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Tetanus and Diphtheria containing Vaccines

UNICEF SUPPLY DIVISION

2018 Vaccine Industry Consultation

OUTLINE

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OUTLINE

Historical Demand through UNICEF

Program Recommendation

TTCV tender

TTCV Vaccines TT to Td replacement

3Sources: UNICEF Supply Division

In 1998 WHO recommended that the

use of Tetanus Toxoid (TT) vaccine

should be replaced with Tetanus-

Diphtheria (Td) to boost protection

against diphtheria

UNICEF issued a program instruction

in 2011, and recommendation was re-

stated by SAGE and WHO Diphtheria

position papers.

28 countries procuring vaccines

through UNICEF still use TT in

their routine immunization

program

Global updates: Replacing TT with Td

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Why is TT/Td replacement required?

➢ In 1998 WHO recommended that the use of tetanus toxoid (TT) vaccine should be replaced

with tetanus-diphtheria (Td) vaccine to boost protection against diphtheria

➢ This recommendation was re-stated in 2002 and 2006

➢ There is evidence of waning immunity to diphtheria following the primary series

➢ Diphtheria outbreaks are occurring in several countries (Bangladesh, Haiti, Kenya, Indonesia,

South Africa, Pakistan, Venezuela and Yemen) due to a mix of low vaccination coverage and

waning immunity

➢ Sub-standard surveillance of diphtheria – giving countries false assumption that it is not an

issue

➢ No changes on program strategy, implementation, nor delivery between TT and Td

➢ Ample supply availability

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TTCV Vaccines UNICEF TTCV Tender: 2019-2021

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Main programmatic shift:

In support of implementation of SAGE recommendation for use of Td vaccine in routine

immunization programmes:

➢ As of January 2019 – UNICEF will no longer fund TT vaccine

➢ As of January 2020 – UNICEF will no longer supply TT vaccine

UNICEF will continue to support Td vaccine, in support of maternal immunization

programme.

Tender Objectives:➢ To ensure availability of both TT to Td vaccines during programmatic transitions➢ To maintain the health of TT/Td market ➢ To maintain affordable prices

Award strategy:2019: Full awards will be made, as per quantities indicated in the tender2020 and 2021: Up to 25% of the total demand will be left unawarded. Unawarded quantities will be finalized by Q3 2019, when more visibility on demand and program transition is obtained.

Status: Closed. Offers received and under evaluation

Communications to countries and partners

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WHO and UNICEF have developed the following

materials to facilitate communications with

countries on the replacement of TT with Td.

• WHO/UNICEF Joint Communique

• WHO/UNICEF Guidance Note

• Frequently Asked Questions and Answers

These documents can be found online:

http://www.who.int/immunization/diseases/tetanus/en/

http://www.who.int/immunization/diseases/MNTE_initiative/en/

https://www.unicef.org/health/index_43509.html

Current Status: work in progress!

➢ 133 out of 194 countries have made the replacement.

➢ 10 countries are in the replacement process from 2018 to 2019

➢ 51 countries are yet to initiate the replacement process, 28 of which procure through

UNICEF

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