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Seasonal Influenza Vaccination Programs Key to Pandemic Preparedness

This year’s flu season has been severe in the United States and serves as a reminder of our vulnerability to a pandemic.

A flu pandemic can occur when a new strain of influenza virus emerges against which populations have little or no immunity. Flu pandemics have occurred four times over the last century. The most well known was the 1918 Spanish flu, which claimed at least 50 million lives.

Seasonal influenza vaccination programs are a critical line of defense against a pandemic. They help ensure countries can deliver vaccine to their populations quickly. Outside of North America and Europe, however, few countries have robust programs in place.

Through the Partnership for Influenza Vaccine Introduction (PIVI), The Task Force is working to help low- and middle-income countries establish or expand seasonal influenza vaccination programs that will help create a strong foundation for a pandemic response.

In this question & answer, PIVI Director Joseph Bresee, MD, explains why these influenza vaccination programs are critical to pandemic preparedness.

This year’s flu season is a bad one in the United States. What does that mean for people around the world?

We are certainly seeing increased influenza activity right now in the United States. But each year in the United States, regardless of the season’s severity, millions of people will get the flu, hundreds of thousands will be hospitalized, and tens of thousands will die.

In low- and middle-income countries, the problem is much worse, since people are less likely to have access to vaccines that might prevent the illness in the first place. As a result, deaths from influenza are high in these low- and middle-income countries, and these are deaths that are largely preventable.

Why is the seasonal influenza vaccine so important?

The vaccine is simply the single best tool to reduce the chance of getting sick and of possible severe complications from influenza. Countries where vaccination programs are the strongest have fewer cases of the disease, fewer missed days of work and school, lower medical costs, but, most importantly, they have fewer hospitalizations and deaths.

Another critical reason to have a robust seasonal vaccination program is that these are the very programs and systems that will be used to vaccinate people during a future influenza pandemic. Countries that have worked out the policies, regulatory capacity, distribution systems, training, and mechanisms for seasonal vaccine campaigns will be able to use those systems to rapidly and efficiently combat pandemics.

How does PIVI help establish seasonal vaccination programs in low-and-middle-income countries?

We provide technical assistance to ministries of health to help collect evidence of the need for vaccination, develop vaccine policies, plan vaccination programs, and evaluate their effectiveness.

Because the cost of vaccine is a factor in a country’s decision to establish a seasonal vaccination program, we also work with vaccine manufacturers to ensure a free or low-cost supply of vaccine in the early years of a vaccination program.

It is essential that each country we help is able to develop and carry out long-term immunization campaigns that are sustainable and effective. That is the only way that we will be able to help ensure that the world is ready to respond to future pandemics.

What is the impact of PIVI’s work?

It is a new program and the full impact of our work will become clear in the next few years. But so far, we have ensured that more than 3.5 million people across the world have been vaccinated that otherwise would not have been. And, while PIVI’s goal is strengthening seasonal flu programs as well as pandemic preparedness, the programmatic influences are far-reaching – from technical assistance in developing vaccine policy to training healthcare workers and helping improve a country’s overall health system.

At a country level, our early partners, such as Laos, have or are moving toward having their own sustainable vaccination programs that do not require support from PIVI. Over time, we will expand routine influenza vaccinations to additional countries, which will reduce the number of deaths from flu while also strengthening the global capacity to prepare for the next pandemic.

The centennial of the 1918 influenza pandemic reminds us that while we do not know when the next pandemic will occur, we do know that it will occur. We must take steps now to ensure that we are prepared for it.

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