Aia update ri task force meet 20th jan
January 2014 THE POLIO ERADICATION ENDGAME BRIEF ON IPV INTRODUCTION, OPV WITHDRAWAL AND ROUTINE IMMUNIZATION STRENGTHENING The Polio Eradication and Endgame Strategic Plan 2013-2018 was drawn up in response to the May 2012 World Health Assembly declaring the completion of poliovirus eradication to be a programmatic emergency for global public health. Under this endgame plan to achieve and sustain a polio-free world, the use of oral polio vaccine (OPV) must eventually be stopped worldwide, starting with OPV that contains type 2 poliovirus (OPV type 2). At least one dose of inactivated polio vaccine (IPV) must be introduced as a risk mitigation measure. The steps involved are: 1. By end 2015, introduce at least 1 dose of IPV into all routine immunization systems, at least 6 months before the switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV, containing types 1 and 3 poliovirus). 2. During 2016, switch from tOPV to bOPV, which does not contain type 2 virus, in routine immunization and polio campaigns. 3. Plan for the eventual withdrawal of all OPV. The tOPV to bOPV switch is necessary because: No wild poliovirus type 2 has been recorded over the past years and the risk of paralytic polio disease due to the type 2 component of OPV now outweighs its benefits. Since OPV is a live attenuated vaccine, in rare cases it can cause paralytic disease in two ways: as Vaccine Associated Paralytic Poliomyelitis (VAPP) or in outbreaks of circulating Vaccine-Derived Poliovirus (cVDPV). The vast majority of cVDPV outbreaks and a substantial proportion of the total VAPP cases are due to the type 2 component of OPV. Replacing tOPV with bOPV is key to ensuring the eradication of type 2 poliovirus. The switch from tOPV to bOPV will serve as a ‘dry run’ for the withdrawal of the other types of OPV. IPV needs to be introduced on an accelerated timeline so that OPV type 2 can be withdrawn. IPV should be introduced at least 6 months before the switch from tOPV to bOPV, i.e., by the end of 2015. Countries using only OPV in their routine immunization programmes should be prepared for a switch from tOPV to bOPV in 2016.
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Aia update ri task force meet 20th jan
- 1. RI Task Force Meeting 20th January 2015 Update of AIA
- 2. Accelerated Immunization Activity :Objectives • To increase the immunization coverage with all vaccines under the National Immunization Schedule. • To reach the beneficiaries in hard to reach areas, especially those who are left out from routine services.
- 3. Fully immunized children aged 12-23 months by province 50.9% 2.5% 7.0% 7.8% 13.7% 19.4% 25.9% 31.6% 39.8% 41.6% 45.5% 45.7% 49.5% 50.3% 51.0% 55.7% 57.1% 59.1% 61.5% 62.7% 64.1% 64.9% 65.3% 66.3% 67.0% 70.0% 70.4% 71.6% 72.8% 76.8% 77.3% 80.6% 82.7% 86.3% 86.8% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% National Farah Nooristan Helmand Urozgan Ghor Zabul Kandahar Badghis Faryab Daikundy Logar Ghazni Khost Badakhsan Kunar Sare-Pul Wardak Kabul Baghlan Kunduz Nimrooz Parwan Nangarhar Jawzjan Laghman Takhar Paktika Herat Balkh Samangan Bamyan Kapisa Panjshir Paktia Progress GVAP update Efforts to improve coverage PEI to EPI
- 4. Accelerated Immunization Activity :Target population • Category A (Highest priority): Areas which are never or rarely reached e.g. • Not reachable during harsh winter (Seasonal problems), • Sub centers without vaccinator having >10 clients /day, • villages with poor access, • Urban slums, periurban areas, • Villages with poor access, • Vacant sub-centers, • Migrant and mobile populations, • Marginalized population etc. • Category B (Second priority): Areas where immunization was planned but not held during previous 3-4 months. • Category C (Third priority): Villages/urban areas where RI is normally done but coverage is considered low.
- 5. S N Province District S N Province District S N Province District 1 Badakshan 1 Faizabad Gazni 7 Giro 12 Logar 1 Pulialm Badakshan 2 Darwaz Gazni 8 Nawa Logar 2 M Agha Badakshan 3 Raghistan Gazni 9 Gillan Logar 3 Khoshi Badakshan 4 Kohistan Gazni 10 zanakhan 13 Nuristan 1 Kamdish Badakshan 5 Yawan Gazni 11 Muqor Nuristan 2 Norgram Badakshan 6 Khahan 7 Ghor 1 Firooz kooh Nuristan 3 Mondol Badakshan 7 Shahribuzurg Ghor 2 Charsada Nuristan 4 Waigal Badakshan 8 Yafta-i-Payan Ghor 3 Dulaynah Nuristan 5 Doaba Badakshan 9 Argoo Ghor 4 Daulatyar 14 Saripul 1 Sangcharak Badakshan 10 Kiran-o-Munjan Ghor 5 Shahrak Saripul 2 Balkhab Badakshan 11 Yumgan Ghor 6 Taywra Saripul 3 Saripul Badakshan 12 Jurum Ghor 7 Pasaband 15 Urozgan 1 Trinikot 2 Badgis 1 Jawand Ghor 8 Lal wa Sar Jangal Urozgan 2 Chora Badgis 2 Qadis Ghor 9 Toolak Urozgan 3 Dehrawud Badgis 3 Abkamary Ghor 10 Sghar Urozgan 4 Shahid Asas 3 Diakundy 1 Miramor 8 Helmond Lashkargah Urozgan 5 Khos Urozgan Diakundy 2 Shahristan Helmond Nahreseraj 16 Wardak 1 Behsood 1 Diakundy 3 Ashterly Helmond Nad Ali Wardak 2 behsood2 Diakundy 4 Bandar Helmond Nawa Wardak 3 Daimerdad Diakundy 5 Khider 9 Kandahar 1 Panjwai Wardak 4 Chak Diakundy 6 Kiti Kandahar 2 Khakriz Wardak 5 Nerkh 4 Farah 1 Farah City Kandahar 3 Arghistan Wardak 6 Jaghtoo Farah 2 bakwa Kandahar 4 Dand 17 Zabul 1 Shajoy Farah 3 Gulistan Kandahar 5 Shahwalikot Zabul 2 Qalot Farah 4 Purchaman 10 Khost 1 Tani Zabul 3 Zadk Tarnk Farah 5 Balaabuluk Khost 2 Nader Shah Kot Zabul 4 Shinkai Farah 6 Khkisafeed Khost 3 Spera Zabul 5 Mezana Farah 7 Anardara Khost 4 Ali sheer Farah 8 Pushtako Khost 5 Dwamanda Farah 9 Sabi ko Khost 6 Matune Provinces 17 5 Faryab 1 Almar Khost 7 Musa Khel Districts 105 Faryab 2 Qaisar Khost 8 Qalandar Faryab 3 Pashton Kot Khost 9 Jaji Miedan 6 Gazni 1 Qarabagh Khost 10 Sabari Gazni 2 Nawor Khost 11 Gurbuz Gazni 3 Jaghuri Khost 12 Baak Gazni 4 Malestan 11 Kunar 1 Dangam Gazni 5 Ajristan Kunar 2 Noorgal Gazni 6 Waghaz Kunar 3 Peach Accelarated Immunization Activity 2014 105 Districts 17 Provinces
- 6. Provinces-17 out of total 34 Round 1 Round 2 Round 3 Farah, Nuristan, Helmand, Uruapan, Kandahar, Ghor, Kabul, Badghis, Faryab, Daikundi, Logar, Ghazni, Khost, Badakhshan, Kunzar Sari-Pul, Wardak. 11th to 16th October 2014 22 to 27th November 2014 27th December to 1st January 2015
- 9. 22963 991 28183 4362 3438 2812 25498 3575 2454 17871 17313 1270 1191 1499 6369 606 507 14094 5092 6485 5921 3201 2008 0 5000 10000 15000 20000 25000 30000 35000 40000 Coverage AIA three rounds: I-16 II-8 III- 4 I II III High coverage of BCG, Penta1,OPV1 PCV1 AND Measles 1 TT1 Implying left out children are being vaccinated through the accelerated activity
- 11. 0 69 4252 937 696 341 4441 809 577 2187 235 34 32 53 0 0 0 274 87 6541 1493 1453 935 660 0 1000 2000 3000 4000 5000 6000 7000 Gazni :3 rounds coverage :AIA I II III
- 12. Coverage against the micro-plan target 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 BCG OPV0 OPV/Penta1 OPV/Penta2 OPV/Penta3 OPV4 PCV1 PCV2 PCV3 Measles1 Measles2 Vaccine TT1 TT2 TT3 TT4 TT5 52.6 1.2 47.0 2.5 2.0 1.2 34.2 2.4 2.0 30.5 0.0 0.0 0.0 1.8 0.1 0.0 0.0 0.0 75.8 0.5 75.4 2.6 0.3 0.0 78.3 0.0 0.0 58.8 0.0 0.0 0.0 18.2 0.1 0.0 0.0 0.0 % of children covered by antigen against the microplan target Helmond Urozgon Kunar Logar Sari pul High coverage of BCG, Penta1,OPV1 PCV1 AND Measles 1 Implying left out children are being vaccinated through the accelerated activity
- 13. HELMOND
- 14. Kunar
- 15. Action points • Letter to concerned PEMTs to conduct remaining rounds before end of Feb 2015. • Collection of the reports from the remaining provinces • Monitoring plan from NEPI and partners • Regularize Quarterly accelerated catch up rounds: ( based on the coverage and other criteria to make microplans to cover the left outs and dropouts from each district)
- 16. Inclusion of age group of 5 to 9 years for the planned measles campaign in 2015
- 18. 5 14 8 9 12 13 1 0 2 1 1 9 7 20 11 9 17 3 8 2 16 17 15 29 27 28 7 2 1 0 2 15 11 29 47 19 44 16 24 17 6 7 11 11 19 13 2 1 1 2 2 9 9 16 13 11 18 15 4 5 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Monthly distribution of Measles cases by age category in Afghanistan January 2013-AUG 2014 <1 Year 1-4 Years 5-9 Years 10-14 Years 15-19 Years 20-24 Years 25+ Years
- 20. 13 26 16 39 40 46 46 49 49 53 0 10 20 30 40 50 60 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 MCV2 National Reported coverage
- 23. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Percentofpopulation Age (in years) Protected by maternal antibodies Protected by routine vaccination with 1st dose Protected by routine vaccination with 2nd dose Protected by SIAs Unprotected by vaccination Current Immunity gap :Measles 2014
- 24. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Percentofpopulation Age (in years) Protected by maternal antibodies Protected by routine vaccination with 1st dose Protected by routine vaccination with 2nd dose Protected by SIAs Unprotected by vaccination Reduction of Immunity gapo with 9 Months to 5 years.
- 25. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Percentofpopulation Age (in years) Protected by maternal antibodies Protected by routine vaccination with 1st dose Protected by routine vaccination with 2nd dose Protected by SIAs Unprotected by vaccination Reduction of Immunity gap with 9 Months to 9 years.
- 26. Action points • Explore funding options for inclusion of 5-9 years for the upcoming measles campaign • Planning for 9months to 9 years • Preparation steps to including of cold chain management and space for the huge campaign
- 27. Thank You