Meeting Report ELEVENTH PACIFIC IMMUNIZATION PROGRAMME MANAGERS MEETING 14–16 July 2020 Virtual meeting WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC RS/2020/GE/21(FJI) English only MEETING REPORT ELEVENTH PACIFIC IMMUNIZATION PROGRAMME MANAGERS MEETING Convened by: WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC AND UNITED NATIONS CHILDREN’S FUND PACIFIC OFFICE Virtual meeting 14–16 July 2020 Not for sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines December 2020 NOTE The views expressed in this report are those of the participants of the Eleventh Pacific Immunization Programme Managers Meeting and do not necessarily reflect the policies of the World Health Organization or the United Nations Children’s Fund. This report has been prepared by the World Health Organization Regional Office for the Western Pacific and the UNICEF Pacific Office for Member States in the Region who virtually participated in the Eleventh Pacific Immunization Programme Managers Meeting, which was held from 14-16 July 2020. Contents SUMMARY ........................................................................................................................................................... 1 1. INTRODUCTION .......................................................................................................................................... 2 1.1 Meeting organization ............................................................................................................................ 2 1.2 Meeting objectives ................................................................................................................................ 2 2. PROCEEDINGS ............................................................................................................................................. 2 2.1 Opening session .................................................................................................................................... 2 2.2 Updates ................................................................................................................................................. 3 2.2.1 Conclusions and recommendations from the Tenth Pacific Immunization Programme Managers Meeting ............................................................................................................................................. 3 2.2.2 Expanded Programme on Immunization overview in the Pacific ..................................................... 3 2.2.3 Vaccine supply system in the Pacific ................................................................................................ 3 2.2.4 Recommendations from the 29th Meeting of the Technical Advisory Group on Immunization and Vaccine-Preventable Diseases in the Western Pacific Region .......................................................... 3 2.2.5 Regional Strategic Framework for VPDs and Immunization in the Western Pacific ........................ 4 2.2.6 Establishment of subregional TAG in PICs ...................................................................................... 4 2.3 Outbreaks due to measles and other VPDs ........................................................................................... 4 2.3.1 Regional update on measles and rubella elimination ........................................................................ 4 2.3.2 Country experience on outbreak response campaign ........................................................................ 5 2.3.3 Country experience on prevention and preparedness campaign ........................................................ 6 2.3.4 Recommendations from the Subregional Committees for the Certification of Poliomyelitis Eradication (SRCC) and Verification of Measles and Rubella Elimination (SRVC)........................ 7 2.3.5 Risk of resurgence or import-related large-scale outbreaks of measles and proposed measures for prevention and measles resurgence ................................................................................................... 7 2.4 COVID-19 pandemic and immunization programme ........................................................................... 8 2.4.1 COVID-19: global, regional and PIC overview ................................................................................ 8 2.4.2 Impact of COVID-19 pandemic on immunization programmes in PICs .......................................... 8 2.4.3 Regional action plan for immunization programme during the COVID-19 pandemic ..................... 8 2.5 Immunization safety .............................................................................................................................. 9 2.5.1 Immunization safety and vaccine regulatory functions ..................................................................... 9 2.5.2 Regional guideline on enhancing vaccination demand in the Western Pacific ................................. 9 3. CONCLUSIONS AND ACTION POINTS ........................................................................................................ 9 3.1 Conclusions ........................................................................................................................................... 9 3.2 Action points ....................................................................................................................................... 11 3.2.1 Action points to Member States ...................................................................................................... 11 3.2.2 Action points for WHO, UNICEF and partners .............................................................................. 12 ANNEXES ........................................................................................................................................................... 14 Annex 1. Programme of activities Annex 2. List of participants, temporary advisers, observers and Secretariat Annex 3. Conclusions and recommendations from 8th SRCC/SRVC Immunization programs / Vaccines / Measles / Rubella / Pacific Islands SUMMARY The Eleventh Pacific Immunization Programme Managers Meeting was jointly convened by the World Health Organization (WHO) Regional Office for the Western Pacific and the United Nations Children’s Fund (UNICEF) Pacific Office, and it was held virtually from 14 to 16 July 2020. National immunization programmes in the 21 Pacific island countries and areas (PICs) have achieved many successes: All countries and areas have remained polio-free since 2000. Chronic hepatitis B infection rates among children have been reduced substantially. And many countries and areas have introduced new and underutilized vaccines or are planning for introduction. Despite considerable progress in achieving regional immunization goals and strengthening immunization systems and programmes, new challenges are emerging in PICs: safety issues related to deaths following immunization in Samoa (two deaths following measles, mumps and rubella, or MMR, vaccination in 2018) and a subsequent drop in immunization coverage; resurgence of measles with increased measles virus importation, which affected several PICs including Fiji, Kiribati, Samoa and Tonga; outbreaks of diphtheria in some PICs; and increased vaccine hesitancy among the general population. WHO is developing the draft Regional Strategic Framework for Vaccine-preventable Diseases and Immunization in the Western Pacific for 2021–2030 to address these challenges and aims to operationalize this Framework in the Pacific context in line with the “reaching the unreached” thematic priority of For the Future: Towards the Healthiest and Safest Region, WHO’s vision for its work with Member States and partners. The Framework also aligns with the goals of universal health coverage, primary health care and global health security. Participants included representatives from 16 Pacific island countries and areas, nine observers and one temporary adviser, apart from the Secretariat from WHO and UNICEF. 1 1. INTRODUCTION 1.1 Meeting organization The Eleventh Pacific Immunization Programme Managers Meeting was convened by the World Health Organization (WHO) Regional Office for the Western Pacific and the United Nations Children’s Fund (UNICEF) Pacific Office virtually from 14 to 16 July 2020. There were participants from 16 Pacific island countries and areas (PICs), nine observers and one temporary adviser, apart from the Secretariat from WHO and UNICEF. The topics were finalized after discussions with WHO, UNICEF and Pacific Immunization Programme Strengthening (PIPS) partners. 1.2 Meeting objectives The objectives of the meeting were: 1) to introduce the final draft of the Regional Strategic Framework for Vaccine-preventable Diseases and Immunization in the Western Pacific for 2021–2030 and discuss its operationalization in the Pacific context; 2) to discuss how to prevent, be prepared for and respond to future outbreaks of measles and other vaccine-preventable diseases (VPDs) based on lessons from measles outbreaks in the Pacific; and 3) to discuss and identify needs in assuring immunization safety, responding to vaccine hesitancy and strengthening vaccine confidence in the Pacific. 2. PROCEEDINGS 2.1 Opening session Dr Socorro Escalante, Coordinator for Essential Medicines and Technologies, delivered the opening remarks on behalf of Dr Takeshi Kasai, WHO Regional Director for the Western Pacific. Collaborative efforts to strengthen immunization