Monitoring and Surveillance
High quality information is critical to evaluate and improve programmes and thereby allow national governments to decide on how best to immunize more people against more diseases. Quality data which demonstrate vaccine impact are also necessary to justify and advocate for public health investments by organizations and governments that provide immunization funding.
One of the goals of the Global Framework for Immunization Monitoring and Surveillance (GFIMS) is to provide programmatic data to monitor immunization coverage trends and other programme performance indicators. Key monitoring activities include the registration of vaccine doses administered and their reporting from the service delivery level to the national level. Periodic analysis, interpretation, and evaluation of those data, as well as monitoring programme process indicators, are critical to guide programme management and to identify rapidly problems that require corrective action. Monitoring data are thus used to sustain coverage achievements and to reach additional children, especially minority or disadvantaged populations, through both routine and outreach services. These data then need to be linked to disease surveillance data to better understand vaccine performance.
Surveillance data provide decision makers with critical information both before vaccine introduction, as related to the existing disease burden and justification for vaccine introduction, and after vaccine introduction to monitor vaccine impact on disease and to assess vaccine safety. Surveillance for diseases caused by infectious agents targeted by newer vaccines are likely to require a syndromic approach, that is identifying persons who are ill with a specific group of symptoms that may indicate the presence of a specific disease that must be confirmed by laboratory testing, as many of these infectious agents cause a variety of clinical syndromes such as diarrhoea, meningitis, sepsis, and pneumonia. For example meningitis causes the same group of symptoms (fever, headache, stiff neck) but could be caused by a variety of organisms (Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitides) Hence, a strong laboratory component of surveillance must complement the clinical syndromic surveillance to allow for diagnostic confirmation of the specific disease.
Over the past decade, considerable progress has been made in establishing global, regional and national systems for surveillance of vaccine preventable diseases. Since 2008, a number of networks for rotavirus and invasive bacterial disease (IBD) surveillance have become part of a WHO-coordinated surveillance network thus expanding the amount of standardized disease burden data globally. These existing global surveillance networks and systems can be further enhanced by ensuring Ministry of Health ownership and supervision, and by further improving the availability and use of high quality data.
Last updated: November 2012
