Workshop on Development of Influenza A(H1N1) Vaccine in a Pandemic (31 August to 4 September 2009) - Meeting Report
In May 2009, the Director-General of the World Health Organization (WHO) raised the pandemic alert level for influenza A (H1N1) to phase five. After that, the Western Pacific Regional Office began to plan workshops on influenza A (H1N1) vaccine deployment in a pandemic in Manila for 16 non-Pacific island countries and in Fiji for 20 Pacific island countries (PICs). The first workshop was held in Manila from 31 August to 4 September 2009. The main objectives of the workshop were:(1) to discuss the operational framework and guidelines for deployment of pandemic influenza A (H1N1) vaccine; (2) to enable participants to understand and manage the processes and structures related to pandemic vaccine deployment; and(3) to enable Member States to undertake required advance preparations, including establishing the required surge capacity to deploy vaccine and ancillary items.Dr Shin Young-soo, WHO Regional Director for the Western Pacific, opened the workshop and provided the introductory remarks. The five-day workshop was jointly organized by the Expanded Programme on Immunization (EPI) and Communicable Disease Surveillance and Response (CSR) units in the WHO Regional Office. The first half-day included presentations on the global and regional status of pandemic A (H1N1) 2009 and on progress in vaccine production. For the next four and a half days, the EPI workshop was held separately from the CSR workshop and focused on the development of a pandemic deployment plan. The pandemic influenza A (H1N1) vaccine deployment workshop was designed and conducted along with the development of pandemic vaccine deployment guidelines of seven core areas of vaccine deployment, namely: legal and regulatory, management of deployments, information and communication systems, human resources and security, supply chain logistics, health care waste management, and termination of deployment operations. Participants were divided into three groups to read documents, to review checklists, to major challenges in these seven core areas, and to come up with solutions. Participants did brain storming according to their country situation and experiences. All groups presented their findings on challenges and solutions at the plenary session. On computers, participants used an Excel database to calculate vaccine storage capacity needed for pandemic A (H1N1) vaccine in each country, using different scenarios based on vaccine uncertainties. Participants also took part a in whole-day computer exercise to develop outlines for the pandemic vaccine deployment plans on the fifth day of the workshop. As pandemic vaccine deployment was a new topic to most member countries, participants were actively engaged in the interactive plenary and group work sessions. Participants were taught the standard operating procedures for all levels of pandemic vaccine deployment, effective management and co-ordination at all levels of the health system during pandemic vaccine deployment, vaccine storage and transport capacity for their respective countries, and how to plan for establishing surge capacity for each essential area of pandemic vaccine deployment. Many countries have not yet finalized the prioritization of groups or percentage of population to be vaccinated for the pandemic influenza A (H1N1) vaccine when it becomes available. As such, these countries were not able to prepare outlines for their pandemic vaccine deployment plans; rather, they did the exercise on different scenarios.It is recommended that countries should prioritize the population groups to be vaccinated for pandemic influenza A ( H1N1) vaccine. High-level advocacy should be conducted by the participants when they return home. Countries should also involve people from several departments and organizations in developing the final details of the pandemic vaccine deployment plan. Finally, it is recommended that countries should incorporate the final pandemic influenza A (H1N1) vaccine deployment plan into the country pandemic response plan.