Kumar Pawan, Ray Arindam, Kumari Amrita, Kaur Amanjot, Hora Rhythm, Singh Kapil, Mehra Rashmi, Koshal Seema S, Verma Shipra, Quadri Syed F, Deb Roy Arup
Immunization Division, Ministry of Health and Family Welfare, Government of India, India.
Bill and Melinda Gates Foundation, Delhi, India.
Vaccine X. 2024 Jul 17;19:100526. doi: 10.1016/j.jvacx.2024.100526. eCollection 2024 Aug.
India became the first country in the WHO South-East Asia Region (SEAR) to introduce the rotavirus vaccine (RVV) in the Universal immunization programme (UIP) in 2016 with nationwide expansion by 2019. It was a landmark move to reduce the diarrheal disease burden in under-five children. To assess the implementation process of introduction of RVV, Post Introduction Evaluation (PIE) was conducted in March 2022.
The evaluation was conducted across 14 states, 28 districts and 28 health facilities to obtain a nationwide geographical inclusion. Stakeholders involved in program decision-making, planning, training, vaccine delivery, logistics, and communication from all levels (National, state, district, health facility, health worker, caregiver) were interviewed using standardized data collection tool for PIE (adapted from the standard WHO PIE questionnaire) and scripted on a digital tool.
A total of 260 interviews were conducted. Political willingness, well-planned preparedness activities, securing vaccines timely, strong supply chain monitoring, availability of domestic RVV products, quality trainings and intense communication activities were the key factors identified for the successful RVV introduction. Key activities during the introduction included cold chain space assessment, trainings of healthcare workforce, dissemination of job aids, updation of recording & reporting formats and strengthening of AEFI surveillance. Lack of community awareness for immunization in a few areas, fear of AEFI amongst some caregivers and local issues with Alternate Vaccine Delivery (AVD) were some reported challenges in achieving high coverage for RVV.
Overall, the nationwide roll-out of RVV was smooth and the vaccine has been well-accepted in the community. The assessment emphasizes on having a well-strategized operational and communication planning, which is very crucial for any new vaccine introduction.
印度于2016年成为世界卫生组织东南亚区域（SEAR）首个在通用免疫规划（UIP）中引入轮状病毒疫苗（RVV）的国家，并于2019年在全国范围内推广。这是减轻五岁以下儿童腹泻疾病负担的一项具有里程碑意义的举措。为评估RVV引入的实施过程，于2022年3月进行了引入后评估（PIE）。
评估在14个邦、28个区和28个卫生机构进行，以实现全国范围的地域覆盖。使用PIE标准化数据收集工具（改编自世卫组织标准PIE问卷）对参与项目决策、规划、培训、疫苗配送、物流和各级（国家、邦、区、卫生机构、卫生工作者、照料者）沟通的利益相关者进行访谈，并记录在数字工具上。
共进行了260次访谈。政治意愿、精心策划的准备活动、及时确保疫苗供应（原文securing vaccines timely直译为“及时确保疫苗安全”，此处调整为“及时确保疫苗供应”更符合语境）、强大的供应链监测、国产RVV产品的可得性、高质量培训和密集的沟通活动是成功引入RVV确定的关键因素。引入过程中的关键活动包括冷链空间评估、医护人员培训、发放工作辅助工具、更新记录和报告格式以及加强AEFI监测。在一些地区，社区对免疫接种缺乏认识，一些照料者对AEFI存在恐惧，以及替代疫苗接种（AVD）的当地问题是实现RVV高覆盖率报告的一些挑战。
总体而言，RVV在全国的推广顺利，该疫苗在社区中已被广泛接受。评估强调要有精心策划的运营和沟通规划，这对于任何新疫苗的引入都至关重要。
