Mandomando Inacio, Messa Augusto, Biey Joseph Nsiari-Muzeyi, Paluku Gilson, Mumba Mutale, Mwenda Jason M
Centro de Investigação em Saúde de Manhiça (CISM), Maputo P.O. Box 1929, Mozambique.
Instituto Nacional de Saúde (INS), Maputo P.O. Box 3943, Mozambique.
Vaccines (Basel). 2023 Apr 3;11(4):788. doi: 10.3390/vaccines11040788.
Following the World Health Organization (WHO) recommendation, 38/47 countries have introduced rotavirus vaccines into the program of immunization in the WHO Regional Office for Africa (WHO/AFRO). Initially, two vaccines (Rotarix and Rotateq) were recommended and recently two additional vaccines (Rotavac and Rotasiil) have become available. However, the global supply challenges have increasingly forced some countries in Africa to switch vaccine products. Therefore, the recent WHO pre-qualified vaccines (Rotavac, Rotasiil) manufactured in India, offer alternatives and reduce global supply challenges related to rotavirus vaccines; Methods: Using a questionnaire, we administered to the Program Managers, Expanded Program for Immunization, we collected data on vaccine introduction and vaccine switch and the key drivers of the decisions for switching vaccines products, in the WHO/AFRO. Data was also collected fromliterature review and the global new vaccine introduction status data base maintained by WHO and other agencies.
Of the 38 countries that introduced the vaccine, 35 (92%) initially adopted Rotateq or Rotarix; and 23% (8/35) switched between products after rotavirus vaccine introduction to either Rotavac (n = 3), Rotasiil (n = 2) or Rotarix (n = 3). Three countries (Benin, Democratic Republic of Congo and Nigeria) introduced the rotavirus vaccines manufactured in India. The decision to either introduce or switch to the Indian vaccines was predominately driven by global supply challenges or supply shortage. The withdrawal of Rotateq from the African market, or cost-saving for countries that graduated or in transition from Gavi support was another reason to switch the vaccine; Conclusions: The recently WHO pre-qualified vaccines have offered the countries, opportunities to adopt these cost-effective products, particularly for countries that have graduated or transitioning from full Gavi support, to sustain the demand of vaccines products.
按照世界卫生组织（WHO）的建议，在世界卫生组织非洲区域办事处（WHO/AFRO）的47个国家中，有38个国家已将轮状病毒疫苗纳入免疫规划。最初推荐了两种疫苗（Rotarix和Rotateq），最近又有两种疫苗（Rotavac和Rotasiil）上市。然而，全球供应挑战日益迫使非洲一些国家更换疫苗产品。因此，最近由印度生产的经WHO预认证的疫苗（Rotavac、Rotasiil）提供了替代方案，并减少了与轮状病毒疫苗相关的全球供应挑战。方法：我们通过问卷调查向免疫规划扩大项目的项目经理收集了WHO/AFRO地区疫苗引入、疫苗更换以及更换疫苗产品决策的关键驱动因素的数据。数据还来自文献综述以及WHO和其他机构维护的全球新疫苗引入状态数据库。
在引入该疫苗的38个国家中，35个（92%）最初采用了Rotateq或Rotarix；23%（8/35）在引入轮状病毒疫苗后在产品之间进行了更换，更换为Rotavac（n = 3）、Rotasiil（n = 2）或Rotarix（n = 3）。三个国家（贝宁、刚果民主共和国和尼日利亚）引入了印度生产的轮状病毒疫苗。引入或更换为印度疫苗的决定主要是由全球供应挑战或供应短缺驱动的。Rotateq从非洲市场撤出，或者对于已毕业或正在从全球疫苗免疫联盟（Gavi）支持过渡的国家而言节省成本，是更换疫苗的另一个原因。结论：最近经WHO预认证的疫苗为各国提供了采用这些具有成本效益产品的机会，特别是对于已毕业或正在从Gavi的全面支持过渡的国家，以维持对疫苗产品的需求。
