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BackgroundVery limited information is available regarding the incidence of cancer in sub-Saharan Africa. We analyzed changes in cancer patterns from 1991 to 2008 in Maputo (Mozambique).MethodsWe calculated the rates of incidence of different cancer sites by sex in the 5-year age-group of the population of Maputo city as well as age-standardized rates (ASRs) and average annual percentage changes (AAPC).ResultsOver the 18-year study period a total of 12,674 cases of cancer (56.9% females) were registered with an overall increase in the risk of cancer in both sexes. In males, the most common cancers were those of the prostate, Kaposi sarcoma (KS) and the liver. Prostate cancer showed the most dramatic increase over the whole study period (AAPC +11.3%; 95% CI: 9.7–13.0), with an ASR of 61.7 per 105 in 2003–2008. In females, the most frequent cancers were of the uterine cervix, the breast and KS, with the former increasing along the whole study period (AAPC + 4.7%; 95% CI: 3.4–6) with an ASR of 62.0 per 105 in 2003–2008 as well as breast cancer (AAPC +6.5%; 95%CI: 4.3–8.7).ConclusionsOverall, the risk of cancer rose in both sexes during the study period, particularly among cancers associated with westernization of lifestyles (prostate, breast), combined with increasingly rising incidences or limited changes in cancers associated with infection and poverty (uterine cervix, liver). Moreover, the burden of AIDS-associated cancers has shown a marked increase.

32Maternal pertussis vaccination is associated with higher levels of pertussis 33 antibodies at birth. We assessed the persistence of pertussis antibodies until

.4-1.8) were more likely to be susceptible. The second dose of MMR vaccine was received by 57.2% (718/1256) of rubella-susceptible women, with the highest proportion being immigrant women compared with women born in Spain. After vaccination, all women showed rubella immunity. Conclusions:The higher rubella susceptibility found in the three youngest age groups and in immigrant women highlights the relevance of antenatal screening, in order to ensure identification and postpartum immunization. The postpartum immunization strategy is an opportunity to protect women of childbearing age and consequently prevent occurrence of CRS, and to increase vaccination coverage against rubella and other vaccine-preventable diseases.

Introduction As of 2018, 118 of 194 WHO Member States reported the presence of an influenza vaccination policy. Although influenza vaccination policies do not guarantee equitable access or ensure vaccination coverage, they are critical to establishing a coordinated influenza vaccination program, which can reduce morbidity and mortality associated with yearly influenza, especially in high-risk groups. Established programs can also provide a good foundation for pandemic preparedness and response. Methods We utilized EXCEL and STATA to evaluate changes to national seasonal influenza vaccination policies reported on the WHO/UNICEF Joint Reporting Forms on Immunization (JRF) in 2014 and 2018. To characterize countries with or without policies, we incorporated external data on World Bank income groupings, WHO regions, and immunization system strength (using 3 proxy indicators). Results From 2014 to 2018 there was a small net increase in national seasonal influenza vaccination policies from 114 (59%) to 118 (61%). There was an increase in policies targeting high-risk groups from 34 in 2014 (34 /114 policies, 29%) to 56 (56/118 policies, 47%) in 2018. Policies were consistently more frequent in high-income countries, in WHO Regions of the Americas (89% of countries) and Europe (89%), and in countries satisfying all three immunization system strength indicators. Low and low-middle income countries, representing 40% of the worlds’ population, accounted for 52/61 (85%) of countries with no evidence of a policy in either year. Conclusion Our results demonstrate that national influenza vaccination policies vary significantly by region, income, and immunization system strength, and are less common in lower-income countries. Barriers to establishing and maintaining policies should be further examined as part of international efforts to expand influenza vaccination policies globally. Next generation influenza vaccine development should work to address barriers to influenza vaccination policy adoption, such as cost, logistics for adult vaccination, country priorities, need for yearly vaccination, and variations in seasonality.

Highlights First study examining potential impact of a maternal RSV vaccine across LMICs. Results from independent models to inform Gavi’s 2018 Vaccine Investment Strategy. Experts and stakeholders advised on methods, assumptions, and key model inputs. Substantial potential to reduce infant morbidity and mortality in Gavi countries.

Each year in Latin America and the Caribbean, seasonal influenza is associated with an estimated 36,500 respiratory deaths and 400,000 hospitalizations. Since the 2009 influenza A(H1N1) pandemic, the Region has made significant advances in the prevention and control of seasonal influenza, including improved surveillance systems, burden estimates, and vaccination of at-risk groups. The Global Influenza Strategy 2019–2030 provides a framework to strengthen these advances. Against the backdrop of this new framework, the University of Colorado convened in October 2020 its Immunization Advisory Group of Experts to review and discuss current surveillance, prevention, and control strategies for seasonal influenza in Latin America and the Caribbean, also in the context of the COVID-19 pandemic. This review identified five areas for action and made recommendations specific to each area. The Region should continue its efforts to strengthen surveillance and impact evaluations. Existing data on disease burden, seasonality patterns, and vaccination effectiveness should be used to inform decision-making at the country level as well as advocacy efforts for programmatic resources. Regional and country strategic plans should be prepared and include specific targets for 2030. Existing investments in influenza prevention and control, including for immunization programs, should be optimized. Finally, regional partnerships, such as the regional networks for syndromic surveillance and vaccine effectiveness evaluation (SARInet and REVELAC-i), should continue to play a critical role in continuous learning and standardization by sharing experiences and best practices among countries.

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