Expansion of Vaccination Services and Strengthening Vaccine-Preventable Diseases Surveillance in Haiti 2010-2016.

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Am J Trop Med Hyg. 2017 Oct;97(4_Suppl):28-36. doi: 10.4269/ajtmh.16-0802.

Expansion of Vaccination Services and Strengthening Vaccine-Preventable Diseases Surveillance in Haiti 2010-2016.

Tohme RA¹ Francois J² Cavallaro KF¹ Paluku G³ Yalcouye I³ Jackson E⁴ Wright T¹ Adrien P⁵ Katz MA⁶ Hyde TB¹ Faye P³ Kimanuka F⁴ Dietz V¹ Vertefeuille J¹ Lowrance D⁶ Dahl B¹ Patel R⁶.

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Abstract

Following the 2010 earthquake Haiti was at heightened risk for vaccine-preventable diseases (VPDs) outbreaks due to the exacerbation of long-standing gaps in the vaccination program and subsequent risk of VPD importation from other countries. Therefore partners supported the Haitian Ministry of Health and Population to improve vaccination services and VPD surveillance. During 2010-2016 three polio measles and rubella vaccination campaigns were implemented achieving a coverage > 90% among children and maintaining Haiti free of those VPDs. Furthermore Haiti is on course to eliminate maternal and neonatal tetanus with 70% of communes achieving tetanus vaccine two-dose coverage > 80% among women of childbearing age. In addition the vaccine cold chain storage capacity increased by 91% at the central level and 285% at the department level enabling the introduction of three new vaccines (pentavalent rotavirus and pneumococcal conjugate vaccines) that could prevent an estimated 5227 deaths annually. Haiti moved from the fourth worst performing country in the Americas in 2012 to the sixth best performing country in 2015 for adequate investigation of suspected measles/rubella cases. Sentinel surveillance sites for rotavirus diarrhea and meningococcal meningitis were established to estimate baseline rates of those diseases prior to vaccine introduction and to evaluate the impact of vaccination in the future. In conclusion Haiti significantly improved vaccination services and VPD surveillance. However high dependence on external funding and competing vaccination program priorities are potential threats to sustaining the improvements achieved thus far. Political commitment and favorable economic and legal environments are needed to maintain these gains.

PMID: 29064356 PMCID: PMC5676636 DOI:10.4269/ajtmh.16-0802