Monitoring progress of maternal and neonatal immunization in Latin America and the Caribbean.

Introduction: The Americas committed to strengthening maternal and neonatal immunization (MNI) through the Pan American Health Organization (PAHO) Regional Immunization Action Plan (RIAP) 2016-20. We describe the progress toward RIAP MNI-related targets and those related to improvement of data quality and information systems; analyze national MNI policies and vaccination coverages; and identify enablers and challenges of monitoring and reporting MNI vaccination coverage in Latin America and the Caribbean (LAC).

Methodology: Descriptive study of national MNI policies, vaccination coverage, and information systems.

Enablers and barriers of maternal and neonatal immunization programs in Latin America.

Background: The Region of the Americas has a long history of implementing maternal and neonatal immunization (MNI) programs. Our study aimed to understand the state of MNI policies, strategies and implementation practices in Latin America (LA).

Methods: Study conducted in 5 middle-income countries: Argentina, Brazil, Honduras, Mexico and Peru.

HPV vaccine implementation and monitoring in Latin America.

Objective: To describe HPV vaccine program implementation, monitoring and evaluation experiences in Latin America.

Materials And Methods: We reviewed published articles in peer-reviewed journals and reports from government web- sites, as well as the PAHO/WHO/UNICEF Joint Reporting form and the ICO/IARC HPV Information Centre database.

Results: By December 2016, 13 countries/territories in Latin America (56%) have introduced HPV vaccines.

[Experience with development of tools to monitor vaccination coverage and preventive chemotherapy coverageExperiência do desenvolvimento de ferramentas para o monitoramento da cobertura vacinal e quimioprofilaxia].

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Progress in vaccination towards hepatitis B control and elimination in the Region of the Americas.

Background: Over recent decades, the Region of the Americas has made significant progress towards hepatitis B elimination. We summarize the countries/territories' efforts in introducing and implementing hepatitis B (HB) vaccination and in evaluating its impact on HB virus seroprevalence.

Methods: We collected information about HB vaccination schedules, coverage estimates, and year of vaccine introduction from countries/territories reporting to the Pan American Health Organization/World Health Organization (PAHO/WHO) through the WHO/UNICEF Joint Reporting Form on Immunization.

Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review.

Background: Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs.

Objectives: We aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region.

Methods: We conducted a systematic review of the literature on impact or effectiveness of PCVs on deaths or hospitalizations due to invasive pneumococcal disease (IPD), pneumonia, meningitis and sepsis.

Impact of pneumococcal conjugate vaccine in children morbidity and mortality in Peru: Time series analyses.

Streptococcus pneumoniae is the leading cause of bacterial pneumonia, meningitis and sepsis in children worldwide. Despite available evidence on pneumococcal conjugate vaccine (PCV) impact on pneumonia hospitalizations in children, studies demonstrating PCV impact in morbidity and mortality in middle-income countries are still scarce. Given the disease burden, PCV7 was introduced in Peru in 2009, and then switched to PCV10 in late 2011.

Influenza vaccination in the Americas: Progress and challenges after the 2009 A(H1N1) influenza pandemic.

Background: There has been considerable uptake of seasonal influenza vaccines in the Americas compared to other regions. We describe the current influenza vaccination target groups, recent progress in vaccine uptake and in generating evidence on influenza seasonality and vaccine effectiveness for immunization programs. We also discuss persistent challenges, 5 years after the A(H1N1) 2009 influenza pandemic.

Pneumococcal conjugate vaccine introduction in Latin America and the Caribbean: progress and lessons learned.

In Latin America and the Caribbean, pneumococcus has been estimated to cause 12,000-28,000 deaths, 182,000 hospitalizations, and 1.4 million clinic visits annually. Countries in the Americas have been among the first developing nations to introduce pneumococcal conjugate vaccines into their Expanded Programs on Immunization, with 34 countries and territories having introduced these vaccines as of September 2015.

Rotavirus vaccine effectiveness in Latin American and Caribbean countries: A systematic review and meta-analysis.

Introduction: There are two group A rotavirus (RVA) vaccines available worldwide since 2006: monovalent (Rotarix(®), RV1) and pentavalent (RotaTeq(®), RV5). Currently, 16 countries and 1 territory in Latin America and the Caribbean (LAC) have introduced RVA vaccines and since their introduction several impact and effectiveness studies have been conducted in different countries. The purpose of this study was to assess RVA vaccine effectiveness in LAC countries.

Lessons learned from the development of a new methodology to assess missed opportunities for vaccination in Latin America and the Caribbean.

The Pan American Health Organization recently developed a practical guide for evaluating missed opportunities for vaccination among children aged <5 years. A missed opportunity occurs when an individual eligible for vaccination has contact with a health facility and does not receive a needed vaccine, despite having no contraindications. In this article, we discuss the strengths and limitations of this new methodology and present lessons learned from recent studies on undervaccination in Latin America.

Electronic immunization registries in Latin America: progress and lessons learned.

Most of the current vaccination coverage monitoring in Latin America relies on aggregated data. Improved monitoring has been shown to result in better coverage. Taking advantage of current information and communication technologies, the use of electronic immunization registries (EIRs) can facilitate coverage monitoring in terms of particularity (at the level of the individual), timeliness, and accuracy.

Vaccine-associated paralytic poliomyelitis in the postelimination era in Latin America and the Caribbean, 1992-2011.

The Americas interrupted the transmission of poliovirus in 1991; most Latin American and Caribbean (LAC) countries rely on the oral polio vaccine (OPV) to maintain elimination. We estimated the risk of vaccine-associated paralytic polio (VAPP) in LAC for 1992-2011. VAPP cases were identified using LAC's acute flaccid paralysis (AFP) surveillance system.

Development of a cholera vaccination policy on the Island of Hispaniola, 2010-2013.

Deployment of oral cholera vaccine (OCV) on the Island of Hispaniola has been considered since the emergence of the disease in October of 2010. At that time, emergency response focused on the time-tested measures of treatment to prevent deaths and sanitation to diminish transmission. Use of the limited amount of vaccine available in the global market was recommended for demonstration activities, which were carried out in 2012.

Systematic documentation of new vaccine introduction in selected countries of the Latin American Region.

Background: Countries in Latin America were among the first developing countries to introduce new vaccines, particularly rotavirus (RV) and pneumococcal conjugate vaccines (PCVs), into their national immunization schedules. Experiences and lessons learned from these countries are valuable to donors, immunization partners, and policy makers in other countries wishing to make informed decisions on vaccine introduction.

Objectives: In order to enhance knowledge and promote understanding of the process of new vaccine introduction in the Latin American Region, with particular focus on RV and PCV, we conducted a systematic qualitative assessment.

Vaccination legislation in Latin America and the Caribbean.

Governments have the authority and responsibility to ensure vaccination for all citizens. The development of vaccination legislation in Latin America and the Caribbean (LAC) parallels the emergence of sustainable, relatively autonomous, and effective national immunization programs. We reviewed vaccination legislation and related legal documents from LAC countries (excluding Canada, Puerto Rico, the United States, and the US Virgin Islands), and described and assessed vaccination legislation provisions.

Vaccination Week in the Americas: an opportunity to integrate other health services with immunization.

Vaccination Week in the Americas (VWA) is an initiative of the countries and territories of the Americas that works to advance equity and access to vaccination. The initiative focuses on reaching populations with limited access to regular health services and promotes solidarity among countries. As the Expanded Program on Immunization is one of the world's best-established health programs, integrating other interventions with immunization services has been highly promoted.

Pandemic influenza vaccination: lessons learned from Latin America and the Caribbean.

In April 2009, the World Health Organization (WHO) reported the emergence of a new influenza (H1N1) virus which led to the first pandemic declaration of the 21st century. Most countries in Latin America and the Caribbean (LAC) had a national preparedness plan in place at this time; however, the vaccination component of such plans was largely undeveloped. Nevertheless, countries were able to capitalize on the infrastructure of their immunization programs and widespread experience utilizing the seasonal influenza vaccine to prepare rapidly, developing H1N1 vaccination plans targeting individuals with chronic disease, pregnant women and health care workers, among others.

Considerations for oral cholera vaccine use during outbreak after earthquake in Haiti, 2010-2011.

Oral cholera vaccines (OCVs) have been recommended in cholera-endemic settings and preemptively during outbreaks and complex emergencies. However, experience and guidelines for reactive use after an outbreak has started are limited. In 2010, after over a century without epidemic cholera, an outbreak was reported in Haiti after an earthquake.

Rubella vaccination of unknowingly pregnant women during mass campaigns for rubella and congenital rubella syndrome elimination, the Americas 2001-2008.

Background: Due to the significant teratogenicity of rubella virus and the use of a live-attentuated vaccine, pregnancy is a contraindication of receipt of rubella vaccine (RCV). Data collected from several countries that have observed susceptible women who had received RCV during pregnancy documented that no infant with congenital rubella syndrome (CRS) has been born, so the risk is theoretical. As part of the regional initiative to eliminate rubella and CRS in the Americas, one of the key strategies was the vaccination of women of childbearing age.

Enhanced laboratory surveillance for the elimination of rubella and congenital rubella syndrome in the Americas.

One of the reasons the 1997 Technical Advisory Group on Vaccine-Preventable Diseases recommended acceleration of rubella and congenital rubella syndrome (CRS) prevention efforts was the fact that the enhanced measles surveillance system in the Americas found that 25% of reported measles cases were laboratory-confirmed rubella cases. Until 1997, the laboratory network primarily focused on measles diagnosis. Since 1999, due to the accelerated rubella control and CRS prevention strategy, laboratories have supported the regional measles, rubella, and CRS elimination goals.

Elimination of rubella and congenital rubella syndrome in the Americas.

In 2003, the Pan American Health Organization (PAHO) adopted a resolution calling for rubella and congenital rubella syndrome (CRS) elimination in the Americas by the year 2010. To accomplish this goal, PAHO advanced a rubella and CRS elimination strategy including introduction of rubella-containing vaccines into routine vaccination programs accompanied by high immunization coverage, interruption of rubella transmission through mass vaccination of adolescents and adults, and strengthened surveillance for rubella and CRS. The rubella elimination strategies were aligned with the successful measles elimination strategies.

Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil.

Background: Because postlicensure surveillance determined that a previous rotavirus vaccine, RotaShield, caused intussusception in 1 of every 10,000 recipients, we assessed the association of the new monovalent rotavirus vaccine (RV1) with intussusception after routine immunization of infants in Mexico and Brazil.

Methods: We used case-series and case-control methods to assess the association between RV1 and intussusception. Infants with intussusception were identified through active surveillance at 69 hospitals (16 in Mexico and 53 in Brazil), and age-matched infants from the same neighborhood were enrolled as controls.