Pan American Health Organization, Comprehensive Family Immunization Unit, Washington, DC, United States.
Pan American Health Organization, Comprehensive Family Immunization Unit, Washington, DC, United States.
Vaccine. 2021 Jul 30;39 Suppl 2:B55-B63. doi: 10.1016/j.vaccine.2020.12.043. Epub 2021 Mar 12.
The Americas committed to strengthening maternal and neonatal immunization (MNI) through the Pan American Health Organization (PAHO) Regional Immunization Action Plan (RIAP) 2016-20. We describe the progress toward RIAP MNI-related targets and those related to improvement of data quality and information systems; analyze national MNI policies and vaccination coverages; and identify enablers and challenges of monitoring and reporting MNI vaccination coverage in Latin America and the Caribbean (LAC).
Descriptive study of national MNI policies, vaccination coverage, and information systems. Sources of information included PAHO-World Health Organization (WHO) / UNICEF Joint Reporting Forms on immunization (JRF) 2013-2019, and other reports.
LAC has met two of three RIAP targets related to MNI (countries with universal hepatitis B birth dose introduction and elimination of maternal and neonatal tetanus) and is on track to meet the other (countries with vaccination of pregnant women). As of 2018, of the 49 countries and territories in LAC, 32 vaccinate pregnant women against influenza and 29 provide tetanus-containing vaccine. Twenty-five countries offer universal hepatitis B birth dose vaccine and 31 offer BCG vaccine. In 2018, regional influenza vaccine coverage among pregnant woman was 75%. Regional coverages for BCG and hepatitis B birth dose (<24 h) vaccines were 93% and 79%, respectively. Countries have exceeded RIAP targets related to the quality of vaccination coverage data and the establishment of electronic immunization registries (EIRs). Challenges in monitoring MNI coverage include estimation of denominators and difficulties disaggregating data by group (e.g., pregnant women versus other groups).
Despite progress in improving MNI in LAC, countries must further strengthen immunization monitoring systems and data quality to better report vaccination coverage among pregnant women and newborns. EIR and MNI information systems must be integrated, such that countries can use accurate data to design more timely and effective vaccination strategies.
美洲各国通过泛美卫生组织（PAHO）2016-20 年区域免疫行动计划（RIAP）承诺加强孕产妇和新生儿免疫接种（MNI）。我们描述了朝着 RIAP 与 MNI 相关目标以及改善数据质量和信息系统相关目标的进展；分析了国家 MNI 政策和疫苗接种覆盖率；并确定了拉丁美洲和加勒比地区（LAC）监测和报告 MNI 疫苗接种覆盖率的促进因素和挑战。
对国家 MNI 政策、疫苗接种覆盖率和信息系统进行描述性研究。信息来源包括 2013-2019 年 PAHO-世界卫生组织（WHO）/联合国儿童基金会联合免疫报告表（JRF）和其他报告。
LAC 已实现与 MNI 相关的三个 RIAP 目标中的两个（国家普遍引入乙型肝炎出生剂量和消除孕产妇和新生儿破伤风），并有望实现另一个目标（为孕妇接种疫苗）。截至 2018 年，在 LAC 的 49 个国家和地区中，有 32 个国家为孕妇接种流感疫苗，有 29 个国家提供含破伤风类毒素的疫苗。25 个国家提供普遍乙型肝炎出生剂量疫苗，31 个国家提供卡介苗疫苗。2018 年，区域孕妇流感疫苗覆盖率为 75%。区域卡介苗和乙型肝炎出生剂量（<24 小时）疫苗覆盖率分别为 93%和 79%。各国已超过与疫苗接种覆盖率数据质量和建立电子免疫登记册（EIR）相关的 RIAP 目标。监测 MNI 覆盖率的挑战包括估计分母和按群体（例如孕妇与其他群体）分解数据的困难。
尽管 LAC 在改善 MNI 方面取得了进展，但各国必须进一步加强免疫监测系统和数据质量，以更好地报告孕妇和新生儿的疫苗接种覆盖率。必须整合 EIR 和 MNI 信息系统，以便各国能够使用准确的数据来设计更及时有效的疫苗接种策略。
