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EPI Techical Committee Meeting 18/10/2018

 
Purpose:
 
The EPI technical committee convened on the 18th of October 2018, at the Director General office at the MoPH.

The committee welcomed the new members who were added to the already existing experts list, based on the amendment 1/1877 to the EPI technical committee decree 1/124.

The meeting objective was to suggest a working plan for the newly formed committee and to discuss what was raised during last meeting regarding revisiting PCV introduction to the vaccination calendar. In addition the MoPH decision to provide all EPI vaccines to the private sector was highlighted. 
 
Proceedings:

Prof. Ammar welcomed the committee to this meeeting, reminding of the purpose of the EPI technical committee, and stressed that all the decisions taken are based on evidence and expertise of the members.

Dr.Bizri mentioned that the Lebanon report on the Polio Free Status has been accepted by the regional certification committee, with minor needed amendments. Thanking all members of the EPI committee, the MoPH team and Dr Randa Hamade for their instrumental input in achieving this status.

To initiate the discussion on the inclusion of the PCV vaccine in the National Immunization calendar a brief about the decision making process and the role of the committee were summarized by Dr Bizri. Based on the findings of three missions by the WHO and a visit by an international expert, MoPH was adviced to include the PCV in the national immunization calendar. The technical committee has advised the inclusion of PCV either type 10 or 13, since both cover the most common serotypes of pneumococcus circulating in Lebanon.

Supported by UNICEF pooled vaccine procurement process, Lebanon was able to purchase the more comprehensive vaccine (PCV13), hence it was chosen to be introduced to the calendar. All vaccines a procured by UNICEF through the pooled process by the UNICEF Copenhagen supply department.
 
The issue of cost benefit of the PCV 13 vaccine was raised by Dr.Adib, to make sure that the limited funds allocated for the Ministry of Health, are well allocated. According to Dr Adib to perform the cost benefit evaluation of the vaccine, pneumonia caused by pneumococcus should be included in the surveillance system. This has initiated a discussion of how to determine whether a pneumonia case was caused by pneumococcus, since no consensus was reached it was proposed to set a meeting for the technical committee to discuss this issue. In addition there is a need to have a clear evidence based procedure, to be followed before adding a new vaccine to the EPI calendar, including initiating surveillance for the disease.
 
Dr Ammar clarified that the procedure followed by the MoPH prior to introducing new vaccines, is to take the opinion of experts in the field and allocate the funds for introduction.
 
It was mentioned that there is an ongoing national study on the prevalent serotypes of pneumococci, performed by Dr. Dbaibo of AUB, it was suggested that he be invited to present his finding in the upcoming EPI technical committee meetings.
The committee was reminded that The MoPH in collaboration with the LPS has set in place a process that will allow pediatricians from the public sector to receive all the EPI vaccines, provided that they commit to abide by the regulations pertinent to the cold chain, vaccine administration free of charge, except for the consultation fee, and reporting on the names of the vaccinated children.
 
Dr Hamadeh announced that the MoPH is planning to launch a national media campaign on immunization starting with lighting the National Museum with the memorable Polio stamp, open day for universities, rally paper….etc.
The official launching will be held on November 27, 2018.
 
Recommendations:

The members of the committee agreed to set a follow up technical meeting to discuss on the way forward regarding PCV13 and what needs to be included in the surveillance.
Dr Mansour will compile all the WHO mission reports pertinent to the introduction of the PCV13 vaccine introduction and present them to the committee.
Dr Dbeibo to be invited to present his findings during the mentioned meeting.
All decisions by the technical committee meetings should be adopted and endorsed by all members, discussions initiated not to be shared with media or in outside discussions.
 
 
List of attendees:
 
Dr. Walid Ammar
Dr. Randa Hamadeh
Dr.Genevieve Begkoyian
Dr. Abdul Rahman Bizri
Dr.Salim Adib
Dr.Myrna Doumit
Dr.Assaad Kadhum
Dr.George Araj
Dr. Bassem Abou Merhi
Dr.Gaby Falakha
Dr.Bernard Gerbeka
Dr. Joseph Rachkidi
Dr. Ziad Mansour
Dr.David Amaneddine
Dr. Hannan Masri
Wafaa Kanaan
Rima Shayya
    ...
    142
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ATC Name B/G Ingredients Dosage Form Price
A07EC02 PENTASA XTEND B Mesalazine - 2g 2g Granules for suspension 8,550,789 L.L
C03CA01 LASIX B Furosemide - 500mg 500mg Tablet 1,454,038 L.L
D07XC04 TRAVOCORT B Diflucortolone valerate - 0.1%, Isoconazole nitrate - 1% Cream 435,405 L.L
J07BB01 VAXIGRIPTETRA, VACCIN GRIPPAL QUADRIVALENT (INACTIVE A VIRION FRAGMENTE) B Influenza vaccine virus (inactivated, split) - 15mcg/4strains/0.5ml Injectable suspension 970,254 L.L
L01EG02 AFINITOR B Everolimus - 5mg 5mg Tablet 142,948,873 L.L
N02AX02 TRAMAL B Tramadol HCl - 50mg 50mg Capsule 349,399 L.L
N03AX18 VIMPAT B Lacosamide - 100mg 100mg Tablet, film coated 7,835,296 L.L
A07EC02 ASACOL B Mesalazine - 500mg 500mg Suppository 1,703,992 L.L
A10BX02 NOVONORM B Repaglinide - 2mg 2mg Tablet 666,546 L.L
C03CA02 BURINEX B Bumetanide - 1mg 1mg Tablet 335,961 L.L
J07BB02 INFLUVAC B Grippal virus surface antigen 3strains - 15mcgx3strains/0.5ml Injectable suspension 573,821 L.L
N02AX02 TRAMAL 100MG B Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 243,235 L.L
A07EC02 SALOFALK 500 B Mesalazine - 500mg 500mg Suppository 677,297 L.L
C03CA02 BURINEX B Bumetanide - 5mg 5mg Tablet 1,054,916 L.L
J07BC01 ENGERIX-B 20 B Hepatitis B, purified antigen - 20mcg/ml 20mcg/ml Injectable suspension 1,652,926 L.L
M01AE03 PROFEMIGR B Ketoprofen - 150mg 150mg Tablet, scored 302,365 L.L
N03AX18 VIMPAT B Lacosamide - 150mg 150mg Tablet, film coated 11,754,896 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
A10BX02 NOVONORM B Repaglinide - 0.5mg 0.5mg Tablet 475,720 L.L
C03DA01 ALDACTONE B Spironolactone - 100mg 100mg Tablet 458,250 L.L
J07BC01 ENGERIX-B 10 B Hepatitis B, surface antigen - 10mcg/0.5ml 10mcg/0.5ml Injectable suspension 1,042,822 L.L
L01EG02 AFINITOR B Everolimus - 10mg 10mg Tablet 205,782,764 L.L
L03AX16 MOZOBIL B Plerixafor - 20mg/ml 20mg/ml Injectable solution 413,801,327 L.L
M01AE03 PROFENID B Ketoprofen - 100mg 100mg Tablet, film coated 469,001 L.L
N03AX18 VIMPAT B Lacosamide - 200mg 200mg Tablet, film coated 13,357,859 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
C03DA01 ALDACTONE B Spironolactone - 25mg 25mg Tablet 237,860 L.L
N06AB08 FAVERIN B Fluvoxamine maleate - 100mg 100mg Tablet, film-scored 1,291,433 L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Suppository 4,153,817 L.L
    ...
    142
    ...
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