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. 2021 Apr;26(17):2001195.
doi: 10.2807/1560-7917.ES.2021.26.17.2001195.

National routine adult immunisation programmes among World Health Organization Member States: an assessment of health systems to deploy COVID-19 vaccines

Sarah R Williams  1   2 , Amanda J Driscoll  2   3 , Hanna M LeBuhn  3 , Wilbur H Chen  3 , Kathleen M Neuzil  3 , Justin R Ortiz  3
Affiliations

National routine adult immunisation programmes among World Health Organization Member States: an assessment of health systems to deploy COVID-19 vaccines

Sarah R Williams et al. Euro Surveill. 2021 Apr.

Abstract

IntroductionAs SARS-CoV-2 disproportionately affects adults, the COVID-19 pandemic vaccine response will rely on adult immunisation infrastructures.AimTo assess adult immunisation programmes in World Health Organization (WHO) Member States.MethodsWe evaluated country reports from 2018 on adult immunisation programmes sent to WHO and UNICEF. We described existing programmes and used multivariable regression to identify independent factors associated with having them.ResultsOf 194 WHO Member States, 120 (62%) reported having at least one adult immunisation programme. The Americas and Europe had the highest proportions of adult immunisation programmes, most commonly for hepatitis B and influenza vaccines (> 47% and > 91% of countries, respectively), while Africa and South-East Asia had the lowest proportions, with < 11% of countries reporting adult immunisation programmes for hepatitis B or influenza vaccines, and none for pneumococcal vaccines. In bivariate analyses, high or upper-middle country income, introduction of new or underused vaccines, having achieved paediatric immunisation coverage goals and meeting National Immunisation Technical Advisory Groups basic functional indicators were significantly associated (p < 0.001) with having an adult immunisation programme. In multivariable analyses, the most strongly associated factor was country income, with high- or upper-middle-income countries significantly more likely to report having an adult immunisation programme (adjusted odds ratio: 19.3; 95% confidence interval: 6.5-57.7).DiscussionWorldwide, 38% of countries lack adult immunisation programmes. COVID-19 vaccine deployment will require national systems for vaccine storage and handling, delivery and waste management to target adult risk groups. There is a need to strengthen immunisation systems to reach adults with COVID-19 vaccines.

Keywords: COVID-19; SARS-CoV-2; adult immunisation; joint reporting form; policy; public health; vaccines.

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Conflict of interest statement

Conflict of interest: Sarah R Williams reports no interests.

Amanda J Driscoll reports no interests.

Hanna M LeBuhn reports no interests.

Wilbur H Chen reports grants to his institution from NIH for influenza vaccine research and grants to his institution from GSK, Pfizer, Bill & Melinda Gates Foundation, and PATH for vaccine (non-influenza) research. He is on Safety Review Committee for a Flugen vaccine trial and a data and safety monitoring board member for intramural NIH NIAID vaccine trials. He is a voting member of the CDC Advisory Committee on Immunization Practices.

Kathleen M Neuzil reports grants to her institution from NIH for influenza vaccine research and grants to her institution from GSK, Pfizer, Bill & Melinda Gates Foundation, and PATH for vaccine (non-influenza) research. She is on the Board of Directors for the National Foundation of Infectious Diseases, is a member of WHO Strategic Advisory Group of Experts on Immunization (SAGE) (all unpaid), and is co-chair of the NIH COVID Vaccine Prevention Network with salary support from NIH.

Justin R Ortiz reports grants to his institution from NIH for influenza vaccine research and from NIH, GSK, Pfizer, and PATH for other vaccine research. He has received travel support from Seqirus to attend an influenza vaccine Real World Evidence Scientific Advisory Board meeting. He has received payments to serve as an Independent Safety Monitor and to be a member of a data and safety monitoring board from Pharmaron for non-influenza vaccine research.

Figures

Figure 1
Figure 1
Reported adult immunisation programmes, by World Health Organization Region, 2018
Figure 2
Figure 2
Reported adult immunisation programmes, by World Bank income categories, 2018
See this image and copyright information in PMC

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