Giuseppe
Emeritus
Meeting of the Strategic Advisory Group of Experts on Immunization, November 2010 ? summary, conclusions and recommendations (WHO, extract, edited)
[Source: World Health Organization, full PDF document (LINK). Extract, edited.]
Weekly epidemiological record
Relev? ?pid?miologique hebdomadaire
7 january 2011, 86th year / 7 janvier 2011, 86e ann?e
No. 1-2, 2011, 86, 1?16
http://www.who.int/wer
Meeting of the Strategic Advisory Group of Experts on Immunization, November 2010 ? summary, conclusions and recommendations
The Strategic Advisory Group of Experts (SAGE) on Immunization(1) met on 9?11 November 2010 in Geneva, Switzerland.(2)
(...)
Seasonal and pandemic influenza
SAGE received an update on pandemic (H1N1) 2009 vaccine pharmacovigilance and deployment. A continuing review of global data conducted by GACVS has found an excellent safety profile. Study results have demonstrated high effectiveness and a good match between vaccine antigen and the circulating pandemic (H1N1) 2009 influenza virus. Pledges for vaccine donations were made quickly to WHO, although there were delays between the pledge and the fulfilment of commitment. In addition, there were delays from commitment to deployment owing to vaccine availability, the requirement for letters of intent and agreement, and a vaccine deployment plan.
WHO deployed 78 million doses, most of which went to the African Region, the South-East Asia Region and the Eastern Mediterranean Region.
WHO is reviewing ways to shorten timelines to expedite the availability of vaccine. Eleven vaccines were prequalified rapidly by using accelerated procedures that included obtaining assistance from regulatory authorities in a number of countries and recruiting additional staff, so that prequalification of other products was not delayed.
SAGE requested that WHO report on the utilization of deployed vaccine, including by risk group, once data collection has been completed. SAGE also noted the variability of influenza seasons in different regions and the challenges this poses to prioritizing the distribution of vaccines.
SAGE expressed support for the review of lessons learnt from pandemic (H1N1) 2009 vaccination activities that WHO is undertaking, and encouraged WHO to carefully consider factors that caused delays and ways to improve coordination among WHO, its Regions, and Member States. SAGE commended WHO on the rapid prequalification of pandemic (H1N1) 2009 vaccines.
The SAGE working group on H5N1 vaccines reported on a review of 2 previous SAGE recommendations made regarding (i) the vaccination of people who may have contact with infected animals during the interpandemic period and (ii) the purpose and size of the H5N1 vaccine stockpile.
SAGE found insufficient new evidence on disease risk to warrant making any change to the original recommendations about target groups, including the recommendation that licensed H5N1 vaccine may be made available to persons in potential contact with highly pathogenic avian influenza. However, SAGE noted additional evidence of a good safety profile, and should data demonstrate a higher risk to subpopulations, the recommendation may be revisited.
SAGE further recommended that vaccine pledges for the WHO pandemic (H1N1) 2009 vaccine stockpile should be used to allow low-income and middle-income countries to immunize essential personnel at the onset of a pandemic.
SAGE expressed a need for more information about the shelf-life and other characteristics of pandemic influenza vaccines before making additional recommendations about options for the constitution of the stockpile.
These issues and other questions about pandemic influenza vaccines will be addressed by SAGE?s working group on influenza vaccines and immunization.
SAGE received a report from its working group on influenza vaccines and immunization, which is tasked with: preparing an evidence-based review of WHO?s recommendations on the use of seasonal influenza vaccine, with a particular focus on low-income and middleincome countries; identifying essential evidence gaps that would hinder the updating of recommendations on the use of influenza vaccines; recommending coverage goals for seasonal influenza vaccination; and providing advice about pandemic vaccine preparedness. At its first meeting in October the many challenges facing influenza vaccine programmes and policy development were identified, particularly the sparse data on the burden of disease in many countries, which makes cost-effectiveness analyses and priority-setting difficult.
Other challenges include the scale of influenza-vaccine programmes and manufacturing capacity, limitations of global surveillance and laboratory capacity, the difficulty of prioritizing target groups and the variability of transmission in different regions and settings. SAGE supported the conceptual matrix proposed by the working group that focuses on key issues (disease burden, vaccine performance and cost-effectiveness, and operational issues) and target populations (children, elderly people, pregnant women and other high-risk groups).
Health-care workers? resistance to receiving influenza vaccine was highlighted as an important area for consideration.
SAGE recommended that the working group develop a research agenda.
(...)
(1) Information on the Strategic Advisory Group of Experts (SAGE) is available at (LINK)
(2) The complete set of presentations and background materials used for the SAGE meeting of 9?11 November 2010 is available at (LINK).
(7) See No. 47, 2010, pp. 463?465
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[Source: World Health Organization, full PDF document (LINK). Extract, edited.]
Weekly epidemiological record
Relev? ?pid?miologique hebdomadaire
7 january 2011, 86th year / 7 janvier 2011, 86e ann?e
No. 1-2, 2011, 86, 1?16
http://www.who.int/wer
Meeting of the Strategic Advisory Group of Experts on Immunization, November 2010 ? summary, conclusions and recommendations
The Strategic Advisory Group of Experts (SAGE) on Immunization(1) met on 9?11 November 2010 in Geneva, Switzerland.(2)
(...)
Seasonal and pandemic influenza
SAGE received an update on pandemic (H1N1) 2009 vaccine pharmacovigilance and deployment. A continuing review of global data conducted by GACVS has found an excellent safety profile. Study results have demonstrated high effectiveness and a good match between vaccine antigen and the circulating pandemic (H1N1) 2009 influenza virus. Pledges for vaccine donations were made quickly to WHO, although there were delays between the pledge and the fulfilment of commitment. In addition, there were delays from commitment to deployment owing to vaccine availability, the requirement for letters of intent and agreement, and a vaccine deployment plan.
WHO deployed 78 million doses, most of which went to the African Region, the South-East Asia Region and the Eastern Mediterranean Region.
WHO is reviewing ways to shorten timelines to expedite the availability of vaccine. Eleven vaccines were prequalified rapidly by using accelerated procedures that included obtaining assistance from regulatory authorities in a number of countries and recruiting additional staff, so that prequalification of other products was not delayed.
SAGE requested that WHO report on the utilization of deployed vaccine, including by risk group, once data collection has been completed. SAGE also noted the variability of influenza seasons in different regions and the challenges this poses to prioritizing the distribution of vaccines.
SAGE expressed support for the review of lessons learnt from pandemic (H1N1) 2009 vaccination activities that WHO is undertaking, and encouraged WHO to carefully consider factors that caused delays and ways to improve coordination among WHO, its Regions, and Member States. SAGE commended WHO on the rapid prequalification of pandemic (H1N1) 2009 vaccines.
The SAGE working group on H5N1 vaccines reported on a review of 2 previous SAGE recommendations made regarding (i) the vaccination of people who may have contact with infected animals during the interpandemic period and (ii) the purpose and size of the H5N1 vaccine stockpile.
SAGE found insufficient new evidence on disease risk to warrant making any change to the original recommendations about target groups, including the recommendation that licensed H5N1 vaccine may be made available to persons in potential contact with highly pathogenic avian influenza. However, SAGE noted additional evidence of a good safety profile, and should data demonstrate a higher risk to subpopulations, the recommendation may be revisited.
SAGE further recommended that vaccine pledges for the WHO pandemic (H1N1) 2009 vaccine stockpile should be used to allow low-income and middle-income countries to immunize essential personnel at the onset of a pandemic.
SAGE expressed a need for more information about the shelf-life and other characteristics of pandemic influenza vaccines before making additional recommendations about options for the constitution of the stockpile.
These issues and other questions about pandemic influenza vaccines will be addressed by SAGE?s working group on influenza vaccines and immunization.
SAGE received a report from its working group on influenza vaccines and immunization, which is tasked with: preparing an evidence-based review of WHO?s recommendations on the use of seasonal influenza vaccine, with a particular focus on low-income and middleincome countries; identifying essential evidence gaps that would hinder the updating of recommendations on the use of influenza vaccines; recommending coverage goals for seasonal influenza vaccination; and providing advice about pandemic vaccine preparedness. At its first meeting in October the many challenges facing influenza vaccine programmes and policy development were identified, particularly the sparse data on the burden of disease in many countries, which makes cost-effectiveness analyses and priority-setting difficult.
Other challenges include the scale of influenza-vaccine programmes and manufacturing capacity, limitations of global surveillance and laboratory capacity, the difficulty of prioritizing target groups and the variability of transmission in different regions and settings. SAGE supported the conceptual matrix proposed by the working group that focuses on key issues (disease burden, vaccine performance and cost-effectiveness, and operational issues) and target populations (children, elderly people, pregnant women and other high-risk groups).
Health-care workers? resistance to receiving influenza vaccine was highlighted as an important area for consideration.
SAGE recommended that the working group develop a research agenda.
(...)
(1) Information on the Strategic Advisory Group of Experts (SAGE) is available at (LINK)
(2) The complete set of presentations and background materials used for the SAGE meeting of 9?11 November 2010 is available at (LINK).
(7) See No. 47, 2010, pp. 463?465
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