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Vaccinology in Latin America © 2018 Sabin Vaccine Institute Vaccinology in Latin America © 2018 Sabin Vaccine Institute. All rights reserved. The material in this document may be freely used for educational or noncommercial purposes, provided that the material is accompanied by an acknowledgement. The Sabin Vaccine Institute is a leading advocate for expanding vaccine access and uptake globally, advancing vaccine research and development, and amplifying vaccine knowledge and innovation. Unlocking the potential of vaccines through partnership, Sabin has built a robust ecosystem of funders, innovators, implementers, practitioners, policy makers and public stakeholders to advance its vision of a future free from preventable diseases. As a non-profit with more than two decades of experience, Sabin is committed to finding solutions that last and extending the full benefits of vaccines to all people, regardless of who they are or where they live. At Sabin, we believe in the power of vaccines to change the world. For more information, visit www.sabin.org and follow us on Twitter, @SabinVaccine. Recommended citation: Andrus et al. Vaccinology in Latin America: A Resource for Immunization Managers. Washington, D.C.: Sabin Vaccine Institute; 2018. Design: Renée Saunders Translation: Silvia Colla Contents Preface ........................................................................................................................................................................................................................1 MODULE 1: EXISTING VACCINES AND VACCINES IN DEVELOPMENT ................................................................................... 2 Vaccines to Prevent Cholera ................................................................................................................................................................................ 3 Vaccines as a Control Strategy Against Viral Hepatitis Infections ..............................................................................................................19 HIV, Tuberculosis, and Malaria ...........................................................................................................................................................................30 Current Situation of Human Papillomavirus Vaccines ..................................................................................................................................37 Seasonal Influenza Vaccination .........................................................................................................................................................................53 Prevention of Meningococcal Disease .............................................................................................................................................................63 Norovirus: The Disease and Vaccine Development ......................................................................................................................................76 Pertussis and Vaccine Prevention ......................................................................................................................................................................86 Efforts and Progress Towards Polio Elimination in the Americas and the World ....................................................................................93 Rotavirus................................................................................................................................................................................................................106 New Insights for the Rational Design of Human Respiratory Syncytial Virus Vaccines: From Molecular Biology to Clinical Trials ...................................................................................................................................................... 117 Vaccines to Prevent Typhoid Fever .................................................................................................................................................................133 Varicella and Varicella Vaccines .......................................................................................................................................................................148 Yellow Fever .........................................................................................................................................................................................................160 Zika Virus ...............................................................................................................................................................................................................170 MODULE 2: DECISION-MAKING ON NEW VACCINES ...........................................................................................................178 Introduction of New Vaccines in Latin America and the Caribbean: Decision-Making ......................................................................179 Introduction of New Vaccines in Latin America and the Caribbean: Measuring Impact and Effectiveness ...................................186 Case Study: The Policy for the Introduction of New Vaccines in Brazil..................................................................................................193 Phase III Clinical Studies for Vaccine Evaluation ..........................................................................................................................................198 National Immunization Technical Advisory Groups ................................................................................................................................... 209 Stronger Immunization Policy in Latin America and the Caribbean: Vaccine Impact, Costs and Cost-Effectiveness Evidence ..........................................................................................................................215 MODULE 3: IMPLEMENTATION AND EXPANSION OF IMMUNIZATION PROGRAMS ......................................................223 Information Systems for the EPI ..................................................................................................................................................................... 224 Vaccine Coverage Monitoring ..........................................................................................................................................................................235 Integration of Immunization Activities with Other Health Activities ...................................................................................................... 242 MODULE 4: VACCINE ADVOCACY AND SOCIAL COMMUNICATION ............................................................................... 248 Advocacy for Stronger Immunization Programs ......................................................................................................................................... 249 The Role of Health Teams in Achieving a Successful Vaccination Campaign ...................................................................................... 258 MODULE 5: LOOKING AHEAD ................................................................................................................................................... 264 Achievements and Future Challenges in the Prevention of Pneumococcal Diseases in Latin America and the Caribbean ...... 265 Perspectives on the Future of Global Eradication of Polio, Measles, Rubella, and Congenital Rubella Syndrome .......................275 Vaccinology in Latin America 1 Preface The first edition of this compilation, Vaccinology in Latin America: A Resource for Immunization Managers, evolved from Sabin’s years of experience of teaching an annual course on the same topics for immunization managers of Latin America. We asked the course presenters to write up their presentations in chapter format to be included in this resource. The topics for the chapters were selected based on the feedback that course participants provided us over the years. In that sense this book is by the participants, for the participants! We have made every attempt to make the book tailor-made for them. To that end, this book has no chapter on immunology, the basic science of vaccine discovery and development. In the past when the course provided a presentation on immunology, the participants preferred other topics more closely aligned with their day-to-day work. Here-in lies the basic objective of this book, to provide immunization managers of Latin America the basics in vaccinology that will help them better manage their programs with the ultimate aim of reaching every child and every family with available vaccines. Ultimately, the quality of this book relies heavily on the expertise, experience and skill of every chapter author. We believe we have assembled an extraordinary faculty of course teachers that have captured key points of their lectures in the chapters they have written. Feedback over the years from course participants on their presentations helps confirm this belief. It has been an honor and pleasure to work with them. This book tries to excel in providing immunization managers with tools that will help them ensure the technical and operational success of their programs. This book is dedicated to our mentor and dear friend, Dr. Ciro de Quadros, who died on May 28, 2014. Ciro had an amazing career in public health and impacted many of the people who were fortunate to work with him. He mobilized resources to launch the annual course in 2011 and to sustain it into the
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