Our Progress: Making A Difference Through Global Immunization
Stories of CDC's Progress
Staff from the DRC Ministry of Health sensitizes community members regarding polio and vaccination in Ankoro Zone de Santé, Katanga Province, a zone with communities who have a history of refusing vaccination for their children.
CDC and global partners kick start new communications strategy to encourage polio vaccinations in Democratic Republic of Congo
While the Democratic Republic of Congo (DRC) had been one of the countries that had stopped polio transmission in the past, poor vaccination coverage has contributed to polio virus circulation and measles outbreaks in Katanga Province in recent years. The problem of poor vaccination acceptance among religious communities in the north of Katanga Province came to the forefront in 2011 after monitoring data revealed high rates of refusal of polio vaccination during National Immunization Days conducted as a polio outbreak response. Wild polio virus (WPV) is suspected to have circulated, undetected, for several years in and around this province, as evidenced by the detection of 12 cases there in 2011. Now, CDC, UNICEF and various global partners are funding a project to increase the acceptance of polio vaccination among resistant communities in Katanga by employing an effective, new communications strategy, known as the SALT Approach. Read More >>
Group photo of GID staff during the 2012 retreat
Global Immunization Division’s 2012 All-Hands Retreat
From September 12-14, 2012, nearly all of GID’s 140 staff from Atlanta and around the globe came together at CDC Atlanta for the division-wide staff retreat. The three days were used to hold a forum for shared visioning and collective strategy-making in order to operationalize CDC’s Global Immunization Strategic Framework 2011-2015 and achieve the goals outlined therein. Dr. Rebecca Martin, Director of GID gave opening remarks, and Dr. Kevin De Cock, the Director of the Center for Global Health, provided closing remarks. A few highlights from the event included very active staff participation in breakout and plenary sessions; the staff contributions to a GID Wall of Achievements; and a flash mob dance performance!
Dr. Victoria Gammino meeting with clan heads in Jigawa state, northern Nigeria.
Reaching nomadic populations in Northern Nigeria and Kenya
Dr. Victoria Gammino of GID is leading an initiative to improve supplemental polio and routine immunization services in Kenya, Nigeria and other African countries with significant mobile populations. Nomadic pastoralists and other mobile groups such as migratory workers and refugees live beyond the reach of established health care programs that are designed to serve sedentary populations. As a result, these groups are often under-immunized, and out of the reach of existing disease surveillance activities. In Nigeria and other parts of West Africa, this is of particular concern as communities with under-immunized children can serve as reservoirs for polio virus, and unwittingly contribute to the continued transmission of polio. Working with the National Primary Health Care Development Agency of Nigeria, WHO and CDC’s Field Epidemiology and Lab Training Program, GID has developed an interdisciplinary approach to identify major migrant groups and characterize the seasonal movements of nomadic populations in Northern Nigeria. GID is also collaborating with the Global Disease Detection program and Kenya’s Ministry of Public Health and Sanitation to devise a strategy specific to Kenya’s unique migrant populations. Borrowing methods from epidemiology, geographic information systems (GIS), and anthropology, GID is designing solutions to improve service provision to these hard-to-reach populations. We are forging important relationships between health care providers and traditional leaders to better understand their views on immunization and link them to essential services. In some areas, this also involves collaboration with animal health providers who are in the unique position to provide critical links between pastoralist animal-herding societies and their non-pastoralist counterparts. This is just one example of how CDC is applying a “One Health” approach to better understand the relationship between humans, animals and their environments to improve health outcomes. Through these efforts, GID and our global partners will be better able to target polio and other immunization services for nomadic and other mobile populations, who are chronically missed by routine and supplementary immunization activities.
Data collector records latitude and longitude coordinates in a rural village in Sokoto State, Nigeria.
GIS Mapping in eight high risk polio endemic states of Northern Nigeria
In collaboration with the Bill and Melinda Gates Foundation, the National Primary Health Care Development Agency (NPHCDA), the Nigerian Ministry of Health, and the WHO, CDC is providing support to a GIS mapping project in 8 high-risk states in Nigeria where polio remains endemic. The main objective of this partnership effort is to identify and locate every human settlement in every ward to produce a Geographic Systems Information (GIS) map for local-level planning of polio immunization activities. Maps of this nature will be a vital tool that partners will use to improve the planning and monitoring of polio immunization. It is anticipated that GIS maps will be more accurate and inclusive than hand-drawn maps and are an effective way to identify new and chronically missed settlements.
Assessing immunogenicity of polio vaccines at a lab in Bangladesh.
Assessing immunogenicity of polio vaccines given at 2 versus 4 week intervals in Bangladesh
Scientists from GID led by Dr. Conchi Estivariz and CDC’s Division of Viral Diseases have partnered with the International Centre for Diarrheal Diseases Research, Bangladesh (ICDDR, B) to determine the difference in infant immune responses to oral polio vaccines given after a shortened 2 week interval versus the routine 4 week interval. The findings of this important research will directly influence the planning of immunization activities for the control and prevention of polio outbreaks.
Chinese colleagues Na Yang and Chenyan Yue pose for a photo with Thomas Skinner and Brittany Raines after media training in the CDC Press Room.
Working to improve vaccine communications and coverage in China
In September 2012, Dr. Linda Quick of GID was honored to host 3 colleagues visiting from CDC China and the Chinese Ministry of Health for a learning exchange on vaccine communications prior to beginning a study to identify key issues that influence the attitudes, concerns and behaviors of Chinese parents towards polio, measles, and routine vaccinations for their children. Issues around vaccine hesitancy will be explored as well. While in Atlanta, our colleagues participated in various sessions led by various staff at GID’s CDC partner divisions and centers, including media training with Thomas Skinner and Brittany Raines, risk communication with Glen Nowak, and research methods with Allison Kennedy.
Mother and baby at outreach vaccination activity in northern Laos, courtesy of Karen Hennessey.
Improving coverage of Hepatitis B vaccination at birth with mobile phones in rural Laos
In early 2013, Dr. Minal Patel of GID’s Disease Eradication & Elimination Branch (DEEB) will launch a research initiative with the Laos Ministry of Health and WHO to determine if the use of mobile phones by village health volunteers can increase coverage of the birth dose of Hepatitis B vaccine. In rural areas, most babies are born at home rather than in a health facility which severely limited access to vaccination. When a new birth occurs, village health volunteers will notify skilled birth attendants via mobile phone. The skilled birth attendants will visit homes with new births and deliver the birth dose of the Hepatitis B vaccine as part of an integrated child health package.
Dr. Kevin DeCock stresses the importance of vaccinations.
CDC Global Health Director, Dr. Kevin DeCock stresses the importance of vaccinations.
Immunization is a global health priority at CDC focusing on polio eradication, reducing measles deaths, and strengthening routine vaccine delivery. Dr. DeCock addresses the crowd at the ceremony to launch the Intensive Activities for Infant Health by the Ministry of Health and Population on Saturday, April 21st in Port-au-Prince, Haiti. During this catch-up campaign 2,300,000 children will be vaccinated against measles, rubella and polio.
Dr. Thomas Frieden visits a colony of migrant garbage sorters in Ghaziabad, India to assess polio eradication efforts.
CDC Director Frieden Observes Polio Eradication Efforts in India
Polio eradication is a top priority for CDC Director Dr. Thomas Frieden. In August 2011, he visited India to witness first-hand the public health challenges that this country faces. He recognized the remarkable progress that has brought India to the verge of polio eradication but cautioned against complacency and called for maintaining high-quality vaccination efforts and sensitive surveillance to ensure success. Dr. Frieden notes that global immunization activities are a critical part of CDC's support to national programs around the world.
Strengthening Immunization Data Quality in Cambodia
At the request of the Cambodian Health Ministry in September 2010, GID conducted an assessment of target population data used by the country's immunization program. GID field officers reviewed the available population data sources as well as their quality and usability by the immunization program. Based on its findings, GID will work with the Cambodian Health Ministry and WHO to improve the quality of population data management and, ultimately, the country's vaccination efforts.
Strengthening surveillance for Polio in Tajikistan
In 2010, following an outbreak of polio in Tajikistan, GID worked with both Ministry of Health and international public health officials to strengthen surveillance for acute flaccid paralysis (AFP), an early sign of possible polio.GID efforts provided scientific insight and guidance to public health officials, who then used this information to direct disease control efforts and plan immunization campaigns.
Evaluating a measles outbreak in Tanzania
GID epidemiologist and a Tanzanian nurse and doctor collect oral fluid specimens for measles virus genotyping during the measles outbreak in Dar es Salaam.
Assessing progress towards maternal and neonatal tetanus elimination in Sierra Leone
In March 2010, the government of Sierra Leone asked GID and other international health partners to assess the country's progress in eliminating maternal and neonatal tetanus (MNT). This study measured the MNT eradication efforts of Sierra Leone, UNICEF, WHO, and the United Nations Population Fund (UNFPA). As a result, these partners received recommendations to help improve their MNT eradication program and save more children's lives.
STOP team members (front) from Brazil at work with a polio vaccination team in Angola (November 2010)
In 2010, members of STOP team #35 worked with the Angolan Ministry of Health to implement polio immunization campaigns, improve surveillance for acute flaccid paralysis, and conduct training and supervisory visits to vaccination teams at the district level. As part of their assignment, the STOP team members provided country health officials and WHO with updated epidemiologic data to guide active case surveillance and polio vaccination campaigns. Angola is currently seeking additional STOP team health professionals to continue this work to end transmission of polio virus in their country.