Barriers and activities to implementing or expanding influenza vaccination programs in low- and middle-income countries: A global survey. Issue 25 (8th June 2021)

• Record Type: Journal Article
• Authors: Kraigsley, Alison M.; Moore, Kristine A.; Bolster, Amanda; Peters, Maya; Richardson, Dominique; Arpey, Meredith; Sonnenberger, Michelle; McCarron, Margaret; Lambach, Philipp; Maltezou, Helena C.; Bresee, Joseph S.
• Is Part Of: Vaccine. Volume 39:Issue 25(2021)
• Page Start: 3419
• Page End: 3427
• Publication Date: 2021-06-08
• Subjects: Influenza -- Vaccination -- Policies -- Pandemic preparedness -- Seasonal influenza vaccines -- Public health practice -- Influenza vaccination programs; AFRO WHO African Region -- AMRO WHO Region of the Americas -- CDC US Centers for Disease Control and Prevention -- CIDRAP Center for Infectious Disease Research and Policy -- EMRO WHO Eastern Mediterranean Region -- EPI Expanded Programme on Immunizations -- EURO WHO European Region -- GAP WHO Global Action Plan for Influenza Vaccines -- GNI gross national income -- LMIC low- and middle-income countries (including lower-middle and upper-middle income) -- MOH Ministry of Health -- NGO non-governmental organization -- NITAG national immunization technical advisory group -- NIVP national influenza vaccination program -- PIVI Partnership for Influenza Vaccine Introduction -- SEARO WHO South-East Asia Region -- TFGH The Task Force for Global Health -- UNICEF United Nations Children's Fund -- WHO World Health Organization -- WPRO WHO Western Pacific Region; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.04.043
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Lack of cost-effectiveness data for vaccination programs a critical barrier. Educating health workers and decision-makers about influenza vaccination is key. Tools are needed to support in-country assessments of influenza burden. Cold-chain is a critical barrier for lower-middle income countries. Abstract: Introduction: Despite considerable global burden of influenza, few low- and middle-income countries (LMICs) have national influenza vaccination programs. This report provides a systematic assessment of barriers to and activities that support initiating or expanding influenza vaccination programs from the perspective of in-country public health officials. Methods: Public health officials in LMICs were sent a web-based survey to provide information on barriers and activities to initiating, expanding, or maintaining national influenza vaccination programs. The survey primarily included Likert-scale questions asking respondents to rank barriers and activities in five categories. Results: Of 109 eligible countries, 62% participated. Barriers to influenza vaccination programs included lack of data on cost-effectiveness of influenza vaccination programs (87%) and on influenza disease burden (84%), competing health priorities (80%), lack of public perceived risk from influenza (79%), need for better risk communication tools (77%), lack of financial support for influenza vaccine programs (75%), a requirement to use only WHO-prequalified vaccines (62%), and young children require two vaccine doses (60%). Activities for advancing influenza vaccination programs included educating healthcare workers (97%) and decision-makers (91%) on the benefits of influenza vaccination, better estimates of influenza disease burden (91%) and cost of influenza vaccination programs (89%), simplifying vaccine introduction by focusing on selected high-risk groups (82%), developing tools to prioritize target populations (80%), improving availability of influenza diagnostic testing (79%), and developing collaborations with neighboring countries for vaccine procurement (74%) and regulatory approval (73%). Responses varied by country region and income status. Conclusions: Local governments and key international stakeholders can use the results of this survey to improve influenza vaccination programs in LMICs, which is a critical component of global pandemic preparedness for influenza and other pathogens such as coronaviruses. Additionally, strategies to improve global influenza vaccination coverage should be tailored to country income level and geographic location.