The Operational Feasibility of Vaccination Programs Targeting Influenza Risk Groups in the World Health Organization (WHO) African and South-East Asian Regions

We investigated the operational feasibility of preseasonal influenza vaccination campaigns in countries in World Health Organization (WHO) African and South-East Asian Regions. Influenza vaccination campaigns targeting most risk groups substantially increase doses and doses per vaccinator over routine immunization baselines. Background Influenza vaccination is uncommon in low-resource settings. We evaluated aspects of operational feasibility of influenza vaccination programs targeting risk groups in the World Health Organization (WHO) African (AFR) and South-East Asian (SEAR) Regions. Methods We estimated routine immunization and influenza vaccination campaign doses, doses per vaccinator, and cold storage requirements for 1 simulated country in each region using evidence-based population distribution, vaccination schedule, and vaccine volumes. Influenza vaccination targeted persons <5 years, pregnant women, persons with chronic diseases, persons >= 65 years, and healthcare workers (HCW). For the AFR country, we compared vaccine volumes to actual storage capacities. Results Targeting HCW had a small operational impact, and subsequent findings exclude this group. During 3-month influenza vaccination campaigns, monthly doses delivered in the AFR country increased from 15.0% for >= 65 years to 93.1% for Conclusions Influenza vaccination of most risk groups will require substantial increases in doses, doses per vaccinator, and cold storage capacity in countries where infrastructure and resources are limited.