Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, 1600 Clifton Road, MS C-25, Atlanta, GA 30333, USA.
Philos Trans R Soc Lond B Biol Sci. 2011 Oct 12;366(1579):2827-32. doi: 10.1098/rstb.2011.0046.
Adoption of new vaccines in developing countries is critical to reducing child mortality and meeting Millennium Development Goal 4. However, such introduction has historically suffered from significant delays that can be attributed to various factors including (i) lack of recognition of the value of a vaccine, (ii) factors related to weak health systems, and (iii) policy considerations. Recently, the Global Alliance for Vaccines and Immunization (GAVI) supported efforts to accelerate the introduction of Haemophilus influenzae type b (Hib) vaccines in developing countries, which resulted in a significant surge in vaccine adoption by these countries. The experience with Hib vaccines, as well as similar efforts by GAVI to support the introduction of new pneumococcal and rotavirus vaccines, provides a strategy for new vaccine adoption that is reviewed in this paper, providing a useful model to help accelerate the uptake of other life-saving vaccines. This strategy addresses barriers for vaccine adoption by focusing on three major areas: (i) communications to increase awareness about the various factors needed for evidence-based decisions that meet a country's health goals; (ii) research activities to answer key questions that support vaccine introduction and long-term programme sustainability; and (iii) coordination with the various stakeholders at global, regional and country levels to ensure successful programme implementation.
在发展中国家采用新疫苗对于降低儿童死亡率和实现千年发展目标 4 至关重要。然而,疫苗的引入在历史上一直受到严重延迟的困扰,这可归因于各种因素,包括:(i) 对疫苗价值的认识不足,(ii) 与薄弱的卫生系统有关的因素,以及 (iii) 政策考虑。最近,全球疫苗免疫联盟(GAVI)支持加快发展中国家引进乙型流感嗜血杆菌(Hib)疫苗的努力,这导致这些国家对疫苗的采用显著增加。Hib 疫苗的经验,以及 GAVI 为支持引进新的肺炎球菌和轮状病毒疫苗所做的类似努力,为新疫苗的采用提供了一种策略,本文对此进行了回顾,为加快采用其他拯救生命的疫苗提供了一个有用的模式。该策略通过关注三个主要领域来解决疫苗采用的障碍:(i) 加强沟通,提高对基于证据的决策的各种因素的认识,这些决策符合国家的卫生目标;(ii) 开展研究活动,回答支持疫苗引入和长期方案可持续性的关键问题;以及 (iii) 在全球、区域和国家各级与各利益攸关方协调,以确保方案的成功实施。