Routine immunization profile: Andorra

*Second dose +6M Routine immunization profile Andorra 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 districts*e Yes Yes ND 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 No YesRubella elimination status b Eliminated 3 Control hepatitis B infectionc Validation pending 6 Achieve financial sustainability of the national immunization programme***c Yes *Only one administrative level in the country **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 76 965 Live births 663 Surviving infants 626 <5 years 3349 <15 years 11 304 Neonatal mortality rate (per 1000 live births)f 1.4 Infant mortality rate (per 1000 live births)f 3.2 Number of districtse 0 GNI (per capita, in USD)g ND Health spending as % of total government expenditureg 19 Immunization schedule, 2017e Birth HepB_Pediatric 2M DTaPHibHepBIPV, MenB 3M PCV 4M DTaPHibHepBIPV, MenB, MenC_conj 5M PCV 12M DTaPHibHepBIPV, MMR 13M MenB, PCV 15M MenC_conj, Varicella 3Y MMR, Varicella 5Y TdaPIPV 12Y HPV*, MernC_conj 15Y TdaPIPV Routine immunization profile Andorra Vaccine coverage estimates, 2013-2017d Number of reported cases of vaccine- preventable diseases, 2013-2017e,i 2013 2014 2015 2016 2017 Measles 0 0 0 0 0 Mumps 2 3 3 7 5 Rubella 0 0 0 0 0 Congenital rubella syndrome 0 0 0 0 0 Diphtheria 0 0 0 0 0 Tetanus 0 0 0 0 0 Pertussis 6 1 22 6 0 Hepatitis A 0 0 2 2 2 Varicella 196 323 93 198 101 ND NR50 0100 Number of reported measles, mumps and rubella casese and MCV coverage estimatesd, 2013-2017 Number of reported diphtheria, tetanus and pertussis casese and DTP3 coverage estimatesd, 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 ND Vaccine hesitancy assessment performed within last 5 years e ND Mandatory proof of immunization at school entrye,i 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 2013 2014 2015 2016 2017 BCG NR NR NR NR NR HepB-BD 96 94 94 94 94 DTP1 98 99 99 99 99 DTP3 96 97 97 98 99 HepB3 94 96 94 94 98 Hib3 96 97 97 98 99 Pol3 97 97 97 98 99 PCV3 ND 93 92 92 98 Rotac NR NR NR NR NR RCV1 95 96 96 97 99 MCV1 95 96 96 97 99 MCV2 91 90 88 90 94 0 20 40 60 80 100 0 1 2 3 4 5 6 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 2 4 6 8 10 12 14 16 18 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 Routine immunization profile Andorra DTP1-DTP3 dropout rate, 2013-2017d Note: Dropout rate is calculated using WUENIC Vaccine stockouts by administrative levele, 2013-2017 *Data on HPV stockouts have only been collected in JRF since 2016 No stockout Subnational level stockout only National level stockout only Stockout at both levels NR ND 2013 2014 2015 2016 2017 BCG ND No No No No DTP No No No No No HepB No No No No No Hib No No No No No Pneumo No No No No No Rota No No No No No OPV NR NR NR NR NR IPV No No No No No Measles No No No No No HPV * * * No No TT No No No No No Abbreviations 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 Surveillance with laboratory confirmation of cases, 2017e Measles Yes Rubella Yes Congenital rubella syndrome Yes Rotavirus No Invasive meningococcal disease Yes Invasive pneumococcal disease Yes Invasive Haemophilus influenzae disease No 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. 2 2 2 1 0 0 1 2 3 4 5 2013 2014 2015 2016 2017 DTP1-DTP3 dropout rate (%) Ye ar Routine immunization profile Andorra 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 † 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. 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