Tuesday, June 28, 2016

DRC's Plan To Vaccinate 11.6 Million Against Yellow Fever


Just over 10 days ago, in WHO: Lower Doses Of Yellow Fever Vaccine Could Be Used In Emergencies - in view of Africa's ongoing Yellow Fever outbreak and a shortfall in global vaccine supplies - we saw their SAGE (Strategic Advisory Group of Experts) on immunization approve the use of `fractional dose' vaccination in an emergency.

While fractional dosing greatly extends the supply of available vaccine, the downside is recipients would be unlikely to gain lifetime immunity (more likely 12 months or so), and would not receive a standard yellow fever vaccination certificate. 

The decision announced on June 17th was described as an emergency fall-back plan, with the WHO stating the situation didn't currently call for its implementation, but if the situation in Africa worsened substantially . . . .

Fast forward a little over a week and the Health Minister of the DRC has announced plans to vaccinate the entire population (over the age of 9 mos) of the capital -  Kinshasa -  and target populations in Kwango, Lualaba and Kasai provinces. 

With reportedly only 1.6 million doses of vaccine available in the DRC - even if diluted to 1/5th strength - it isn't clear how they will obtain enough vaccine to provide the estimated 11.6 million doses required.

Six days ago the WHO announced the Launch of emergency vaccination campaigns on the DR Congo and Angola border (see below), but this new plan would seem to far exceed it in the DRC.

    Brazzaville, 22 June 2016 – As the yellow fever outbreak in Angola and Democratic Republic of the Congo continues, the World Health Organization will launch emergency pre-emptive vaccination campaigns on the DR Congo, Angola border and the city of Kinshasa in the DR Congo to halt the epidemic and prevent the risk of further international spread.
    The initial phase of the campaign which begins in July will focus on districts where there is high movement of people and intense trade activities, particularly the northern border districts of Angola and targeted border districts in neighbouring countries. Specifically, within a 75-100km belt spanning the border between Angola and DR Congo and targeted health zones/communes at risk in Kinshasa city in the DR Congo. This will create an immune buffer to prevent further international spread.

    So far, I haven't seen any official comment from the WHO on the DRC's more aggressive plan.  The most complete coverage of the DRC's decision comes from VOA NEWS.

    Congo Launches Vaccination Campaign Against Yellow Fever

    VOA News

    June 27, 2016 8:15 PM

    The Democratic Republic of Congo says it will begin a campaign next month to vaccinate 11.6 million people against yellow fever after an epidemic was declared in the capital.

    Health Minister Felix Kabange said the campaign will begin July 20 and will aim to vaccinate everyone in the capital of Kinshasa except children under nine months, and will also target populations in the provinces of Kwango, Lualaba and Kasai.

    Last week, Congo's government announced an epidemic in Kinshasa and two other provinces after reporting 67 confirmed cases of yellow fever and more than 1,000 other suspected cases. An outbreak in neighboring Angola has led to the deaths of about 345 people.

    Kabange did not say how health authorities would acquire enough vaccination doses for the campaign. The vaccine is in short supply around the world, and takes about a year to make.

    The World Health Organization recommended this month that the vaccine be diluted up to a fifth of the standard dose to deal with the current emergency.

    The WHO says the lower dosage will protect people for at least a year, but will likely not give lifelong immunity.

    (Continue . . . )

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