Routine immunization profile: Bosnia and Herzegovina

*Only in the Republic of Srpska Routine immunization profile Bosnia and Herzegovina Progress towards achieving European Vaccine Action Plan goals, 2017 Goal Indicator Status Goal Indicator Status 1 Sustain polio-free status a (Current risk) Yes (High) 4 Meets vaccination coverage targets DTP3 national immunization coverage ≥95%d ≥90% DTP3 coverage achieved in ≥90% of districtse No No No 2 Measles elimination statusb Endemic 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 Endemic 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 3 507 017 Live births 32 478 Surviving infants 32 271 <5 years 155 330 <15 years 495 521 Neonatal mortality rate (per 1000 live births)f 4 Infant mortality rate (per 1000 live births)f 4.9 Number of districtse 18 GNI (per capita, in USD)g 4910 Health spending as % of total government expenditureg 15 Immunization schedule, 2017e Birth BCG, HepB_Pediatric 1M HepB_Pediatric 2M DTaPHibIPV1 3M *DTaPHibIPV 4M DTaPHibIPV 10M HepB_Pediatric, DTaPHibIPV 12M MMR 18M DTaPHibIPV* 2Y OPV 5Y DTaPIPV 6Y MMR, OPV*, DT* 14Y OPV, Td 18Y TT Routine immunization profile Bosnia and Herzegovina Vaccine coverage estimates, 2013-2017d Number of reported cases of vaccine- preventable diseases, 2013-2017e 2013* 2014 2015 2016 2017 Measles 3000 1677 133 18 Mumps ND 56 170 113 Rubella ND 8 16 4 Congenital rubella syndrome ND ND 0 0 Diphtheria ND ND 0 0 Tetanus ND 0 0 0 Pertussis ND 12 20 122 Hepatitis A ND 8 3 4 Varicella ND 6366 14 582 8882 DTP3 reported coverage by subnational area†, 2017e MCV2 reported coverage by subnational area†, 2017eMCV1 reported coverage by subnational area†, 2017e *No JRF submitted Surveillance with laboratory confirmation of cases, 2017e Measles Yes Rubella Yes Congenital rubella syndrome Yes Rotavirus No Invasive meningococcal disease No Invasive pneumococcal disease No 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. ≥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 97 98 95 97 97 HepB-BD ND ND ND ND ND DTP1 94 92 89 90 92 DTP3 89 86 82 78 75 HepB3 91 89 82 78 77 Hib3 93 79 78 69 68 Pol3 87 86 74 79 75 PCV3 NR NR NR NR NR Rotac NR NR NR NR NR RCV1 92 89 83 68 69 MCV1 92 89 83 68 69 MCV2 93 92 88 78 80 Routine immunization profile Bosnia and Herzegovina Number of reported measles, mumps and rubella casese and MCV coverage estimatesd, 2013-2017 DTP1-DTP3 dropout rate, 2013-2017d *No JRF submitted Note: Dropout rate is calculated using WUENIC Reported target population, reported number of DTP3 doses administered and DTP3 reported coveragee, 2013-2017 *No JRF submitted *No JRF submitted Number of reported diphtheria, tetanus and pertussis casese and DTP3 coverage estimatesd, 2013-2017 Percentage of districts by DTP3 reported coveragee, 2013-2017 *No JRF submitted Immunization system characteristics, 2017 Sustained access to WHO accredited polio, measles, and rubella laboratoriesh Yes NITAG in place that meets six WHO criteriae Yes* National system in place to monitor AEFIse Yes Communication plan in place to respond to vaccine safety-related eventse Yes Vaccine hesitancy assessment performed within last 5 years e No Mandatory proof of immunization at school entrye Yes *Republic of Srpska meets 5 criteria 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 0 500 1000 1500 2000 2500 3000 3500 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 20 40 60 80 100 120 140 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 5000 10000 15000 20000 25000 30000 35000 40000 2013* 2014 2015 2016 2017 % c o ve ra ge N u m b er Year DTP3 reported population DTP3 reported doses DTP3 reported coverage 24 24 18 28 41 47 41 28 35 29 41 39 6 0 20 40 60 80 100 2013* 2014 2015 2016 2017 Percentage of subnational areas Ye ar ≥90% 80-89% 50-79% <50% ND 5 7 8 13 18 0 5 10 15 20 2013 2014 2015 2016 2017 DTP1-DTP3 dropout rate (%) Ye ar Routine immunization profile Bosnia and Herzegovina Vaccine stockouts by administrative levele, 2013-2017 Abbreviations Data sources *Data on HPV stockouts have only been collected in JRF since 2016 **No JRF submitted 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 † 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 No No No Both DTP Both No No Both HepB Both No National No Hib Both No No Both Pneumo NR NR NR NR Rota NR NR NR NR OPV Both Both Both Both IPV Subnational ND No Both Measles No No No No HPV * * * NR NR TT No No Both No ©World Health Organization 2019