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(NDVP) for COVID-19 Vaccines in Samoa Government of Samoa

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(NDVP) for COVID-19 Vaccines in Samoa Government of Samoa National Deployment and Vaccination Plan (NDVP) for COVID-19 Vaccines in Samoa Government of Samoa 1 Endorsement page Endorsement page with signatures on behalf of relevant government sectors. 2 Contents Endorsement page 2 Acronyms 4 Executive Summary 7 Background 9 Introduction 11 2. Regulatory preparedness 12 3. Planning and coordination of the vaccine introduction 13 4. Resources and funding 15 5. Target populations and vaccination strategies 19 Vaccination Schedule 25 IPC and PPE 26 6. Cold, Supply chain management and health care waste management 26 Biohazard and immunization waste management: 35 7. Human resources management and training 35 Training Plan and Methods 36 Enhanced supportive supervision 36 8. Vaccine acceptance and uptake (demand) 37 Crisis communication 39 9. Vaccine safety monitoring and management of AEFI and injection safety 39 10. Immunization monitoring system 40 11 Disease surveillance 41 12. Evaluate introduction of COVID-19 vaccines 41 Documentation 42 ANNEX I: VACCINE COVERAGE SCENARIOS 44 ANNEXII: VIRAT/VRAF 2.0 46 ANNEX III: Roadmap Assumptions 51 REFERENCES 52 3 Acronyms ACEO Assistant Chief Executive officer ACT Access to COVID Tools AMC Advance Market Commitment AEFI Adverse Event Following Immunization AESI Adverse Event of Special Interest AUA Apia Urban Area Asia Pacific Strategy for Emerging Diseases and Public Health APSED Emergencies ADB Asian Development Bank CPR Cardio-Pulmonary-Resuscitation CFR Case Fatality Rate CDC Centre for Disease Control CEO Chief Executive Officer CEPI Coalition for Epidemic Preparedness Innovations COVID19 Coronavirus Disease 2019 DFAT Department of Foreign Affairs and Trade EVM Effective Vaccine Management EUA Emergency Use Authorization EPI Expanded Program of Immunization GAVI Global Alliance for Vaccine and Immunizations GoS Government of Samoa GDP Gross Domestic Product HW Health worker HCW Health Care Waste HPAC Health Program Advisory Committee IPC Infection Prevention and Control ILI Influenza-like illness IEC Information, Education and Communication 4 JIMT Joint Incident Management Team LDC Least Developed Countries MTIIH MalietoaTanumafili II Hospital MR Measles and Rubella mRNA Messenger Ribonucleic Acid MOF Ministry of Finance Samoa-MFAT Samoa-Ministry of Foreign Affairs and Trade MOH Ministry of Health M&E Monitoring & Evaluation MDVP Multi-Dose Vial Policy NCC National Coordination Committee NDVP National Deployment and Vaccination Plan NITAG National Immunization Technical Advisory Group NTWG National Technical Working Group NGOs Non-Governmental Organizations PIC Pacific Island Countries PICT Pacific Island Countries and Territories PPE Personal Protective Equipment PIE Post-Introduction Evaluation PHEIC Public Health Emergency of International Concern RCA Rapid Convenient Assessment RITAG Regional Immunization Technical Advisory Group RMI Republic of Marshall Islands RCCE Risk Communication and Community Engagement SARI Severe acute respiratory syndrome SARS-CoV Severe acute respiratory syndrome Coronavirus SAGE Strategic Advisory Group of Experts SRA Stringent Regulatory Authorities TTMH TupuaTamaseseMeaole Hospital 5 UNICEF United Nation Children's Fund USD United States Dollars VIS Vaccine Information Sheet VIRAT Vaccine Introduction Readiness Assessment Tool VRAF Vaccine Readiness Assessment Framework WASH Water, Sanitation and Hygiene WPR Western Pacific Region WFP World Food Program WHO World Health Organization 6 EXECUTIVE SUMMARY I. STRATEGIC CONTEXT A.Country Context Samoa, classified as an upper middle-income country with a gross national income (GNI) per capita of US$4,120 in 2018, is a small Polynesian independent island state located in the South Pacific. The population of Samoa in 2019 is approximately 197,097 people distributed among the two main (Upolu and Savaii) and two smaller islands (Apolima and Manono). The major drivers of the Samoan economy are tourism, agriculture and fishing, remittances and aid flows. The economy expanded by an annual average of 4.3 percent between 2002-07, before the global financial crisis, but over the last decade growth has slowed to an average of 1 percent per year, due in large part to a sequence of economic shocks and natural disasters that have hit the country over this period. Samoa’s economic development opportunities are constrained by remoteness from large markets and foreign suppliers, the small size of the domestic market, as well as the high frequency and intensity of natural disasters, the risk of which is expected to be exacerbated by climate change. These challenges have translated into comparatively low and volatile gross domestic product (GDP) growth rates, a structural gap between domestic revenues and expenditures, elevated public debt, high vulnerability to external shocks and subsequently a significant reliance on development aid. The Strategy for the Development of Samoa (SDS)1, which covers fiscal years 2016/17 through 2019/20, focuses on “Improved Quality of Life for All” and outlines the Government of Samoa (GoS) vision for country’s economic and social development. It is being implemented through development strategies across 14 key national outcomes within 4 broad priority areas, namely, economic, social, infrastructure and environment. Samoa values health as a critical component of well- being/quality of life and assigns it as the second priority area of ‘Social Policies’ with the sixth key outcome being ‘A Healthy Samoa and Well Being Promoted’. This is also reflected in Samoa’s commitment to international and regional agreements that prominently feature health outcomes as critical indicators of well-being and development, including the Agenda 2030 for Sustainable Development, the Sustainable Development Goals, the 2014 Samoa Pathway, and the Pacific Framework for Regionalism. A key objective under the social priority is “an inclusive, people-centered health service with emphasis on health prevention, protection and compliance through; a national immunization program; a screening program for rheumatic fever; and non-communicable disease (NCD) control and management programs.” B. Sectoral (or Multi-Sectoral) and Institutional Context Health outcome indicators have been steadily improving over the past three decades in Samoa, with Samoa having achieved the highest life expectancy in the Pacific and among the lowest infant mortality rates (IMRs). Samoa’s life expectancy increased from 65 years in 1990 to 75 years in 2015; women have higher life expectancy, at 78 years, compared to men, at 71.8 years. The under-5 mortality rate declined from 37 per 1,000 live birth in 1985 to 18 per 1,000 in 2015, and the IMR has halved since 1985, down to 15 per 1,000 live births in 2015. These indicators are better than might be expected for the country’s income level and compare favorably to the East Asia and the Pacific region in general and the Pacific Island Countries (PICs) on averages, in particular. Even though Samoa only recently graduated to upper middle-income group status with an income level at the lower boundary of the income group, life expectancy and the IMR in Samoa are almost at par with upper middle-income country averages. Despite these positive health outcomes, Samoa continues to face the challenges of an unfinished Millennium Development Goals agenda, rising NCDs and the impact of the recent public health diseases.The country has gone through a major emergency in the form of a severe measles outbreak in late 2019 and early part of 2020. Just as it was recovering from the Measles Outbreak, the COVID19 pandemic began. With this emergency reaching a year and the development of the promising 7 COVID19 vaccines, Samoa is aiming to enter the economic recovery path. With limited and small-scale health sector, Samoa’s priority is to ensure that the national interest with the health safety of the people is achieved even at this preventive and preparation phase. In this endeavor, the at-risk population groups such as frontline staff are always at the risk of acquiring and spreading the disease to the general population. As per the 2018 GoS-WB Hypertension Implementation Cascade Study, Samoa’s NCDs situationwith a high proportion of people with diabetes, cardiovascular diseases, renal diseases and cancer are of major concern. All of which are considered as risk factors for acquiring the COVID19 disease. In order to protect the people from this pandemic, Samoa has registered with COVAX and submitted its vaccine request forms as per the timelines. To guide the country in the right direction in this vaccination initiative, a high-level National Coordination Committee has been set up with the main Government ministries and partners. Given HPAC’s cross-sectoral and policy strategic focus in the health sector, the HPAC outfit will be utilized to best serve this national mechanism. This committee is being technically supported by the MOH Technical Working Group (MOH-TWG) formed with all the professional and technical experts from within the health sector. As per resolution from the SNCC- COVID19 meeting of December 22, 2020; the MOH-TWG will remain as a health technical group led by the MOH. All related government agencies and development partners will be represented at the national committee level. The TORs for both Committees’ are attached as Annex 1. The cabinet approved 2019 Novel Coronavirus (COVID-19) National Preparedness and Response Plan and the National Epidemic and Pandemic Preparedness and Response Plan FY20/21to FY24/252 have outlined Samoa’s prioritized population
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