A celebration twenty years in the making: the journey of Japanese encephalitis vaccine introduction and delivery

Participants attending the regional meeting gathered for a photo. Photo: PATH/ Dr. Tham Chi Dung.

PATH, in collaboration with the Laos Ministry of Health, hosted a meeting in Vientiane, Laos, to review new data and lessons learned about Japanese Encephalitis (JE) vaccine introduction and delivery. The meeting brought together researchers, health providers, government officials, and bi- and multi-lateral stakeholders from South and Southeast Asia and beyond. Attendees and panelists represented Bangladesh, Cambodia, Laos, India, Nepal, the Philippines, Vietnam, and more. 

The meeting objective was to summarize a 20-year trajectory of JE vaccine progress and to identify opportunities to sustain focus and continue momentum. Presenters shared JE vaccination progress from the past two decades, and discussed efforts to sustain routine vaccination. Data were presented on JE vaccine cost-effectiveness studies conducted in Bangladesh, Laos, and Vietnam. Further discussions focused on the important role of advocacy and communications in immunization efforts. The meeting concluded with an informative discussion wherein numerous country officials collaboratively shared what is needed in the future to sustain and increase JE vaccine introduction and delivery, including support to ensure ongoing surveillance, advocacy for JE health education, and dialogue about resource needs to cover program costs and vaccine supply.

WHO recommends second malaria vaccine for young children

The World Health Organization (WHO) has included a second malaria vaccine, R21/Matrix-M, in its recommendation for malaria vaccines. The October 2 announcement of the addition of R21 came just two years after a first vaccine, RTS,S/AS01E, was recommended by WHO for use in children from five months of age. The announcement also expanded the use of malaria vaccines (R21 and RTS,S) to all areas where malaria caused by Plasmodium falciparum is endemic, although countries are advised to prioritize areas of moderate to high transmission. 

According to Nanthalile Mugala, MD, MMed, PATH’s Chief of the Africa Region, “the availability of a second malaria vaccine for children in the region should increase access to this valuable addition to the malaria toolbox. Malaria vaccines, used alongside other proven interventions, can help bring this deadly disease under control and take us another step closer to a world free from malaria.”

Noting that PATH was proud to have helped bring a first malaria vaccine through development into use for children at risk, Dr. Mugala said she hoped that learnings from the RTS,S experience will continue to inform the development pathway for R21 and its future implementation. Read more.

Bangladesh takes major step to reduce cervical cancer deaths

Girls line up to receive the HPV vaccine at a school in Dhaka during the campaign that began on October 15. ​​​​​Photo: PATH/Maksudur Rahman.

Bangladesh is rolling out a nationwide HPV vaccination campaign in phases; it started on October 15 in all districts and sub-districts of the Dhaka division and other divisions of the country will follow in 2024. The campaign is reaching a multi-aged cohort of both in- and out-of-school girls and following the WHO-recommended single-dose schedule. Upon the campaign’s completion, HPV vaccine is expected to be added to the country’s routine immunization schedule. 

The government of Bangladesh has expressed their firm commitment to achieving high coverage and equitable distribution of this cancer-preventing vaccine among the country’s most vulnerable communities. Supported in part by the HPV Vaccine Acceleration Program Partners Initiative (HAPPI) Consortium (led by JSI Research & Training Institute, Inc.), PATH was part of the collaborative support effort to introduce HPV vaccine in Bangladesh alongside Gavi, WHO, and UNICEF.

Operations and health economics research to inform HPV vaccination program planning

Results from operations research and health economics studies that can help inform planning and budgeting for HPV vaccination programs are now available. PATH worked with national immunization program managers in Ethiopia, Guyana, Rwanda, Senegal, Sri Lanka, and Uganda to evaluate the costs and operational context of ongoing HPV vaccination programs. The findings provide evidence that can inform HPV vaccine program decision-making [link to PATH.org article]. 

PATH’s health economics team also recently completed analyses exploring the cost effectiveness of implementing HPV vaccination programs in Kenya and Mozambique, where HPV is a leading cause of cancer. These studies can help policy- and decision-makers determine how to prioritize vaccines and vaccination programs to ensure the best health and economic outcomes for their communities. In both countries, analyses show that vaccinating girls is highly-cost effective compared to no vaccination, though ideal product choice depends on several factors, including availability of financing support from Gavi, the Vaccine Alliance and/or the government.

Conference round up

`At the 14th African Rotavirus Symposium, held on November 8 to 10 in Abuja, Nigeria, several oral presentations featured PATH’s work with partners on health economics evaluations. Two presentations shared results from recent impact and cost-effectiveness analyses conducted in  Mozambique and Nigeria. A third presentation highlighted results from an economic analysis of the implications of Ghana’s rotavirus vaccine product switch in 2020.

MenFive® receives SAGE endorsement

Just months after receiving prequalification by the World Health Organization. MenFive® - the first conjugate vaccine to protect against the five predominant causes of meningococcal meningitis in Africa – has received endorsement from the Strategic Advisory Group of Experts (SAGE) on Immunization. In September 2023, SAGE recommended that all countries in the African meningitis belt introduce the novel MenFive vaccine into their routine immunization program in a single-dose schedule at 9 to 18 months of age. High risk countries and countries with high-risk districts are encouraged to conduct catch-up campaigns at the time of introduction to reach all individuals aged 1 to 19 years old. African countries at high risk for meningococcal outbreaks can conduct preventive mass campaigns using MenFive. The implementation of MenFive as outlined in the SAGE recommendation will be instrumental in eliminating annual meningitis outbreaks and epidemics in the African meningitis belt—a string of 26 countries from Senegal and The Gambia in the west to Ethiopia in the east – as outlined in the WHO 2030 Global Roadmap. It is the only vaccine that prevents meningitis caused by serogroup X, a pathogen increasingly implicated in African meningitis outbreaks. The final WHO recommendation is anticipated in early 2024.
 

Resources and opportunities

New and updated resources

Current and planned vaccine manufacturing in Africa (available in English, French, and Chinese) 

A new vaccine could bring an end to meningitis epidemics in Africa | Web article

Updated meningitis fact sheet

Japanese encephalitis (JE) 20 year project timeline

CVIA at upcoming events

International conference on typhoid and other salmonelloses
December 5 to December 7, 2023
Kigali, Rwanda

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