The impact of new vaccine introduction on immunization and health systems: A review of the published literature

Abstract

We conducted a systematic review of the published literature to examine the impact of new vaccine introduction on countries' immunization and broader health systems. Six publication databases were searched using 104 vaccine and health system-related search terms. The search yielded 15,795 unique articles dating from December 31, 1911 to September 29, 2010. Based on review of the title and abstract, 654 (4%) of these articles were found to be potentially relevant and were referred for full review. After full review, 130 articles were found to be relevant and included in the analysis. These articles represented vaccines introduced to protect against 10 different diseases (hepatitis A, hepatitis B, Haemophilus influenzae type b disease, human papilloma virus infection, influenza, Japanese encephalitis, meningococcal meningitis, Streptococcus pneumoniae disease, rotavirus diarrhea and typhoid), in various formulations and combinations. Most reviewed articles (97 [75%]) reported experiences in high-income countries. New vaccine introduction was most efficient when the vaccine was introduced into an existing delivery platform and when introduced in combination with a vaccine already in the routine childhood immunization schedule (i.e., as a combination vaccine). New vaccine introduction did not impact coverage of vaccines already included in the routine childhood immunization schedule. The need for increased cold chain capacity was frequently reported. New vaccines facilitated the introduction and widespread use of auto-disable syringes into the immunization and the broader health systems. The importance of training and education for health care workers and social mobilization was frequently noted. There was evidence in high-income countries that new vaccine introduction was associated with reduced health-care costs. Future evaluations of new vaccine introductions should include the systematic and objective assessment of the impacts on a country's immunization system and broader health system, especially in lower-income countries.

Immunization Status of Children under 5 Years Hospitalized in the Paediatric Ward of the Hôpital Roi Baudouin de Guediawaye

“…The introduction of new vaccines does not affect significantly the immunization coverage of the children in general because it integrates a vaccine platform that already exists. [4]. There is a very low coverage for the second dose of measles and rubella.…”

Vaccine procurement during an influenza pandemic and the role of Advance Purchase Agreements: Lessons from 2009-H1N1

“…In the case of influenza vaccines, an appropriate cold-chain infrastructure is also required to store the vaccines. Such advanced infrastructure, knowledge and technical ability (Hinman, 2013) is beyond the capacity of many developing states (Hyde, 2012). For example, the African Region of the WHO is considered to have the weakest infrastructure (WHO, 2012a) in terms of legislative framework and financing, preparedness, and public health emergency response (WHO, 2012b).…”

New vaccine introductions: Assessing the impact and the opportunities for immunization and health systems strengthening

“…Seven publication databases (Medline, Embase, Nursing Update, West African Journal of Nursing, CINAHL, Web of Science and Global Health) were searched for the published literature review [6], using 104 terms encompassing vaccines, immunization systems, and health systems themes. The search, completed on September 29, 2010 and not limited to a beginning year, yielded 24,768 articles.…”