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National Immunization Strategy 2017-2022


Foreword
 
There have been many transformations to the NIP inthe recent years. New vaccines wereadded to the vaccination schedule, the cohorts served by the public sector kepton expandingsince the onset of the Syrian crisis, measures to consolidatethe vaccine purchasing arrangements were adopted,and there wasa leveraging up ofthe vaccinovigilanceand its effective management.In 2016, the Ministryof health in Lebanon decided that it was the time to take stock, constructon the current NIP strengthsand achievements andidentify areas for further improvement. A strategy for the NIP for 2016-2020 wasenvisagedin agreementwith the development partners. A detailed situation analysis assessment was initiatedin October 2015 in two stages: at the initial stage, the country and health system contexts were analyzed, and immunization system performance was measured. In the second stage, a framework was developed in consultations with key stakeholders to define gaps in the evidence. Immunization coverage evaluation survey was conducted in 2016 and fed into filling the lacunas in information.

The present document expresses the country vision, goals and priorities of the national immunization program. It relies on a careful examination of the situation analysis, an assessment of the enablers and challenges facing the immunization services and defines the national immunization strategies addressing these contests. The strategies were formulated as informed choices across more than one solution deemed most feasible and efficient considering the country context.

The document is structured in three sections:

Section 1“Situational analysis” presents briefly the organization and operation of the national immunization program as well as the recent achievements and remaining challenges,

Section 2 “Conceptual framework” describes the future vision of the country in regards to vaccine preventable diseases, the long term goals to be achieved and the more specific results –immunization system objectives and targets for 2020,

Section 3 defines the Strategies to address the bottlenecks and achieve immunization system objectives by 2020. Most of strategies (so called “immunization system specific” ones) are presented by relevant health system blocks.The focus of the NIP Strategy, is to assistthe MOPH to meet international goals set by the World Health Organization (WHO) under the Global Immunization Vision and Strategy (GIVS). The Strategy articulates action areas to conserve the successful achievements of the last years, built on the current favoring momentum and propose solutions for the drawbacks

The Strategy comprises nineStrategic Priority Areas to complement and strengthen the NIP.

The matrix (Figure 2) in Annexesshows expected results of the immunization system development strategies by health system building blocks and links them to the root causes (weaknesses and treats) identified during the system analysis...
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ATC Name B/G Ingredients Dosage Form Price
J07AL02 PREVENAR 20 B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F,8, 9V,10A, 11A, 12F, 14, 15B, 18C, 19A, 19F,22F, 23F, 33F (2.2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein (approximately 51mcg) adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 7,415,107 L.L
J07AL02 VAXNEUVANCE B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F, 9V,14, 18C, 19A, 19F, 22F, 23F,33F (2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg) Conjugated to CRM197 carrier protein and adsorbed on aluminium phosphate adjuvant - Injectable suspension 6,988,413 L.L
J07AP03 TYPHIM VI B Salmonella typhi polysaccharides - 0.025mg/0.5ml 0.025mg/0.5ml Injectable solution 1,118,077 L.L
J07AP03 TYPHIBEV TYPHOID CONJUGATED VACCINE (MONOVALENT) B Salmonella typhi polysaccharides Vi purified - 25mcg of Vi-PS2/0.5ml Injectable suspension 4,020,777 L.L
J07AX URO-VAXOM B Lyophilized bacterial lysates of E-Coli - 6mg 6mg Capsule 2,689,029 L.L
J07AX BRONCHO-VAXOM CHILDREN B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 3.5mg Capsule 1,988,887 L.L
J07AX BRONCHO-VAXOM ADULTS B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 7mg Capsule 2,746,814 L.L
J07BB01 INFLUVAC TETRA B Influenza virus surface antigens inactivated (haemagglutinin and neuraminidase) - 15mcg/4strains/0.5ml Injectable suspension 970,254 L.L
J07BB01 VAXIGRIPTETRA, VACCIN GRIPPAL QUADRIVALENT (INACTIVE A VIRION FRAGMENTE) B Influenza vaccine virus (inactivated, split) - 15mcg/4strains/0.5ml Injectable suspension 970,254 L.L
J07BB02 INFLUVAC B Grippal virus surface antigen 3strains - 15mcgx3strains/0.5ml Injectable suspension 573,821 L.L
J07BC01 ENGERIX-B 20 B Hepatitis B, purified antigen - 20mcg/ml 20mcg/ml Injectable suspension 1,652,926 L.L
J07BC01 ENGERIX-B 10 B Hepatitis B, surface antigen - 10mcg/0.5ml 10mcg/0.5ml Injectable suspension 1,042,822 L.L
J07BC01 HEPATITIS-B VACCINE (r DNA) PAEDIATRIC G Hepatitis B, purified surface antigen adsorbed on aluminium hydroxide (Al+++) (0.25mg to 0.40mg) - 10mcg/0.5ml 10mcg/0.5ml Injectable suspension 323,866 L.L
J07BC02 HAVRIX '1440' B Hepatitis A, inactivated, whole virus - 1,440 ELISA units/ml 1,440 ELISA units/ml Injectable suspension 2,215,996 L.L
J07BC02 HAVRIX JUNIOR 720 B Hepatitis A, inactivated, whole virus - 720 ELISA units/0.5ml 720 ELISA units/0.5ml Injectable suspension 1,491,665 L.L
J07BC02 AVAXIM PEDIATRIQUE (vaccin inactivé de l'hépatite A adsorbé) B Hepatitis A, inactivated, whole virus - 80 antigen units/0.5ml 80 antigen units/0.5ml Injectable suspension 1,531,980 L.L
J07BC02 VAQTA B Hepatitis A, inactivated, whole virus - 25U/0.5ml 25U/0.5ml Injectable suspension 2,539,862 L.L
J07BC02 HEALIVE-HEPATITIS A VACCINE (HUMAN DIPLOID CELL) INACTIVATED BioTech Hepatitis A, inactivated antigen (TZ84 Strain), human diploid cell - 0.5ml/dose 0.5ml/dose Injectable suspension 1,777,904 L.L
J07BC02 HEALIVE-HEPATITIS A VACCINE (HUMAN DIPLOID CELL) INACTIVATED BioTech Hepatitis A, inactivated antigen (TZ84 Strain), human diploid cell - 1ml/dose 0.5ml/dose Injectable suspension 2,257,655 L.L
J07BD52 PRIORIX B Rubella virus live attenuated - ?10³ CCID50, Mumps virus live attenuated - ?103.7 CCID50, Measles virus live attenuated - ?10³ CCID50 Injectable lyophilised powder for solution+diluent 1,142,266 L.L
J07BD52 M-M-R II (MEASLES, MUMPS AND RUBELLA VIRUS VACCINE LIVE) B Rubella virus live attenuated - , Mumps virus live attenuated - , Measles virus live attenuated - Injectable solution+diluent 12,924,401 L.L
J07BD52 MEASLES, MUMPS AND RUBELLA VACCINE LIVE ATTENUATED (FREEZE-DRIED) MMR G Rubella virus live attenuated - ?1000CCID50 /0.5ml, Mumps virus live attenuated - ?5000CCID50 /0.5ml, Measles virus live attenuated - ?1000CCID50 /0.5ml Injectable freeze dried powder + diluent 739,113 L.L
J07BF03 POLIOMYELITIS VACCINE INACTIVATED B Poliomyelitis virus type 1 inactivated - 40D.U, Poliomyelitis virus type 2 inactivated - 8D.U, Poliomyelitis virus type 3 inactivated - 32D.U Injectable suspension 1,206,771 L.L
J07BG01 RABIVAX-S (RABIES VACCINE INACTIVATED) BioTech Freeze dried inactivated purified rabies antigen (Pitman Moore PM3218 as virus strain) - Injectable freeze dried material 1,552,138 L.L
J07BH01 ROTATEQ ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT B Rotavirus G1, live attenuated - ?2.2x106 IU, Rotavirus G2, live attenuated - ?2.8x106 IU, Rotavirus G3, live attenuated - ?2.2x106 IU, Rotavirus G4, live attenuated - ?2.0x106 IU, Rotavirus P1, live attenuated - ?2.3x106 IU Suspension 4,508,592 L.L
J07BH01 ROTARIX ORAL B Rota virus human RIX4414, live attenuated - ?106 CCID50 Suspension 5,167,074 L.L
J07BH01 ROTASIIL, ROTAVIRUS VACCINE, LIVE ATTENUATED (ORAL FREEZE-DRIED) BioTech Rotavirus bovine-human , live attenuated - Suspension 2,822,069 L.L
J07BH01 ROTASIIL, ROTAVIRUS VACCINE, LIVE ATTENUATED (ORAL LIQUID) BioTech Rotavirus bovine-human , live attenuated - Liquid 2,822,069 L.L
J07BK01 VARILRIX + SOLVENT IN SYRINGE B Varicella virus, live attenuated - ?1033 PFU ?1033 PFU Injectable lyophilised powder for solution+diluent 3,473,833 L.L
J07BK01 VARIVAX B Varicella virus, live attenuated - 1350PFU Injectable powder for suspension+diluent 4,102,751 L.L
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