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

2. 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

3. 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

4. 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

5. MCV2 introduction
AFR preparing MCV2 PIE results review to be available Aug
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

6. 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)

7. 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