Introducing New Vaccines in Developing Countries

Sonali Kochhar; Barbara Rath; Lea D Seeber; Gabriella Rundblad; Ali Khamesipour; Mohammad Ali


Expert Rev Vaccines. 2013;12(12):1465-1478. 

In This Article

Timing of Vaccine Introduction in Relation to the Existing National Immunization Program

Prior to the vaccine introduction, solid models should be built around the question how many individuals will likely benefit from the vaccine introduction, what should be achieved by the intervention and when. At the time when the introduction of a new vaccine is anticipated, there should be thorough consideration regarding the ideal timing of vaccine introduction in relation to the national immunization program. Sometimes it is necessary for a vaccine to be introduced before it has become an integral part of the national/local immunization recommendations or EPI vaccination schedule. The choice depends on the type of the vaccine and the prevalence of the disease. Countries should determine the objective of the vaccine introduction (disease elimination, decrease disease burden, decease hospitalization, etc.) to be able to model the best vaccine introduction option. Other factors to be considered include age of the recipient population, schedules (catch up immunizations in addition to routine immunizations or introduction into the national immunization program), urban, rural or regional population targets (including population density, population migration), transmission of the disease (hyperendemic or endemic outbreaks), dosing, onset and duration of protection (e.g., after one, two or three doses) and need for integration with other preventive measures (e.g., vector control). Modeling can help to plan for the optimal use of limited quality of the vaccines, used to estimate vaccine effectiveness and cost–effectiveness, required vaccine coverage to achieve program objectives at different levels of vaccine efficacy and used to determine the impact of the vaccination program.[102]

Promoting a vaccine that is not already part of the national program may, however, provide an additional challenge. Clear public health messages need to be conveyed reassuring the general public that the vaccine is as safe and efficacious as the remaining vaccines in the immunization program.