance for Vaccines and Immunization has deprioritized maternal vaccinations against seasonal flu [244][245][246][247] while the Global Influenza Initiative recommends that all pregnant women be vaccinated in their third trimester [225]. This lack of harmonization between guidelines highlights the additional work needed to develop evidence-based recommendations for programs in resource poor countries [248].…”

Active pharmacovigilance of the seasonal trivalent influenza vaccine produced by Instituto Butantan: A prospective cohort study of five target groups

“…It is now an integral part of the regulation of drug and vaccine safety. National post-licensure vaccine safety monitoring systems vary considerably in their structure, methods, and performance, with disparities occurring particularly between high-, middle-and low-income countries [4].…”