By Sallieu S. Kanu
Geneva, 04 December 2023 – Countries eligible for Gavi support can now apply to introduce diphtheria, tetanus and pertussis (DTP)-containing vaccine boosters (DTP boosters) – as well as to switch to hexavalent vaccine – a six-in-one vaccine that combines the pentavalent vaccine (diphtheria, tetanus, whole-cell pertussis [DTwP], hepatitis B and Haemophilus influenzae type b) with inactivated polio vaccine (IPV).
These new programmes, part of Gavi’s commitment to leave no child behind with immunisation, will enable countries to protect more children against common childhood illnesses, use public health resources more efficiently and strengthen the reach of health systems. Combined, the three pathogens, DTP, are estimated to kill about 110,000 people annually, with the greatest burden in Asia and sub-Saharan Africa (mainly children aged one to four years). The DTP boosters will be vital in protecting children who have not received any routine vaccines, are under-immunised or come from missed communities. Low immunisation coverage makes vulnerable communities susceptible to recurrent vaccine-preventable disease outbreaks, worsening health and development outcomes. Providing these boosters also reinforces a life-course approach to vaccination and can strengthen vaccination contacts during the second year of life and in school health programmes.
The Gavi Board approved the whole-cell pertussis hexavalent vaccine in June 2023. This combination vaccine is expected to help countries deliver protection against all six diseases more efficiently and reduce programmatic challenges due to multiple vaccines and injections – which would reduce the burden on children, caregivers and health care workers and make it easier to reach un- and under-immunised children. In support of polio eradication, combining IPV with pentavalent increases opportunities for under-immunised children to receive sufficient IPV doses, and providing IPV as part of a combination vaccine with other core antigens ensures streamlined integration into national immunisation programmes, as we look toward a post-polio world.
Thabani Maphosa, Managing Director of Country Programmes Delivery, Gavi, said: “Immunisation reaches more communities than any other routine health intervention; however, there are still too many un- and under-immunised children in the world, and this situation has been made worse by the COVID-19 pandemic. By continually expanding our vaccine portfolio, and targeting the children and communities most frequently left behind, we can save more lives, support child and adolescent health through vaccinations beyond infancy, and make way to provide other important services.”
Every five years, Gavi develops a Vaccine Investment Strategy, with a rigorous process to identify new vaccines or vaccine candidates that would have the most impact in lower-income countries. DTP boosters, the hepatitis B birth dose, rabies vaccine, multivalent meningococcal conjugate vaccine (MMCV) and respiratory syncytial virus (RSV) vaccines were all part of Gavi’s 2018 Vaccine Investment Strategy. However, the introduction of these products was delayed due to the COVID-19 pandemic and countries’ limited bandwidth to establish new programmes or, in the case of RSV vaccine and MMCV, lack of WHO-approved vaccines. Gavi and Alliance partners are preparing to open the funding windows for the remaining vaccines in 2024. The process of developing Gavi’s 2024 Vaccine Investment Strategy is underway, with a shortlist of candidates to be discussed at the Gavi Board meeting this week in Accra, Ghana.