World Health Organization 20 July, 2018 Discussion points day 1 Measles-rubella Technical Advisory Group Meeting 2-3 June 2015, Nairobi, Kenya

General Invite more priority countries to TAG Health worker vaccination: slow progress Advocacy for measles-rubella through professional societies: progress in some countries but not at regional level TAG to update on 5 vial developments

Measles elimination Decrease of funding availability since last TAG Measles funding after polio eradication Strategies in countries to fund measles elimination plans, including government and partner contributions Dialogue started at AFR on measles elimination verification commission and country committees Country categorization useful approach Ongoing discussion about timely dispersion of funding for SIA preparation

Measles vaccination invalidity Policies need to be updated Invalidity needs to be clearly defined Considerable variations – need to review for individual countries Marking next vaccination visit on immunization card has been successfully piloted

MCV2 introduction AFR preparing MCV2 PIE results review to be available Aug. 2015 Discussion on criteria for MCV2 introduction Leave as is because served well and already handled with flexibility regarding surveillance indicators Remove because barrier to increase of measles vaccination coverage Review 2008 TAG recommendations, model of MCV2 impact on SIA intervals, and wait for PIE review results before making decision Develop criteria for expected MCV2 increase compared to MCV1 coverage (can use GVAP indicators as starting point) Periodic SIA have to continue

MR introduction Relative importance of cost, lack on information on CRS burden and concern about multiple injections as barriers; role of Gavi funding for routine needs clarification Need for further discussion how to accelerate protection of women of childbearing age in addition to 9 months to 14 years SIA, e.g. post-partum vaccination Major MR/MMR supply issues to continue because of limited number of suppliers – early planning needed MR should be given for both measles doses More info needed on trends in proportion of rubella susceptible women aged 15 years+ (e.g. shift due to private sector vaccination)

Immunization in Ebola-affected countries MSF has successfully modelled and pilot tested methods to vaccinate children in EVD-affected countries Vaccination should resume asap during EVD outbreak but under strict protocol Experience under scale-up conditions needed