Sunday, June 15, 2025
6/15/2025
Strengthening Immunization Program Implementation in Consequential Sub-National Geographical Areas of Brazil - Brazil has made significant progress reducing vaccine preventable diseases (VPDs), including the elimination of polio, rubella and neonatal tetanus. However, the country still faces many challenges, as evidenced by declining vaccination coverage rates and resurgence of previously controlled VPDs. Brazil is the largest and most populous country in Latin America, comprising many social, epidemiological and geographical disparities, including pockets of vulnerable and under-vaccinated subpopulations, often of disproportionate epidemiological consequences. In response to these challenges and setbacks, Brazil launched a new strategy in 2023, embracing a revitalized microplanning approach. The Sabin Vaccine Institute (Sabin) proposes to work seamlessly with Brazil’s National Immunization Program (PNI) to implement and expand this strategy to increase coverage and protect vulnerable and at-risk populations from VPD morbidity and mortality. In collaboration with PNI, the Centers for Disease Control and Prevention and other partners, Sabin will identify sub-national areas and subpopulations for prioritization. These will include vulnerable subpopulations, states with the lowest human development indices, hard-to-reach areas, and settings with high numbers of un- and under-vaccinated individuals. We will leverage and enhance Brazil’s microplanning strategy to strengthen immunization services, with a focus on enhancing vaccine uptake, improving cold chain management, boosting neonatal vaccination rates, and heightening surveillance of VPDs. Additionally, through outbreak preparedness and control measures, pharmacovigilance, and fostering strategic partnerships, we aim to strengthen response to public health emergencies and improve resilience of the health system. Expected results include the following: Increased vaccination coverage in targeted subpopulations and nationally o Expansion of microplanning actions to increase vaccination coverage in under-vaccinated subpopulations through tailored delivery strategies. o Increased capacity through training of local teams on immunization, VPD surveillance and vaccine pharmacovigilance. o Improved communications via the design of tailored, regionalized outreach approaches. o Increased vaccine demand by addressing vaccine hesitancy and its determining and conditioning factors. o Optimization of the cold chain to facilitate vaccine access in hard-to-reach locations. o Increased number of maternity ward health professionals equipped for high-quality birth-dose vaccination activities. o Improved effective communication between the Brazilian government and border countries to improve vaccination access for resident and foreign populations. Improved comprehensive disease surveillance o Enhancement of sensitive, timely and active surveillance. o Increased integration of surveillance systems and primary care. Reduction in VPD outbreaks o Improved timely detection of VPD cases and adoption of preparedness and control measures to support rapid outbreak response. o Enhanced preparedness through simulation exercises. o Verification of measles elimination. Fostering the strength of the immunization system o Expansion of surveillance for adverse events following immunization (AEFIs). o Increased capacity of community health agents to identify AEFIs. Greater collaboration and technical cooperation o Strengthened interagency coordinating committees. o Improved measures to qualify and register foreign doses. In conclusion, the proposed initiatives will have a profound impact on immunization across the country, particularly in sub-national consequential geographies. By implementing these measures, we will fortify Brazil's immunization program, thereby safeguarding against VPDs and promoting public health resilience.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).