Technical Advisory Group (TAG) on Immunization and Vaccine Preventable Diseases in the Western Pacific Region (18th Meeting - 30 June-2 July 2009) - Meeting Report
The 18th meeting of the Technical Advisory Group (TAG) on Immunization and Vaccine-Preventable Diseases (VPDs) in the Western Pacific Region (WPR) was held from 30 June to 2 July 2009 in Manila, Philippines. A meeting of the Regional Interagency Coordinating Committee was convened concurrently with the TAG Meeting, as in previous years.The objectives of this meeting were to review and update technical and programmatic recommendations on achieving and monitoring progress towards measles elimination, hepatitis B control, sustaining poliomyelitis-free status, achieving maternal and neonatal tetanus elimination, strengthening routine immunization services, introducing new and underutilized vaccines, and improving VPD surveillance.The TAG acknowledged regional progress towards the twin goals of measles elimination and hepatitis B control and maintaining poliomyelitis-free status. Regarding measles, TAG recommended that the Western Pacific Regional Office convene a task force to define criteria and processes for validation of elimination and that countries and areas review and implement the Strategic Advisory Group of Experts on Immunization (SAGE) recommendations, enhance surveillance performance at the subnational level, collect more specimens for virus isolation and detection and use measles elimination activities as opportunities to accelerate rubella control. Regarding rubella, TAG recommended that the Western Pacific Regional Office finalize the strategic plan of action for accelerated rubella control and prevention of congenital rubella syndrome (CRS) and that countries and areas plan to decrease annual rubella incidence to < 10 cases per million population and annual CRS incidence to < 10 per million live births through a combination of approaches by 2015. TAG endorsed the recommendations of the Hepatitis B Expert Working Group held in November 2008 in Seoul, the Republic of Korea, and recommended that the Expert Resource Panel hold quarterly teleconferences and annual meetings and that the Western Pacific Regional Office formulate an operational plan to put into effect TAG recommendations made in 2008 and 2009. TAG reemphasized the need of hepatitis B vaccine for health care workers. TAG commended the Region on completion of phase 1 wild poliovirus laboratory containment. To maintain poliomyelitis-free status, TAG encouraged countries and areas to monitor and ensure high routine vaccination coverage and sensitive and timely surveillance for acute flaccid paralysis at the subnational level. TAG looks forward to guidance on the roles of oral and inactivated polio vaccines from the forthcoming WHO position paper on this subject expected in 2010.The Global Immunization Vision and Strategy (GIVS) and Reaching Every District (RED) approach should be adopted by countries and areas to achieve the 2010 GIVS goals of 90% immunization coverage nationally and 80% coverage in every district. TAG encouraged countries and areas to strengthen management of vaccine, cold chain and logistics, to ensure functional National Regulatory Authorities that include surveillance for adverse events following immunization, and to establish National Immunization Technical Advisory Groups to facilitate evidence-based policy-making.Reliable sentinel surveillance systems are needed to provide data for new vaccine introduction decision-making and impact evaluation. A biregional plan for control of Japanese encephalitis (JE) is needed with a 2015 goal of 90% JE vaccination coverage among at-risk groups. An intersectoral expert consultation on prevention of human papilloma virus (HPV) infection and cervical cancer should be convened. Countries and areas introducing HPV vaccine should consider using school and reproductive health approaches. Countries and areas should prepare pandemic influenza (H1N1) 2009 vaccine deployment plans in consultation with the Western Pacific Regional Office. The funding gap to implement expanding immunization initiatives and goals is increasing, making increased resource mobilization efforts critical.