Routine immunization profile: Spain

Routine immunization profile Spain Progress towards achieving European Vaccine Action Plan goals, 2017 Goal Indicator Status Goal Indicator Status 1 Sustain polio-free status a (Current risk) Yes (Low) 4 Meets vaccination coverage targets DTP3 national immunization coverage ≥95%d ≥90% DTP3 coverage achieved in ≥90% of districtse,i Yes Yes Yes 2 Measles elimination statusb Eliminated 5 Make evidence-based decisions about introduction of new vaccines*e NITAG made a recommendation about PCV NITAG made a recommendation about RV NITAG made a recommendation about HPV Yes Yes Yes YesRubella elimination status b Eliminated 3 Control hepatitis B infectionc Validation pending 6 Achieve financial sustainability of the national immunization programme**c Yes *New vaccines introduced or not introduced based on NITAG evidence-based recommendations **Country self-sufficient for procuring routine vaccines Demographic, income and health expenditure summary, 2017 Total Populationf 46 354 321 Live births 399 129 Surviving infants 398 172 <5 years 2 016 949 <15 years 6 808 282 Neonatal mortality rate (per 1000 live births)f 1.7 Infant mortality rate (per 1000 live births)f 2.6 Number of districtse 19 GNI (per capita, in USD)g 27 150 Health spending as % of total government expenditureg 15 Immunization schedule, 2017e 2M DTaPHibHepBIPV 4M DTaPHibHepBIPV, DTaPHibIPV, MenC_conj 11M DTaPHibHepBIPV 12M MenC_conj, MMR 15M Varicella 18M DTaPHibIPV 3-4Y MMR, Varicella 12Y HPV(2x) 14Y Td Routine immunization profile Spain Vaccine coverage estimates, 2013-2017d Number of reported cases of vaccine- preventable diseases, 2013-2017e,i 2013 2014 2015 2016 2017 Measles 131 159 37 35 157 Mumps 13 880 3310 3767 5038 6787 Rubella 2 5 4 2 1 Congenital rubella syndrome 1 1 0 0 0 Diphtheria 0 2 1 2 0 Tetanus 13 4 8 9 6 Pertussis 2342 3535 8352 5144 4775 Hepatitis A 665 630 594 1353 4582 Varicella 125 895 128 596 140 393 132 956 66 504 DTP3 reported coverage by subnational area†, 2017e,i MCV2 reported coverage by subnational area†, 2017e,iMCV1 reported coverage by subnational area†, 2017e,i Surveillance with laboratory confirmation of cases, 2017e,i Measles Yes Rubella Yes Congenital rubella syndrome Yes Rotavirus Yes Invasive meningococcal disease Yes Invasive pneumococcal disease Yes Invasive Haemophilus influenzae disease Yes Note: Case-based surveillance (with laboratory confirmation of cases) assessed for measles, rubella, and congenital rubella syndrome. Hospital-based sentinel surveillance and/or population-based surveillance (both with laboratory confirmation of cases) assessed for rotavirus, invasive meningococcal disease, invasive pneumococcal disease, and invasive Haemophilus influenzae disease. ≥95% 90-94% 80-89% <80% ND ≥95% 90-94% 80-89% <80% ND ≥95% 90-94% 80-89% <80% ND ND NR50 0100 2013 2014 2015 2016 2017 BCG NR NR NR NR NR HepB-BD NR NR NR NR NR DTP1 98 98 98 98 98 DTP3 96 97 97 97 98 HepB3 95 96 97 97 93 Hib3 96 96 97 97 98 Pol3 96 97 97 97 94 PCV3 NR NR NR NR NR Rotac NR NR NR NR NR RCV1 95 96 96 97 96 MCV1 95 96 96 97 96 MCV2 91 93 94 95 93 Routine immunization profile Spain Number of reported measles, mumps and rubella casese,i and MCV coverage estimatesd, 2013-2017 DTP1-DTP3 dropout rate, 2013-2017d Note: Dropout rate is calculated using WUENIC Reported target population, reported number of DTP3 doses administered and DTP3 reported coveragee, 2013-2017 Number of reported diphtheria, tetanus and pertussis casese,i and DTP3 coverage estimatesd, 2013-2017 Percentage of districts by DTP3 reported coveragee,i, 2013-2017 Immunization system characteristics, 2017 Sustained access to WHO accredited polio, measles, and rubella laboratoriesh Yes NITAG in place that meets six WHO criteriae No National system in place to monitor AEFIse Yes Communication plan in place to respond to vaccine safety-related eventse No Vaccine hesitancy assessment performed within last 5 years e No Mandatory proof of immunization at school entrye Yes Note: The six WHO NITAG criteria are 1. legislative or administrative basis for the advisory group; 2. formal written terms of reference; 3. at least five different areas of expertise represented among core members; 4. at least one meeting per year; 5. circulation of the agenda and background documents at least one week prior to meetings; 6. mandatory disclosure of any conflict of interest 0 20 40 60 80 100 0 1000 2000 3000 4000 5000 6000 7000 8000 2013 2014 2015 2016 2017 % c ov er ag e N um be r o f c as es Year Measles Mumps Rubella MCV1 coverage MCV2 coverage 0 20 40 60 80 100 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 2013 2014 2015 2016 2017 % c ov er ag e N um be r o f c as es Year Diptheria Tetanus Pertussis DTP3 coverage 0 20 40 60 80 100 0 50000 100000 150000 200000 250000 300000 350000 400000 450000 500000 2013 2014 2015 2016 2017 % c ov er ag e N um be r Year DTP3 reported population DTP3 reported doses DTP3 reported coverage 89 100 100 100 95 11 5 0 20 40 60 80 100 2013 2014 2015 2016 2017 Percentage of subnational areas Ye ar ≥90% 80-89% 50-79% <50% ND 2 1 1 1 0 0 1 2 3 4 5 2013 2014 2015 2016 2017 DTP1-DTP3 dropout rate (%) Ye ar Routine immunization profile Spain Vaccine stockouts by administrative levele, 2013-2017 Abbreviations *Data on HPV stockouts have only been collected in JRF since 2016 † The boundaries and names shown and the designations used on the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Map disclaimer AEFI Adverse event following immunization MCV1 measles-mumps-rubella vaccine, first dose BCG Bacille Calmette-Guerin vaccine for tuberculosis MCV2 measles-mumps-rubella vaccine, second dose CRS congenital Rubella Syndrome MMR measles-mumps-rubella vaccine DT diptheria-tetanus-containing vaccine ND Data not available DTP diptheria-tetanus-pertussis-containing vaccine NITAG National Immunization Technical Advisory Group DTP1 diphtheria-tetanus-pertussis-containing vaccine, first dose NR Not relevant as vaccine not included in immunization schedule DTP3 diphtheria-tetanus-pertussis-containing vaccine, third dose OPV oral polio vaccine GNI Gross national income PCV pneumococcal conjugate vaccine HepB hepatitis B PCV3 pneumococcal conjugate vaccine , third dose HepB3 hepatitis B vaccine, third dose Pol3 polio-containing vaccine, third dose HepB-BD hepatitis B vaccine, birth dose RCV1 rubella-containing vaccine, first dose Hib Haemophilus influenzae type b Rotac rotavirus vaccine-complete series Hib3 Haemophilus influenzae type b vaccine, third dose Td tetanus-diphtheria-containing vaccine HPV human papillomavirus TT tetanus toxoid vaccine IPV inactivated polio vaccine W,M,Y Weeks, Months, Years MCV measles-containing vaccine No stockout Subnational level stockout only National level stockout only Stockout at both levels NR ND 2013 2014 2015 2016 2017 BCG NR NR NR NR NR DTP ND No No No No HepB ND No No No Both Hib ND No No No No Pneumo NR NR NR NR NR Rota NR NR NR NR NR OPV NR NR NR NR NR IPV ND No No No No Measles ND No No No No HPV * * * No No TT ND No No No Both ©World Health Organization 2019 Data sources a European Regional Commission for Certification of Poliomyelitis eradication (RCC) meeting report: www.euro.who.int/32ndRCC b European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thRVC c European Vaccine Action Plan 2015-2020 Midterm report d WHO/UNICEF Estimates of National Immunization Coverage (WUENIC): (http://www.who.int/immunization/monitoring_surveillance/data/en/) e WHO/UNICEF Joint Reporting Form on immunization (JRF) f World Population Prospects: The 2017 Revision, New York, United Nations g World Bank, World Development Indicators h Polio Laboratory Network: www.euro.who.int/poliolabnetwork & Personal communication based on annual accreditation process of the European Measles and Rubella Laboratory Network i Communication with the country