A report on current global access to new childhood vaccines VIMS Report: Global Vaccine June, 2012 Developed from information in the VIMS Database (www.jhsph.edu/ivac/vims.html) Johns Hopkins Bloomberg School of Public Health International Vaccine Access Center (IVAC) Contact: vims@jhsph.edu International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health Rangos Bldg, Suite 600 855 N. Wolfe Street Baltimore, MD 21205 www.jhsph.edu/ivac Updates Include: New vaccine introductions Updated introduction maps
TABLE OF CONTENTS Vaccine Dashboard Executive Summary Methods Updates on Global and GAVI Uptake for Hib, Pneumococcal Conjugate and Rotavirus Vaccines trends over time A line graph that displays the rate of vaccine introduction since 2000 and projected to 2020 both globally and for GAVI eligible countries. Current Global and GAVI Statuses A pie chart portraying current global and GAVI vaccine introduction statuses. World maps portraying vaccine introduction status globally and in GAVI countries. Present Coverage A pie chart portraying the proportion of children who are likely to receive the vaccination based upon the coverage rates of countries that have introduced. Present Access A pie chart portraying the proportion of children who live in a country that has introduced the vaccine into their national immunization program. Vaccine introduction by income level A line graph comparing the historical and projected rate of PCV and Hib vaccine introduction in High and Low income countries. Table 1. Status by Vaccine for All Countries The status of Hib, Pneumococcal Conjugate and Rotavirus Vaccine for each country. Acknowledgement and Notes Appendix The appendix includes a description of VIMS, support and funding for VIMS, how to sign up for VIMS and how to cite VIMS as a source. This report can be found at: http://www.jhsph.edu/ivac/index.html. The full report and a PowerPoint presentation with graphics can be found in the VIMS database. To gain access to VIMS, please email vims@jhsph.edu. 1
VACCINE INTRODUCTION DASHBOARD Year of First Vaccine Income Level Hib Vaccine PCV Rotavirus Vaccine High Income 1989 (Iceland) 2000 (US) 2006 (3 countries) Middle Income 1994 (2 countries) 2008 (5 countries) 2006 (5 countries) Low Income 1997 (Gambia) 2009 (Rwanda) None GAVI Supported 2001 (2 countries) 2009 (2 countries) 2008 (Bolivia) Total number of countries that have introduced each vaccine Vaccine Global GAVI Eligible Total (194 Countries) 73 Countries At Risk Regional Hib 177 0 2 66 179 PCV 75 8 0 17 83 Rotavirus 35 0 1 8 36 2
EXECUTIVE SUMMARY The following report displays data and figures on the introduction status of Hib vaccine, pneumococcal conjugate vaccine (PCV) and rotavirus vaccine both globally and in 73 GAVI eligible countries. It uses information stored in the Vaccine Information Management System (VIMS) online database maintained by IVAC at the Johns Hopkins Bloomberg School of Public Health and supported by the GAVI Alliance. The images and text below describe: how many countries have introduced each vaccine or plan to in the future; global and GAVI rates of coverage and access; historical trends of the rate of introduction globally; and the introduction status of every country individually. The report concludes with a more detailed description of VIMS and its potential uses. 3
METHODS This report has been generated by the Vaccine Information Management System (VIMS) database developed and maintained at the Johns Hopkins Bloomberg School of Public Health for use by the International Vaccine Access Center (IVAC) and its affiliated projects and partners. VIMS provides a centralized, webbased warehouse for key information related to IVAC s work. Information was gathered from internationally recognized sources, such as UNICEF, World Health Organization, vaccine manufacturers, ministries of health and news media. Current Global and GAVI Statuses for Hib, Pneumococcal Conjugate and Rotavirus Vaccines Data on historical years of vaccine introduction are gathered from the WHO. Information on current introduction status are gathered from internationally recognized sources, such as UNICEF, WHO, vaccine manufacturers, ministries of health and news media. Forecasted introduction dates are from AVI Strategic Demand Forecast v4.0 and WHO updates. For more information on sources, see data inside VIMS or email vims@jhsph.edu. Present Coverage Coverage in each country was calculated with the following formula: Value*Surviving Infants*(DTP3 Coverage Rate). The country receives an Value of 1 if the vaccine has been universally or regionally introduced into the Routine Immunization Program. The country receives an Value of 0 if the vaccine has NOT been introduced into the Routine Immunization Program. Present Access Access in each country was calculated with the following formula: Value*Surviving Infants. The country receives an Value of 1 if the vaccine has been universally or regionally introduced into the Routine Immunization Program. The country receives an Value of 0 if the vaccine has NOT been introduced into the Routine Immunization Program. Note on Regional Coverage and Access Calculations To calculate coverage or access in countries that have introduced regionally, the number of surviving infants in the region that introduced the vaccine was estimated by multiplying the total number of surviving infants in the country by the proportion of the total population that live in the regions that introduced the vaccine. Vaccine introduction by income level Countries were classified using 2011 World Bank income classifications. Year of introduction or forecasted introduction was determined through WHO reports, news media and AVI Strategic Demand Forecast v4.0. Table 1. Status by Vaccine for All Countries This table uses WHO and GAVI Alliance information, as well as corroborated media reports, to list the status and date of introduction of Hib, Pneumococcal Conjugate and Rotavirus Vaccine for each country. Projected introduction dates for GAVI countries are taken from the most recent publicly available AVI Strategic Demand Forecast and WHO information. For non-gavi countries, the World Health Organization and a variety of other sources are used. Information on a particular country s GAVI application status or projected introduction dates may be sensitive and is not for public circulation without prior consent from VIMS personnel. If data is used in a presentation, it should include a statement indicating this. 4
200 Global Hib Vaccine by Year 180 160 140 Number of Countries 120 100 80 60 40 20 0 52% of the world s infants (66.4 million) are not likely to receive Hib vaccine this year because either their country has not yet introduced it, or they are not receiving routine immunizations (measured by DTP3 coverage). Present Hib Coverage (G lobal Surviving Infants) 44% of the world s infants (57.0 million) live in countries or regions that have not yet introduced Hib vaccine into their National Immunization Program. Present Hib Access (G lobal Surviving Infants) N o Coverage 66.4 m il 52% With Coverage 62.3 m il 48% N o Access 57.0 mil 44% With Access 71.7 mil 56% Present Hib Coverage is calculated as the number of surviving infants globally covered by DTP3 vaccine in countries or regions of countries that have introduced Hib vaccine. Present Hib Access is calculated as the number of surviving infants globally that live in countries or regions of countries that have introduced Hib vaccine. 5
179 countries have introduced a Hibcontaining vaccine into their National Immunization Program. This includes universal, regional and at risk prorams. 11 countries have announced plans to introduce a Hib-containing vaccine into their NIP. 1 country is known to have coverage at greater than 50% through the private market. 3 countries have yet to make a decision regarding introduction. Global Hib Vaccine Status N o D ecision 2% Widespread Planning 6% Private Market 1% A map of countries that have introduced Hib vaccine below. Introduced into N ational Program 92% Already Introduced (U niversal) As of June 2012 177 Countries Already Introduced (Regional) As of June 2012 2 Countries 6
80 GAVI Hib Vaccine by Year 70 60 Number of Countries 50 40 30 20 10 0 57% of infants in GAVI countries (42.8 million) are not likely to receive Hib vaccine this year because either their country has not yet introduced it, or they are not receiving routine immunizations (measured by DTP3 coverage). Present Hib Coverage (G AVI Surviving Infants) 48% of infants in GAVI countries (35.9 million) live in countries or regions that have not yet introduced Hib vaccine into their National Immunization Program. Present Hib Access (G AVI Surviving Infants) N o Coverage 42.8 mil 57% With Coverage 32.0 mil 43% N o Access 35.9 mil 48% With Access 38.8 mil 52% Present Hib Coverage is calculated as the number of surviving infants by GAVI country covered by DTP3 vaccine in countries or regions of countries that have introduced Hib vaccine. Present Hib Access is calculated as the number of surviving infants by GAVI country that live in countries or regions of countries that have introduced Hib vaccine. 7
GAVI Hib Vaccine Status 66 countries have introduced a Hibcontaining vaccine into their National Immunization Program. This includes universal, regional and at risk programs. 5 countries have approved, with or without, GAVI support to introduce. 1 country has announced plans to apply for GAVI support. 1 country has yet to make a decision regarding introduction. N o D ecision 1 country 1% GAVI Approved/ Approved with Clarification 5 countries 7% Planning 1 country 1% A map of GAVI countries that have introduced Hib vaccine below. Introduced into N ational Program 66 countries 90% Already Introduced (U niversal) 65 Countries Already Introduced (Regional) 1 Country Countries Eligible for GAVI Support* *Angola, Armenia, Azerbaijan, Bhutan, Bolivia, Congo, Cuba, Georgia, Guyana, Honduras, Indonesia, Kiribati, Moldova, Mongolia, Sri Lanka, and Ukraine are graduating from GAVI in 2012 and are no longer eligible to apply for new vaccine support. 8
Global PCV by Year 140 120 100 Number of Countries 80 60 40 20 0 76% of the world s infants (98.1 million) are not likely to receive PCV this year because either their country has not yet introduced it, or they are not receiving routine immunizations (measured by DTP3 coverage). Present PCV Coverage (Global Surviving Infants) 73% of the world s infants (94.5 million) live in countries or regions that have not yet introduced PCV into their National Immunization Program. Present PCV Access (Global Surviving Infants) With Coverage 30.7 m il 24% With Access 34.2 m il 27% N o Coverage 98.1 m il 76% N o Access 94.5 m il 73% Present PCV Coverage is calculated as the number of surviving infants globally covered by DTP3 vaccine in countries or regions of countries that have introduced PCV. Present PCV Access is calculated as the number of surviving infants globally that live in countries or regions of countries that have introduced PCV. 9
83 countries have introduced PCV into their National Immunization Program. This includes universal, regional and at risk programs. 58 countries have announced plans to introduce PCV into their NIP, including Mongolia that has begun a regional pilot program. 2 countries are known to have coverage at greater than 50% through the private market. 51 countries have yet to make a decision regarding introduction. Global PCV Status N o D ecision 26% Widespread Private Market 1% Planning 30% A map of countries that have introduced PCV below. Introduced into N ational Program 43% U niversal Program (75 Countries) At R isk Program (8 Countries) 10
GAVI PCV by Year 70 60 50 Number of Countries 40 30 20 10 0 87% of infants in GAVI countries (65.3 million) are not likely to receive PCV this year because either their country has not yet introduced it, or they are not receiving routine immunizations (measured by DTP3 coverage). Present PCV Coverage (GAVI Surviving Infants) 84% of infants in GAVI countries (63.1 million) live in countries or regions that have not yet introduced PCV into their National Immunization Program. Present PCV Access (GAVI Surviving Infants) With Coverage 9.4 mil 13% With Access 11.6 mil 16% N o Coverage 65.3 m il 87% N o Access 63.1 mil 84% Present PCV Coverage is calculated as the number of surviving infants by GAVI country covered by DTP3 vaccine in countries or regions of countries that have introduced PCV. Present PCV Access is calculated as the number of surviving infants by GAVI country that live in countries or regions of countries that have introduced PCV. 11
GAVI PCV Status 17 countries have introduced PCV into their National Immunization Program. This includes universal, regional and at risk programs. 21 countries have approved, with or without, GAVI support to introduce. 10 countries have conditional GAVI approval to introduce. 15 countries have announced plans to introduce PCV into their NIP, including Mongolia that has begun a regional pilot program. 10 countries have yet to make a decision regarding PCV. A map of GAVI countries that have introduced PCV below. Introduced into N ational Program 23% N o D ecision 14% Planning 21% GAVI Approved/ Approved with Clarification 29% G AVI Conditional Approval 14% Already Introduced 17 Countries Countries Eligible for GAVI Support* *Angola, Armenia, Azerbaijan, Bhutan, Bolivia, Congo, Cuba, Georgia, Guyana, Honduras, Indonesia, Kiribati, Moldova, Mongolia, Sri Lanka, and Ukraine are graduating from GAVI in 2012 and are no longer eligible to apply for new vaccine support. 12
Global Rotavirus Vaccine by Year 120 100 80 Number of Countries 60 40 20 0 84% of the world s infants (108.5 million) are not likely to receive Rotavirus vaccine this year because either their country has not yet introduced it, or they are not receiving routine immunizations (measured by DTP3 coverage). Present Rotavirus Coverage (G lobal Surviving Infants) 82% of the world s infants (106.1 million) live in countries or regions that have not yet introduced Rotavirus vaccine into their National Immunization Program. Present Rotavirus Access (G lobal Surviving Infants) With Coverage 20.3 m il 16% With Access 22.6 mil 18% N o Coverage 108.5 m il 84% N o Access 106.1 m il 82% Present Rotavirus Coverage is calculated as the number of surviving infants globally covered by DTP3 vaccine in countries or regions of countries that have introduced Rotavirus vaccine. Present Rotavirus Access is calculated as the number of surviving infants globally that live in countries or regions of countries that have introduced Rotavirus vaccine. 13
Global Rotavirus Vaccine Status 36 countries have introduced Rotavirus vaccine into their National Immunization Program. This includes universal, regional and at risk programs. 57 countries have announced plans to introduce Rotavirus vaccine into their NIP, including Zambia that has begun a regional pilot program. 2 countries are known to have coverage at greater than 50% through the private market. 99 countries have yet to make a decision regarding introduction. A map of countries that have introduced Rotavirus vaccine below. Widespread Private Market 1% N o D ecision 51% Planning 29% Introduced into N ational Program 19% Introduced Program (35 Countries) Regional Program (1 Country) 14
GAVI Rotavirus Vaccine by Year 70 60 50 Number of Countries 40 30 20 10 0 96% of infants in GAVI countries (71.4 million) are not likely to receive Rotavirus vaccine this year because either their country has not yet introduced it, or they are not receiving routine immunizations (measured by DTP3 coverage). Present Rotavirus Coverage With (G AVI Surviving Infants) Coverage 3.3 mil 4% 95% of infants in GAVI countries (71.0 million) live in countries or regions that have not yet introduced Rotavirus vaccine into their National Immunization Program. Present Rotavirus Access (G AVI Surviving Infants) With Access 3.8 mil 5% N o Coverage 71.4 mil 96% Present Rotavirus Coverage is calculated as the number of surviving infants by GAVI country covered by DTP3 vaccine in countries or regions of countries that have introduced Rotavirus vaccine. N o Access 71.0 mil 95% Present Rotavirus Access is calculated as the number of surviving infants by GAVI country that live in countries or regions of countries that have introduced Rotavirus vaccine. 15
8 countries have introduced Rotavirus vaccine into their National Immunization Program. This includes universal, regional and at risk programs. 13 countries are approved, with or without, for GAVI support to introduce. 8 countries have conditional GAVI approval to introduce, including Zambia that has begun a regional pilot program. 21 countries have announced plans to introduce Rotavirus vaccine into their NIP. 23 countries have yet to make a decision regarding introduction. GAVI Rotavirus Vaccine Status Introduced into N ational Program 11% N o D ecision 31% GAVI Approved/ Approved with Clarification 18% G AVI Conditional Approval 11% A map of GAVI countries that have introduced Rotavirus vaccine below. Planning 29% Already Introduced ( Program) 8 Countries Countries Eligible for GAVI Support* *Angola, Armenia, Azerbaijan, Bhutan, Bolivia, Congo, Cuba, Georgia, Guyana, Honduras, Indonesia, Kiribati, Moldova, Mongolia, Sri Lanka, and Ukraine are graduating from GAVI in 2012 and are no longer eligible to apply for new vaccine support. 16
100% Vaccine by Income Group 90% 80% Percentage of countries that have universally introduced vaccine 70% 60% 50% 40% 30% Hib HIC Hib LIC PCV HIC PCV LIC 20% 10% 0% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Year since first introduction Note: Limited projections are available for PCV introduction in High Income Countries A line graph showing the proportion of high and low income countries that have introduced or are projected to introduce PCV and Hib vaccine over time. Year of first introduction is 1989 for Hib vaccine and 2000 for PCV. It took 20 years for Hib vaccine to reach 70% of low income countries. PCV is projected to reach 70% of low income countries seven years faster, protecting millions of children sooner from deadly pneumococcal disease. 17
Table 1. Status by Vaccine for All Countries HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of AFGHANISTAN ALBANIA ALGERIA ANDORRA ANGOLA ANTIGUA AND BARBUDA ARGENTINA ARMENIA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH 1/11/2009 (Exact) GAVI conditional approval to introduce 2/1/2009 (Day 10/1/2008 (Day 1/1/1999 (Month 1/1/2006 (Month 1/1/2000 (Month 1/1/1997 (Month 8/12/2009 (Exact) 1/1/1993 (Month 1/1/1994 (Month 8/1/2011 (Day 1/1/1998 (Month 1/1/1998 (Month Risk 7/1/2009 (Exact) 3/12/2011 (Exact) 1/1/2007 (Month 1/1/2011 (Month 1/1/2005 (Day 1/1/2002 (Month 1/1/2009 (Month 6/1/2008 (Day 1/1/2007 (Month 1/1/2006 (Month 1/1/2008 (Month 18
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of BARBADOS BELARUS BELGIUM BELIZE BENIN BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA Regional 1/1/2000 (Month 1/1/1993 (Month 1/1/2001 (Month 1/1/2005 (Month 9/1/2009 (Exact) 1/1/2000 (Month 1/1/2008 (Day 11/15/2010 (Day 1/1/1999 (Month 1/1/2002 (Month 6/1/2010 (Day 1/1/2006 (Month 1/1/2004 (Month 1/1/2010 (Month 1/1/2009 (Month 1/1/2006 (Day 7/26/2011 (Exact) 11/1/2010 (Day 6/1/2010 (Month 9/20/2011 (Exact) 1/1/2007 (Day 1/1/2008 (Month 7/1/2006 (Day 19
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of CAMEROON CANADA CAPE VERDE CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA COLOMBIA COMOROS CONGO COOK ISLANDS COSTA RICA CÔTE D IVOIRE CROATIA CUBA Widespread coverage through private market 2/1/2009 (Exact) 1/1/1992 (Month 1/1/2010 (Month 9/1/2008 (Exact) 7/1/2011 (Exact) 1/1/2002 (Month Regional 6/30/2011 (Exact) GAVI conditional approval to introduce 7/1/2008 (Exact) 1/1/1996 (Month 1/1/1998 (Month 1/1/2011 (Month 9/1/2011 (Month 8/1/2009 (Exact) 1/13/2009 (Exact) 6/1/2009 (Day 1/1/1998 (Month 3/1/2009 (Day 1/1/2002 (Month 1/1/1999 (Month 1/1/2008 (Month 12/1/2010 (Exact) 12/1/2010 (Exact) 20
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of CYPRUS CZECH REPUBLIC KOREA, DEMOCRATIC PEOPLE S REPUBLIC OF CONGO, THE DEMOCRATIC REPUBLIC OF THE DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA 1/1/2001 (Month 1/1/2001 (Month 1/1/2009 (Day 1/1/1993 (Month 8/1/2007 (Day 1/1/2006 (Month 1/1/2002 (Month 1/1/2003 (Month 1/1/2002 (Month 6/1/2008 (Day 1/1/2005 (Month Risk Risk 1/1/2007 (Month 1/1/2010 (Month 3/21/2011 (Day 10/1/2007 (Day 1/1/2010 (Month 9/1/2009 (Day 8/1/2010 (Day 11/1/2010 (Month Widespread coverage through private market 1/1/2012 (Month 1/1/2007 (Month 4/1/2006 (Day 21
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of ETHIOPIA FIJI FINLAND FRANCE GABON GAMBIA GEORGIA GERMANY GHANA GREECE GRENADA GUATEMALA GUINEA GUINEA-BISSAU GUYANA 5/1/2007 (Day 1/1/1997 (Month 1/1/1990 (Month 1/1/1992 (Month 4/2/2010 (Exact) 1/1/1997 (Month 1/1/2010 (Day 1/1/1990 (Month 1/1/2002 (Month 1/1/2000 (Month 1/1/2000 (Month GAVI conditional approval to introduce 10/15/2011 (Exact) 9/1/2010 (Day 5/1/2006 (Day 8/19/2009 (Exact) 7/1/2006 (Day Widespread coverage through private market 4/26/2012 (Exact) 1/1/2006 (Day GAVI conditional approval to introduce 9/1/2009 (Day 4/26/2012 (Exact) 1/1/2010 (Month 4/1/2010 (Day 22
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of HAITI HONDURAS HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA Regional 4/16/2012 (Exact) GAVI conditional approval to introduce 1/1/1999 (Month 1/1/1999 (Month 5/1/1989 (Day 9/1/2011 (Day 1/1/2012 (Day 1/1/1992 (Month 1/1/1994 (Month 1/1/1999 (Month 1/1/2003 (Month 11/1/2010 (Day 1/1/2001 (Month 7/1/2008 (Day 1/1/2001 (Month Risk GAVI conditional approval to introduce 4/1/2011 (Exact) 4/1/2009 (Day 1/1/2011 (Month 9/1/2008 (Day 7/1/2009 (Day 5/1/2005 (Day 11/1/2010 (Day 1/1/2011 (Month 2/14/2011 (Exact) GAVI conditional approval to introduce 1/1/2009 (Month 1/1/2012 (Day 1/1/2010 (Month 23
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of KIRIBATI KUWAIT KYRGYZSTAN LAO PEOPLE S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LITHUANIA LUXEMBOURG MADAGASCAR MALAWI MALAYSIA MALDIVES 9/1/2008 (Day 1/1/1998 (Month 1/1/2007 (Month 4/1/2009 (Exact) 9/8/2009 (Day 1/1/1994 (Month 1/1/2003 (Month GAVI conditional approval to introduce Risk 12/12/2008 (Exact) GAVI conditional approval to introduce 1/1/2008 (Day 1/1/2007 (Month 1/1/2004 (Month 1/1/1994 (Month 7/1/2008 (Day 1/1/2002 (Month 1/1/2002 (Month GAVI conditional approval to introduce 1/1/2010 (Month 1/1/2005 (Day 11/12/2011 (Exact) 1/1/2006 (Month 24
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of MALI MALTA MARSHALL ISLANDS MAURITANIA MAURITIUS MEXICO MICRONESIA, FEDERATED STATES OF MONACO MONGOLIA MONTENEGRO MOROCCO MOZAMBIQUE 1/1/2007 (Month 1/1/1996 (Month 1/1/1998 (Month 3/1/2009 (Exact) GAVI conditional approval to introduce 1/1/2006 (Month 1/1/1999 (Month 1/1/1996 (Month 1/1/2002 (Month 1/1/2005 (Month 1/1/2006 (Month 1/1/2007 (Month 10/1/2009 (Day Introduced with regional pilot program 3/15/2011 (Exact) 1/1/2011 (Month 1/1/2009 (Month 1/1/2009 (Month 3/1/2008 (Month 1/1/2012 (Month 10/20/2010 (Exact) MYANMAR NAMIBIA NAURU NEPAL 9/9/2009 (Exact) 1/1/2009 (Month 12/1/2009 (Day 1/1/2009 (Month 5/1/2007 (Day 4/1/2008 (Day 10/20/2010 (Exact) 25
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of NETHERLANDS NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES 1/1/1993 (Month 1/1/1994 (Month 1/1/1999 (Month 9/22/2008 (Exact) 1/1/1998 (Month 1/1/1992 (Month 1/1/2001 (Month 10/1/2008 (Day 1/1/1998 (Month 1/1/2000 (Month 4/1/2008 (Day 1/1/2002 (Month 1/1/2005 (Month 1/1/2011 (Month GAVI conditional approval to introduce GAVI conditional approval to introduce 6/1/2006 (Day 6/1/2008 (Day 12/12/2010 (Exact) 1/1/2009 (Month 7/1/2006 (Day 1/1/2008 (Month 3/1/2008 (Day 1/1/2010 (Month 1/1/2009 (Month 1/1/2006 (Month 12/1/2008 (Month 2/1/2006 (Day 12/1/2009 (Month 1/1/2009 (Month 4/1/2012 (Day 26
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of POLAND PORTUGAL QATAR 4/1/2007 (Day 1/1/2000 (Month 1/1/1996 (Month Widespread coverage through private market KOREA, REPUBLIC OF Widespread coverage through private market MOLDOVA, REPUBLIC OF ROMANIA RUSSIAN FEDERATION RWANDA SAINT KITTS AND NEVIS SAINT LUCIA SAINT VINCENT AND THE GRENADINES SAMOA SAN MARIO SAO TOME AND PRINCIPE SAUDIA ARABIA 1/1/2009 (Day 3/1/2010 (Day 1/1/2002 (Month 1/1/2000 (Month 1/1/2002 (Month 1/1/2003 (Month 1/1/2007 (Month 1/1/1996 (Month 10/1/2009 (Month 1/1/2002 (Month 1/1/2001 (Month 1/1/2005 (Month 1/1/2004 (Month 7/13/2009 (Day 3/1/2009 (Day 1/1/2009 (Month 5/25/2012 (Exact) 27
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SPAIN SRI LANKA SUDAN SUDAN, REPUBLIC OF SOUTH SURINAME 1/1/2005 (Month 1/1/2006 (Month 11/1/2010 (Exact) 1/1/2007 (Day 1/1/2000 (Month 1/1/2000 (Month Risk 1/28/2011 (Exact) GAVI conditional approval to introduce 11/1/2009 (Exact) 1/1/2009 (Month 1/1/2005 (Month 8/1/2008 (Exact) 1/1/1999 (Month 1/1/1998 (Month Risk 4/1/2009 (Exact) 1/1/2003 (Month 1/1/2008 (Exact) 1/2/2008 (Exact) 1/1/2005 (Month 8/1/2009 (Exact) 7/18/2011 (Exact) 28
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAJIKISTAN 6/4/2009 (Exact) 1/1/1992 (Month 1/1/1990 (Month 1/1/2001 (Month 8/1/2008 (Day 1/1/2009 (Day 1/1/2006 (Month THAILAND MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF TIMOR-LESTE TOGO TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TUVALU 9/1/2008 (Day 7/3/2008 (Exact) GAVI conditional approval to introduce 1/1/2005 (Month 1/1/1999 (Month 4/1/2011 (Day 1/1/2006 (Month 12/1/2010 (Month 7/1/2009 (Day Risk 11/1/2008 (Day GAVI conditional approval to introduce 29
HIB PNEUMO ROTA Country Status Date of Status Date of Status Date of UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM TANZANIA, UNITED REPUBLIC OF UNITED STATES URUGUAY UZBEKISTAN VANUATU VENEZUELA VIET NAM YEMEN ZAMBIA ZIMBABWE 1/1/2002 (Month 9/1/2006 (Day 1/1/1999 (Month 1/1/1992 (Month 4/1/2009 (Exact) 1/1/1990 (Month 1/1/1994 (Month 3/1/2009 (Day 1/31/2011 (Day 1/1/2000 (Month 6/1/2007 (Month 9/1/2006 (Day 7/1/2000 (Day 3/1/2008 (Day 6/1/2010 (Exact) 1/1/2005 (Month 2/1/2004 (Day 1/1/2008 (Day 1/29/2011 (Exact) Introduced with regional pilot program GAVI conditional approval to introduce 1/1/2006 (Month 1/1/2006 (Month 4/26/2012 (Day 1/23/2012 (Exact) 30
ACKNOWLEDGEMENTS AND NOTES This report and the Vaccine Information Management System (VIMS) is supported by the GAVI Alliance, Johns Hopkins Bloomberg School of Public Health and the International Vaccine Access Center (IVAC). This report has been generated by the Vaccine Information Management System (VIMS) database developed and maintained at the Johns Hopkins Bloomberg School of Public Health for use by the International Vaccine Access Center (IVAC) and its affiliated projects and partners. VIMS provides a centralized, web-based warehouse for key information related to work in vaccine access that all interested parties can use. Information was gathered from internationally recognized sources, such as UNICEF, World Health Organization, vaccine manufacturers, ministries of health and news media. Please note that all forecasted dates in this report rest on assumptions and actual dates may vary. Vaccine introduction dates do not imply an obligation by GAVI to support coverage. All information, methodologies and sources are available in the VIMS database. This report can be found at: http://www.jhsph.edu/ivac/index.html. The full report and a PowerPoint presentation with graphics can be found in the VIMS database. To gain access to VIMS, please email vims@jhsph.edu. 31
SOURCES GAVI Eligibility Status DTP3 Coverage Rate Surviving Infants Projected Dates Dates of Current Vaccine Use Status and Program Type GAVI Alliance. GAVI Eligible Countries. 2011. Last accessed February 24, 2012 at http://www.gavialliance.org/support/apply/countries-eligible-for-support/ World Health Organization. WHO Vaccine Preventable Diseases Monitoring System (WHO/UNICEF Best Estimates). Aug 3, 2011. Last accessed Sept, 2011 at: http://www.who.int/immunization_monitoring/data/data_subject/en/index.html UNICEF. Immunization Summary (2012 Edition): A Statistical Reference Containing Data through 2010. Last accessed February 24, 2012 at: http://www.childinfo.org/ immunization.html This information comes from a variety of sources, primarily the most recent AVI Strategic Demand Forecast and WHO regional projections. For more information, please contact vims@jhsph.edu This information comes from a variety of sources, such as the GAVI Alliance, WHO, UNICEF, ministries of health, the news media and IVAC partners/contacts. For more information, please contact vims@jhsph.edu It is cross-referenced with WHO information (below). Vaccine. World Health Organization. 2012. Updated 29 Feb, 2012. Accessed at: http://www.who.int/entity/immunization_monitoring/data/year_ vaccine_introduction.xls This information comes from a variety of sources, such as the GAVI Alliance, WHO, UNICEF, ministries of health, the news media and IVAC partners/contacts. For more information, please contact vims@jhsph.edu 32
SELECTED KEY TERMS Any definitions not provided below can be found in the Glossary located in the Help section in VIMS. Children with Access: the number of children (based on surviving infants 2010) who live in a country that has introduced the vaccine into the national immunization program. This does not include countries with widespread market use or high-risk programs. For regional introductions, those regions that have introduced may be included and the regions which have not introduced excluded. Covered Children: the number of children (based on surviving infants of 2010) who are likely to receive the vaccination based upon the coverage rates of countries who have introduced. The WHO/UNICEF best estimate DTP3 vaccination coverage rate is used as a proxy for Hib, Pneumo and Rotavirus rates. Introduced into national immunization program: the vaccine has been incorporated into the national government s immunization program, either for all children, an at-risk subset, or for a regional program and it may include programs that are being phased in over time. This status can apply to any country, regardless of GAVI eligibility. Regional: local government immunization programs, but the national government has not included the vaccine in its immunization program. Widespread coverage through private market: most (over half) of the target population is receiving the vaccine through private market use. Risk: program for this vaccine only covers children in specific high risk groups this may include children with health conditions, those of vulnerable socioeconomic statuses or ethnic groups, or those living in regions of high risk. : the country s application to GAVI for New and Underused Vaccines Support (NVS) financing for this vaccine has been approved or s. Approved: the application meets all the criteria and is approved for GAVI support. Approved with : the application lacks specific pieces of data, which must be provided generally within a month. Data must be received before the application is considered officially approved for GAVI Support. GAVI conditional approval to introduce: the application to GAVI for New and Underused Vaccines Support (NVS) for this vaccine does not fulfill specific or significant application requirements. Missing requirements must be provided in a subsequent round to complement the original application. If the conditions are not met within the given timeframe after the first submission, re-submission of a new application is required. GAVI Resubmission: the New and Underused Vaccines Support (NVS) application for this vaccine is incomplete and a full application should be submitted in a future round. GAVI application submitted under review: the country has submitted a New and Underused Vaccines Support (NVS) application for this vaccine and is awaiting GAVI evaluation. : country has made a public statement (through government or other recommending body on vaccines) that they plan to introduce the vaccine and apply for GAVI New and Underused Vaccines Support (NVS), but has not yet submitted an application. 33
: a country that is not eligible for GAVI support has plans to introduce the vaccine into its national immunization program, and has taken steps to initiate its program, such as contacting the vaccine manufacturer. OR A country that is eligible for GAVI support and plans to introduce without it. : the country has not indicated a firm decision to introduce the vaccine into its national immunization program or to apply for GAVI New and Underused Vaccines Support (NVS) for the vaccine. Unknown: sources differ or are unclear on whether this country has a national program or not. 34
APPENDIX VIMS was conceived at the Johns Hopkins Bloomberg School of Public Health as a collaborative project between the Hib Initiative, PneumoADIP and the GAVI Alliance. It provides a centralized, web-based warehouse for key information related to the vaccine access. This includes data on the global uptake of Hib, Pneumococcal, Rotavirus and Hep B vaccines; demographic indicators; and tools for strategic social mapping of key vaccine policy stakeholders and decision makers. The data contained in VIMS can be accessed using the search functions within each tab, or downloaded via the report generation functions. The data are continuously updated as information is received, so as to permit real time reporting. VIMS has been under development since 2008 and is now in full operational use by the International Vaccine Access Center (IVAC). Bringing together inputs from a range of sources into one secure location, we believe this tool could be of great use to the global vaccine community and are rolling it out to key partners. Support and funding for VIMS is provided by the GAVI Alliance, Johns Hopkins Bloomberg School of Public Health, and the International Vaccine Access Center (IVAC). Use of VIMS: Using VIMS, stakeholders can generate their own custom reports based on any combination of countries, demographic data, and vaccine information, or print out specific country reports as needed. Due to the sensitive nature of some of the information in VIMS, only authorized parties are given access to the system. If you have further questions or would like to learn how to obtain a user ID for access to VIMS, please contact the VIMS team at vims@jhsph.edu. Any data on projected introduction dates should not be reproduced or disseminated without prior consent from VIMS personnel. If data is used in a presentation, please cite VIMS accordingly: Source: IVAC, Johns Hopkins Bloomberg School of Public Health. Vaccine Information Management System (VIMS) Global Vaccine Report, June, 2012. www.jhsph.edu/ivac/vims.html. Accessed: Date of access. Information on a particular country s GAVI application status may be confidential. Please do not share this information publicly without consent from VIMS personnel. 35