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Review
. 2023 Nov 22;11(12):1743.
doi: 10.3390/vaccines11121743.

A Systematic Review of Vaccination Guidance for Humanitarian Responses

Lauren E Allison  1 , Mervat Alhaffar  1   2 , Francesco Checchi  1 , Nada Abdelmagid  1 , Barni Nor  3 , Majdi M Sabahelzain  4 , Page M Light  1 , Neha S Singh  5
Affiliations
Review

A Systematic Review of Vaccination Guidance for Humanitarian Responses

Lauren E Allison et al. Vaccines (Basel). .

Abstract

Delivering vaccines in humanitarian response requires rigourous and continuous analysis of evidence. This systematic review mapped the normative landscape of vaccination guidance on vaccine-preventable diseases in crisis-affected settings. Guidance published between 2000 and 2022 was searched for, in English and French, on websites of humanitarian actors, Google, and Bing. Peer-reviewed database searches were performed in Global Health and Embase. Reference lists of all included documents were screened. We disseminated an online survey to professionals working in vaccination delivery in humanitarian contexts. There was a total of 48 eligible guidance documents, including technical guidance (n = 17), descriptive guidance (n = 16), operational guidance (n = 11), evidence reviews (n = 3), and ethical guidance (n = 1). Most were World Health Organization documents (n = 21) targeting children under 5 years of age. Critical appraisal revealed insufficient inclusion of affected populations and limited rigour in guideline development. We found limited information on vaccines including, yellow fever, cholera, meningococcal, hepatitis A, and varicella, as well as human papilloma virus (HPV). There is a plethora of vaccination guidance for vaccine-preventable diseases in humanitarian contexts. However, gaps remain in the critical and systematic inclusion of evidence, inclusion of the concept of "zero-dose" children and affected populations, ethical guidance, and specific recommendations for HPV and non-universally recommended vaccines, which must be addressed.

Keywords: conflict; crises; disaster; guidance; humanitarian; vaccination; vaccine-preventable diseases; zero dose children.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the vaccination guidance in humanitarian settings search according to PRISMA guidelines.
Figure 2
Figure 2
Vaccination guidance for humanitarian settings classified according to lead development organisation. * Includes documents published in academic journals such as evidence reviews.
Figure 3
Figure 3
Number of vaccination guidance documents classified according to humanitarian crisis type and setting.
Figure 4
Figure 4
Intended target user identified by vaccination guidance document.
See this image and copyright information in PMC

References

    1. World Health Organization The Guide to Tailoring Immunization Programmes (TIP) 2013. [(accessed on 15 August 2022)]. Available online: https://www.euro.who.int/__data/assets/pdf_file/0003/187347/The-Guide-to....
    1. United Nations Children’s Fund COVID-19 Pandemic Fuels Largest Continued Backslide in Vaccinations in Three Decades. 2022. [(accessed on 15 August 2022)]. Available online: https://www.unicef.org.uk/press-releases/covid-19-pandemic-fuels-largest...
    1. PATH Zero-Dose Children: Reaching the Unreached. 2022. [(accessed on 15 August 2022)]. Available online: https://www.path.org/articles/zero-dose-children-reaching-unreached/
    1. Gavi, the Vaccine Alliance 2021–2025 Gavi Investment Opportunity. 2019. [(accessed on 15 August 2022)]. Available online: https://www.gavi.org/gavi-investment-opportunity-2021-2025.
    1. World Health Organization Global Humanitarian Overview 2022 (Part One) 2022. [(accessed on 12 August 2022)]. Available online: https://gho.unocha.org/

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