Bishop Chrissy, Parashar Deeksha, Kizza Diana, Abeshu Motuma, Kaddar Miloud, Bchir Abdallah, El Maghraby Atef, Schirrmacher Hannah, Wang Zicheng, Griffiths Ulla, Malm Shahira, Kadandale Sowmya, Farrukh Saadia
Triangulate Health Ltd., Doncaster DN11 9QU, UK.
UNICEF MENA Regional Office, Abdulqader Al-Abed Street, Building No.15 Tla'a Al-Ali, Amman 1723, Jordan.
Vaccines (Basel). 2025 Aug 14;13(8):860. doi: 10.3390/vaccines13080860.
: The middle-income countries (MICs) in the Middle East and North Africa (MENA) region face multifaceted challenges-including fiscal constraints, conflict, and vaccine hesitancy-that impede the timely introduction of critical vaccines. This study examines the status, barriers, and facilitators to introducing three critical vaccines-human papillomavirus vaccine (HPV), pneumococcal conjugate vaccine (PCV), and rotavirus vaccine (RV)-across seven MENA MICs, to identify actionable solutions to enhance vaccine uptake and immunisation coverage. : Using the READ methodology (ready materials, extract, analyse, and distil data), this review systematically analysed policy documents, reports, and the literature on the introduction of HPV, PCV, and RV vaccines in seven MENA MICs. A data extraction framework was designed to capture the status of vaccine introduction and barriers and facilitators to introduction. Findings and data gaps were validated with stakeholder consultations. : Of the seven study countries, progress in introducing PCV and RV has been uneven across the region (five countries have introduced PCV, four have introduced RV, and only a single country has introduced HPV at time of writing), hindered by vaccine hesitancy, fiscal challenges, and insufficient epidemiological data. Morocco is the only country to introduce all three vaccines, while Egypt has yet to introduce any. Other common barriers include the impact of conflict and displacement on healthcare infrastructure, delayed introduction due to the 2020 COVID-19 pandemic, and limited local production facilities and regional cooperation. In addition, not all countries eligible for Gavi MICs support have applied. These findings provide a roadmap for policymakers to accelerate equitable vaccine introduction in the MENA region. : Targeted efforts, such as addressing fiscal constraints, improving local manufacturing, tackling gender barriers, and fostering public trust, paired with regional collaboration, can help bridge gaps and ensure no community is left behind in preventing vaccine-preventable diseases.
中东和北非（MENA）地区的中等收入国家面临多方面挑战，包括财政限制、冲突和疫苗犹豫，这些阻碍了关键疫苗的及时引入。本研究考察了七个中东和北非中等收入国家引入三种关键疫苗——人乳头瘤病毒疫苗（HPV）、肺炎球菌结合疫苗（PCV）和轮状病毒疫苗（RV）——的现状、障碍和促进因素，以确定可采取行动的解决方案，以提高疫苗接种率和免疫覆盖率。
使用 READ 方法（准备材料、提取、分析和提炼数据），本综述系统分析了关于七个中东和北非中等收入国家引入 HPV、PCV 和 RV 疫苗的政策文件、报告和文献。设计了一个数据提取框架，以掌握疫苗引入的现状以及引入的障碍和促进因素。通过与利益相关者的磋商验证了研究结果和数据差距。
在七个研究国家中，PCV 和 RV 的引入在该地区进展不均衡（截至撰写本文时，五个国家引入了 PCV，四个国家引入了 RV，只有一个国家引入了 HPV），受到疫苗犹豫、财政挑战和流行病学数据不足的阻碍。摩洛哥是唯一引入所有三种疫苗的国家，而埃及尚未引入任何疫苗。其他常见障碍包括冲突和流离失所对医疗基础设施的影响、由于 2020 年 COVID-19 大流行导致的引入延迟，以及当地生产设施和区域合作有限。此外，并非所有符合 Gavi 中等收入国家支持条件的国家都已申请。这些研究结果为政策制定者在中东和北非地区加速公平引入疫苗提供了路线图。
有针对性的努力，如解决财政限制、改善本地制造、消除性别障碍和增强公众信任，再加上区域合作，可以帮助弥合差距，并确保在预防疫苗可预防疾病方面没有社区被落下。
