Successive introduction of four new vaccines in Rwanda: High coverage and rapid scale up of Rwanda's expanded immunization program from 2009 to 2013.
Gatera MRwanda Biomedical Center, Kigali, Rwanda. Electronic address: gamaurice2003@gmail.com.
Bhatt SGeisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA.
Ngabo FMinistry of Health, Government of Rwanda, PO Box 84, Kigali, Rwanda.
Utamuliza MRwanda Biomedical Center, Kigali, Rwanda.
Sibomana HRwanda Biomedical Center, Kigali, Rwanda.
Karema CRwanda Biomedical Center, Kigali, Rwanda; Swiss Tropical and Public Health Institute, University of Basel, Socinstrasse 57, P.O. Box, Basel, 4002, Switzerland.
Mugeni CMinistry of Health, Government of Rwanda, PO Box 84, Kigali, Rwanda.
Nutt CTPartners In Health, 3rd Floor, 888 Commonwealth Avenue, Boston, MA 02215, USA.
Nsanzimana SRwanda Biomedical Center, Kigali, Rwanda.
Wagner CMDana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
Binagwaho AGeisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA; Ministry of Health, Government of Rwanda, PO Box 84, Kigali, Rwanda; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
English
As the pace of vaccine uptake accelerates globally, there is a need to document low-income country experiences with vaccine introductions. Over the course of five years, the government of Rwanda rolled out vaccines against pneumococcus, human papillomavirus, rotavirus, and measles & rubella, achieving over 90% coverage for each. To carry out these rollouts, Rwanda's Ministry of Health engaged in careful review of disease burden information and extensive, cross-sectoral planning at least one year before introducing each vaccine. Rwanda's local leaders, development partners, civil society organizations and widespread community health worker network were mobilized to support communication efforts. Community health workers were also used to confirm target population size. Support from Gavi, UNICEF and WHO was used in combination with government funds to promote country ownership and collaboration. Vaccination was also combined with additional community-based health interventions. Other countries considering rapid consecutive or simultaneous rollouts of new vaccines may consider lessons from Rwanda's experience while tailoring the strategies used to local context.