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FIDEC in South Florida (United States)

 Americas’ Health Month. For the eighth consecutive year, from October to December 2021, FIDEC joined the activities of the Americas’ Health Month to raise awareness of the importance of vaccination. Educational talks were offered and printed materials were distributed in waiting rooms of Latin American consulates in Miami, including Argentina, Colombia, Guatemala, Mexico, and Peru. While points of hesitancy and misinformation were clarified, vaccine providers offered visitors the opportunity to get vaccinated on site against the flu and/or COVID-19. Furthermore, information about vaccines and current recommendations were shared on social media.

Visitors to the consulates of Argentina and Guatemala were informed about vaccines. Adults including the Colombian staff seized the opportunity to get immunized.

 Presentation “The importance of vaccination”. In February 2022, FIDEC was invited to participate in the Parent Teacher Student Association at Coral Reef High School virtual meeting to discuss the reasons why it is important to get vaccinated. After an introduction on the history of vaccines and the vaccine approval process, FIDEC emphasized the impact that vaccination has had on prevention and control of infectious diseases. Finally, FIDEC shared current vaccine recommendations for children and adults issued by the Advisory Committee on Immunization Practices.

 Miami-Dade Immunization Coalition. On March 31, 2022, after two years of virtual meetings due to the COVID-19 pandemic, Roxana Stamboulian, Executive Director of FIDEC, and Luján Soler, Physician and FIDEC Vaccination Program Director in the United States, coordinated and presented once again an in-person meeting of the Miami-Dade Immunization Coalition, which was relaunched in April 2019. The Foundation is a very active party, together with the Division of Infectious Diseases at the University of Miami and representatives of governmental and nongovernmental organizations. The aim is to increase vaccination rates in the community, in collaboration with the Miami-Dade Health Department.

Dr. Luján Soler, from FIDEC, lectured during the first in-person meeting of the Coalition since the pandemic. Roxana Stamboulian accompanied her (standing to the left).

 Membership in the National Network of Immunization Coalitions. In April 2022, the National Network of Immunization Coalitions introduced FIDEC and the Miami-Dade County Immunization Coalition on Network News and welcomed them as members of the Network. It is made up of over a hundred and forty organizations that promote vaccination in the U.S.

 Forum of Latin American Experts on Influenza 2022. Organized by FIDEC with the support of Seqirus, the Forum of Latin American Experts on Influenza 2022 took place in Miami on May 23-24. The goals were to exchange data and share experiences on influenza vaccination in Latin American countries in the context of the COVID-19 pandemic and in the post-pandemic era, to prepare a consensus document with recommendations on influenza vaccination, and to draw up regional strategies to increase vaccination rates in Latin America. Participating experts are members of FIDEC’s Working Group on Influenza and represent Argentina, Brazil, Colombia, Chile, the U.S., Guatemala, the Dominican Republic, and Uruguay (see Joint Effort to Prevent Influenza in the Americas).

Latin American experts on influenza after the meeting in Miami had concluded.

 Awareness Day Campaigns. Throughout the year, FIDEC joins national and international campaigns to help increase public awareness of infectious disease prevention. Between 2021 and 2022, various activities were held to support the World Pneumonia Day (November 12), the International HPV Awareness Day (March 4), the Vaccination Week in the Americas (April 20-25), and the World Hepatitis Day (July 28), among others.

 National Immunization Awareness Month. The national campaign to remind the community of the importance of vaccination takes place every August. It has become a priority as many children and adults have either not begun to receive or not completed the required vaccination schedules as a result of the pandemic. Therefore, the risk of reemergence of vaccine-preventable diseases has increased. In 2022, as in the previous campaigns, FIDEC shared educational materials in social networks. Among other messages, they stressed that it is essential to have kids vaccinated before school starts.

 Social Media Campaign to Support COVID-19 Vaccination. FIDEC continues to develop and share updated educational materials on COVID-19 vaccination. They aim to build up public trust in vaccines by answering common questions and debunking myths about vaccine safety and efficacy. Information about the boosters needed and the latest recommendations are also provided.

 Runway to Knowledge Fashion Show. FIDEC and Manos del Sur Foundation organized the 16th Annual Fashion Show and Breakfast “Runway to Knowledge”, which took place in Key Biscayne on September 22, 2022. The proceeds raised will be used to fund two ongoing programs carried out by Las Tunas, a non-profit organization founded in Buenos Aires in 2002. The first educational program gives students opportunities to learn about technology so as to improve their chances to access the job market. The second one invites them to take part in a youth orchestra for educational transformation.

Tickets to the charity fashion show were sold out.

FIDEC and FUNCEI in Latin America

 Newsletter on vaccines. Since October 2021, FUNCEI has been publishing Vacunas Ahora (Vaccines Now), a digital newsletter for healthcare professionals available by free email subscription. The documents are also available for download from FUNCEI informa sobre vacunas, the Foundation’s website dedicated to vaccines. The contents of the newsletter, which is sent every three months, and those on the website are complementary. Therefore, both formats are essential for anyone who seeks reliable, up-to-date data. The full spectrum of vaccine information is organized as follows: 

• Latest news on vaccines.
• Vaccine descriptions and vaccination schemes, sorted according to the life stage and situation when they are needed or recommended, and according to the disease they prevent.
• Useful resources for the general public, such as articles, videos, and audios.
• Resources for healthcare professionals, such as scientific articles, vaccination manuals, infographics, data sheets, and a schedule of conferences and other events.
• Vaccine communication resources. 
  

This program is carried out by FUNCEI and FIDEC's Vaccine Workgroup. The editors-in-chief of Vacunas Ahora are Hebe Vázquez, Vaccine and Infectious Disease specialist, and Ana Paula Cordero, science journalist specialized in Vaccine Communication.

 Virtual campus for healthcare professionals interested in vaccines. Also since October 2021, physicians, nurses, pharmacists, and other healthcare professionals may register for free to sign in the virtual campus at FUNCEI Informa sobre Vacunas. The opening activity was the First Course on Communication and Vaccines, ongoing since November. During 2022, FUNCEI has been working to expand the educational offer (see Better trained professionals to promote vaccines).

 First 1,000 Days of Nutrition for a Healthy Life. FIDEC and FUNCEI continue to step up this campaign in El Sauzalito, province of Chaco (Argentina). The goal is to improve nutrition at a key stage of human development, from conception to two years of age, as it opens a “window of opportunity” to promote the achievement of a person’s full potential throughout their life. Thanks to the support of all FIDEC’s contributors, in November 2021, FUNCEI’s medical team involved in the campaign, together with the doctors in charge of it, Micaela Sogga and Clara Villaverde, started the planned healthcare interventions, in collaboration with the director and staff of Dr. Arturo Illia Hospital. On that visit and in July 2022, FIDEC delivered supplies to the local Hospital to help take care of pregnant women and infants (see First 1,000 Days of Nutrition for a Healthy Life).

 Polio Eradication. The Global Polio Eradication Initiative (GPEI) was hit by the COVID-19 pandemic, but it is now regaining ground. One recent weapon in the arsenal is a new vaccine – the novel oral polio vaccine (nOPV2). It was developed in collaboration with global expert partners, such as FIDEC in Latin America. The Foundation has taken part in different polio eradication projects since 2012.

In November 2020, the nOPV2 received a recommendation for use under the World Health Organization’s Emergency Use Listing (EUL) procedure to have a rapid roll out. As of August 2022, approximately 450 million doses of nOPV2 were administered in 20 countries. The GPEI acknowledged that additional efforts are urgently needed to address viral circulation. For this reason, by the end of 2021 a study sponsored by FIDEC started in Dominican Republic to evaluate the safety and immunogenicity of nOPV2 when two doses are administered at different intervals to infants. While the road to eradication remains challenging, the threat of polio reemerging proves the need to continue striving to ensure a polio-free world. FIDEC is playing a crucial role to achieve this public health goal.

A baby receives the novel oral polio vaccine during the ongoing clinical study sponsored by FIDEC.

 Fighting Back against Dengue in the Province of Jujuy (Argentina). This project has been run uninterruptedly in Libertador General San Martín, San Pedro de Jujuy, and other locations since 2020, sponsored by Rotary Club International and FUNCEI. Members of the Foundation's medical team and Education Department collaborate with health authorities, healthcare personnel, educators, students, and families to strengthen disease prevention measures, especially, the elimination of the breeding grounds for the disease-causing mosquito, Aedes aegypti.

This work has been led by Jorge Grinpelc, President of the Rotary Foundation Buenos Aires, and coordinated by the local company Ledesma in Libertador General San Martín and by the Rotary Club Perlas in San Pedro de Jujuy. Educational activities and events complement the actions performed throughout the year by city governments, vector control teams, and the General Bureau of the Environment.

The first campaign ended in 2021. In December, Dr. Pablo Elmassian, infectious disease specialist at FUNCEI, delivered an online medical lecture for primary healthcare agents and other healthcare professionals to share updated data about dengue and guidelines on its prevention, control, and containment. He also informed about COVID-19. In addition, as part of the educational activities within the community, FUNCEI distributed information via print press, television, radio, and social networks, including the video “Cumbia del Mosquito” (Mosquitos’ Cumbia), which went viral and was highly appreciated among educators, students, and their families.

Children singing and dancing “Mosquitos’ Cumbia”.

Given the excellent reception of the first campaign and the drastic reduction of dengue cases in 2021 against previous years, the second stage was launched in 2022, aiming to consolidate the actions performed and to make the campaign sustainable, in collaboration with health and education authorities, since dengue cases reappear every four years. FUNCEI keeps offering virtual training and home and classroom education strategies and activities for educators, students, and their families.

School libraries received 1,500 copies of the book Contraataque al dengue. ¡Unite a la misión! (Fighting Back against Dengue: Join Our Mission!), published by FUNCEI and core learning tool of this educational campaign. Strategies are suggested to adapt contents to the different levels of elementary education. For instance, children are challenged to an innovative and fun experience as they became “Aedes detectives” to detect mosquito breeding grounds at home and in the surrounding areas, and to take the appropriate measures to remove or sanitize them. Some of these rural areas had dengue cases in 2022, so school participation in the campaign was highly appreciated.

FUNCEI’s team and the Rotary Foundation are convinced that these campaigns shall continue to result in a well-prepared, better assisted community, within this framework of joint, responsible efforts shared with regional educators and primary healthcare agents, with the coordination of Ledesma and Rotary Club Perlas.

 A Ciencia Cierta (TV Show). In January 2022, FUNCEI began broadcasting season 19 of their TV show, which has been continuously on air for almost two decades. With Dr. Daniel Stamboulian as host and Science Director, and Dr. María Teresa Rosanova as cohost and Medical Coordinator, the show is aimed at informing the community and increasing awareness of disease prevention and complications, and of other ways to promote health at each life stage. A positive attitude is encouraged to manage risk factors, prevent risky behaviors, and thus improve our daily life. Another goal is to collaborate with public and private institutions that produce educational material to the same end.

* At the request of the audience, due to topic relevance, or as decided by network/producer.

The show hosts discuss each topic with local and/or international specialists, addressing patients’ most common concerns. An interdisciplinary team also works daily to provide the community with the best healthcare information and recommendations to improve their quality of life. Moreover, there is a section for medical trivia, general interest topics, and Dr. Stamboulian’s usual reflections.

Since 2020, A Ciencia Cierta has been recorded at FUNCEI's studio.

The program airs on Wednesdays at 4:30 p. m. on METRO TV channel (#8 on Cablevisión and Flow, #511 on Telecentro, and #55 on Red Intercable, Argentine cable TV operators). Besides its own YouTube channel, with over 200 programs uploaded and over 200,000 total views, it has a strong presence on Facebook, Instagram, and Twitter, where it keeps getting new followers. Therefore, many important companies have joined broadcast sponsors.

 Stamboulian Talks. In March 2022, FUNCEI began broadcasting the fifth consecutive season of their series of free and interactive lectures to provide continuing education for physicians, pharmacists, biochemists, and nurses from Latin America. Specialists communicate interesting, valuable, or updated information from different specialties with clear, concise, and attractive presentations, followed by a question and answer session with the audience. After each presentation, videos are shared on the Multimedia section of FUNCEI’s website and on FUNCEI’s YouTube channel and social network accounts (see Fifth Series of Talks for Healthcare Professionals).

 A campaign to talk about vaccines. To commemorate the 20th anniversary of the Vaccination Week in the Americas, FUNCEI and FIDEC launched Hablemos sobre Vacunas (Let’s Talk about Vaccines), a campaign to promote vaccination throughout life. Since April 25, 2022, various materials were produced and shared on the Foundations’ websites and social networks to encourage healthcare professionals and the general public to discuss vaccine safety, effectiveness, and relevance.

Short messages about vaccines by FUNCEI specialists.

 Continuing Education Program on Healthcare for Pharmacists and Nurses. FUNCEI has been working for 10 years in partnership with the Argentinian company Farmacity to educate their personnel on infectious diseases, vaccines, and travel medicine. The Foundation teaches courses; organizes training sessions for pharmacists, nurses, and other healthcare professionals who work at drugstores; and advices the Office of Operations Management. They also provide printed and digital education material for professionals and patients, or act as advisors on Farmacity’s own material.

Between May and August 2022, FUNCEI held two online sessions for pharmacists and nurses on good vaccination and injection practices. A virtual course on travel medicine was also offered. To complement all three activities, documents with supporting information were produced and shared. In addition, FUNCEI sent a comprehensive newsletter on monkeypox. Another activity planned for 2022 is to summarize and update the emergency protocol for health offices in drugstore.

This program is carried out by doctor Daniel Stamboulian (President of FUNCEI), Roxana Stamboulian (Executive Director of FUNCEI), Ana Paula Cordero (Program Communications and Activity Coordinator), Pablo Elmassian (Scientific Advisor for the Office of Operations Management at Farmacity, author of the travel medicine course, and scientific reviewer of newsletters and materials), Liliana Moreno (Business Manager), and Carolina Savignano (secretary in charge of administrative tasks and follow-up).

 The Power of the Immune System and Vaccines. This is the second edition of this campaign, launched in 2021 by FUNCEI. Its aim is to raise awareness of the importance of self-care in educators, students, and their family members, and to motivate them towards healthy habits to prevent disease and strengthen the immune system. Special emphasis is placed on vaccination as an effective tool against infectious disease, so that children grow healthy and happy. 

Members of FUNCEI's medical team and Education Department train educators and have created print and digital learning material. In 2021, schools and other locations in the provinces of Jujuy and Buenos Aires, and in the City of Buenos Aires (CABA) strengthened their efforts and creativity to achieve their goals, in spite of the pandemic. As COVID-19, in addition to misinformation and increasing vaccine hesitancy, contributed to falling child vaccination rates in the country and the world, FUNCEI launched the second edition of the campaign in CABA in 2022. It was declared of educational interest by the General Bureau of Child and Teen Development (Ministry of Human Development and Habitat) of the City of Buenos Aires. It is sponsored by Pfizer (see Experimentation, creation, and play to improve self-care and grow happy).

Educators, school and preschool students, and teenagers with their educational material at the start of the 2022 campaign in the city of Buenos Aires.

 FUNCEI and FIDEC Epidemiology Newsletter. In August 2022, the Foundations released issue number 120 of this free, digital publication for healthcare professionals, which they edit since 2010. It is monthly emailed to approximately 16,000 subscribers in Latin America, the U.S., and other countries. It can also be downloaded from FIDEC and FUNCEI’s websites. With Dr. Daniel Stamboulian as Director, this project is led by Dr. Lilián Testón (writer and coordinator) and Soledad Llarrull (copy editor). It is sponsored by Pfizer.

 Salesforce Training Program for Young People. This training program was created by Guayerd Academy, in collaboration with FIDEC, FUNCEI, Las Tunas, and Manos del Sur. Scholarships are awarded to high school graduates or seniors with potential to thrive in computing. Since August 2022, young people from Argentina, Colombia, Paraguay, Bolivia, and Uruguay have been learning programming with the most used coding languages in the world and how to develop sites, applications, and solutions in Salesforce. This is the platform companies choose to relate with their leading clients worldwide. Such education in digital disciplines will increase the chances of young people to access quality jobs.

 Educational video about hand washing. “¡Invisibles pero no invencibles!” (Invisibles buy Not Invincibles!) is another learning tool created by FUNCEI’s Educational Department so that children discover microscopic travelers in dirty hands – germs. Through a microscope lens, they will learn these intruders’ names and the diseases they cause. Azul, the video protagonist, will then show viewers the most simple but effective strategy to protect oneself against germs. The video is available on YouTube and is a complement to the contents of the book Los defensores de nuestra salud. El sistema inmunológico (Bodyguards of our Health. The Immune System), which was edited by FUNCEI’s Educational Department and is the core material of the educational campaign entitled El Poder del Sistema Inmunológico y las Vacunas (The Power of the Immune System and Vaccines).

 Online Healthcare Services. Servicios de Salud Online is a portal available for healthcare professionals and patients who wish to request a second opinion on frequent medical conditions across multiple branches of medicine. It has been specifically designed for people that live in remote areas, with limited access to specialists. Therefore, services are provided online, and users do not need to visit a medical center.

They may consult about diagnosis or treatment of diseases in children, teenagers, or adults. A form will guide them to describe the situation as precisely as possible, and they will also be asked to attach a medical report or diagnostic imaging, such as X-rays, CT scans, and lab test results, to help the medical staff better assess the case.

If the team of professionals determines that a second opinion will help solve the condition or improve health, they will get in touch with the participant to obtain more information, if needed, or they will refer the participant to a doctor by phone or via email for a second opinion about their case. Patients will get an answer within 10 days of the form's acceptance. The second opinion final report will be delivered in writing. As a separate service, patients can later arrange an appointment with the same specialist for an in-person examination.

Dr. Daniel Stamboulian and Dr. César Gnocchi act as general coordinators of this program. Tulio De Rose and Dr. Débora Greco are Administrative Coordinator and Medical Coordinator, respectively. Healthcare professionals and personnel of FUNCEI are members of the medical and administrative staff.

FIDEC in Armenia

 Occupational Health Program aimed at employees of Tierras de Armenia, Converse Bank, and Zvartnots International Airport. Since 2008, FIDEC Armenia operates an occupational health program in the wine-producing company Tierras de Armenia, based in the province of Armavir. This program provides rural workers with on-site first aid and free medical services, such as preemployment assessments and regular checkups from then on. Acute medical conditions and chronic diseases are treated attending to each person's needs. In addition, educational activities are done to promote a healthy lifestyle. For these purposes, an in-house nurse works full-time at Tierras de Armenia, and a physician coordinates the program. A network of outpatient clinics and specialty medical centers in Armavir and Yerevan has also been established to refer employees who need diagnostic tests or medium-to-high complexity treatments or operations.

In April 2020, FIDEC Armenia expanded the scope of this successful program to start holding consultations with two other Argentine-Armenian companies: Converse Bank and Zvartnots International Airport. The Foundation has assisted all three companies in designing evidence-based measures to prevent the spread of COVID-19 and overseeing their implementation. Between 2021 and 2022, FIDEC Armenia helped organize a series of events, both online and in-person, to inform the employees about specifics of COVID-19, to raise awareness on the benefits of the available vaccines, and to answer questions about their potential risks. Moreover, FIDEC Armenia, in collaboration with the Armenian Ministry of Health and the National Center for Disease Control and Prevention, set up mobile vaccination sites in Tierras de Armenia and Converse Bank. The Foundation also had consultations with the Zvartnots International Airport for selecting an insurance company that offers the optimal coverage and medical services for the employees.

Q&A session and vaccination of employees at Tierras de Armenia.

 Human Papillomavirus (HPV) Program. As of 2019, FIDEC Armenia has been working to promote vaccination against HPV, in collaboration with the Ministry of Health of Armenia, the National Immunization Program (NIP), and the National Center for Disease Control and Prevention. Communicating reliable evidence-based information became an urgent need after the vaccine was introduced in Armenia in 2018 because anti-vaccine groups managed to misinform healthcare professionals and the community via social networks and created unfounded fears and doubts. As a consequence, Armenia became the country with the lowest vaccination rates, although the vaccine is available free of charge for all teenage girls of 13 years of age. To help revert this alarming situation, FIDEC Armenia led and funded educational and awareness-raising activities aimed at healthcare professionals and the community using social networks, mass media, and indoor and outdoor posters and banners.

 COVID-19 Risk Communication Working Group. In 2021, FIDEC Armenia continued to assist the Ministry of Health and the National Center for Disease Control and Prevention by having consultations regarding the COVID-19 pandemic and sharing the experience gathered in Latin American countries. It was also a member of the COVID-19 Risk Communication Working Group, together with the aforementioned organizations, the National Institute of Health, the American University of Armenia, WHO Armenia, the United Nations Development Programme, UNICEF Armenia, and prominent physicians from the Armenian diaspora.

The working group held weekly teleconferences to discuss the situation and to coordinate the members’ educational and communication activities to manage the pandemic. Measures to encourage vaccine acceptance in the community were implemented as well. To train healthcare professionals in charge of vaccination, FIDEC Armenia produced videos and flyers explaining how to store vaccines and how to recognize symptoms and manage potential severe allergic reactions. The foundation also designed and printed posters and large banners to be displayed in public spaces and outdoor vaccination sites (shopping malls, public transportation, pharmacies, supermarkets, parks, and other high-traffic locations). The messages focused on who could get vaccinated and where and how to do it. Visually appealing reminders on effectiveness and safety of the vaccines were also featured.

Flyers with instructions for healthcare professionals on how to recognize and manage anaphylaxis, and banners displayed in public spaces to promote vaccination against COVID-19.

 Shirak Health Pilot Project. In July 2022, FIDEC Armenia launched a comprehensive healthcare initiative in the province of Shirak, with the financial support of the Armenian diaspora in Argentina. The main goal is to provide the low-income rural population with free medical services to diagnose and treat the most prevalent health conditions in that area. The main target beneficiaries are men and women aged 40-75 years in two communities: Horom and Pemzashen. In addition, a project component is aimed at the younger population to educate men and women on family planning practices and to decrease the prevalence of sexually transmitted diseases associated with high rates of labor migration. Finally, intestinal worm infections (helminthiasis) are being diagnosed and treated in 1,300 children aged 3-10 years who live in the same communities. Based on the outcomes of this 5-month pilot experience, FIDEC Armenia will design a program tailored to specific needs to enhance its impact (see Another Step towards a Better Life in Shirak).

Dr. Daniel Stamboulian and Dr. Pablo Elmassian, from FIDEC, visited Armenia to launch the project.

Epidemiological Study to Determine the Prevalence of HPV infection in Armenia. In August 2022, FIDEC Armenia completed the first epidemiological study to assess the prevalence of HPV infection in Armenian women, which began in 2019. It comprised three stages:

• HPV detection in urine samples from women aged 17-20 years.
• Testing for specific HPV types (genotyping) in cervical samples preserved at National Center of Oncology named after V. A. Fanarjyan.
• Assessment of prevalence of HPV infection by studying cervical cells of women aged 21-39 years.
  

The study outcomes will help Armenian public health officials make decisions and design policies based on locally acquired data to improve infection control.

Procedures during the last stage of the Epidemiological Study to Determine the Prevalence of HPV infections.

This research project was set up through an agreement with the International Agency for Research on Cancer (IARC; a specialized agency of the World Health Organization, WHO) and the Bill & Melinda Gates Foundation. The field study in Armenia has been led by Dr. Iacopo Baussano (IARC/WHO) and coordinated by FIDEC Armenia, in partnership with FIDEC (USA), Vaccinet, the National Center for Disease Control and Prevention, the Armenian Ministry of Health, and 12 local health facilities in Yerevan and in the provinces of Armavir, Kotayk, and Tavush. The IARC/WHO acknowledged that the field study was a benchmark, given the exemplary quality of execution resulting from the great team and highly collaborative partners.

Video featuring the HPV study in Armenia and displayed on the International Agency for Research on Cancer’s web site.

 Fun Fitness for All. During 2022, FIDEC Armenia has been developing this new project, which aims to install outdoor fitness stations to promote a healthy lifestyle among young people and adults in Armenia, and thus improve their quality of life. At present, public places for physical activity are scarce, especially, in rural areas. The stations will be strategically placed in all major parks and recreational areas, as well as near cultural centers, youth centers, and community libraries. Priority sites are cities and villages in the provinces of Syunik, Tavush, Gegharkunik, Shirak, and Vayots Dzor.

The program will include official opening events in partnership with government sport authorities and regional municipalities, educational activities to promote equipment use and to highlight the benefits of each type of exercise, and the organization of Community Fitness Days that engage local influencers and celebrities, as well as professional and aspiring trainers from the diaspora to promote an active life and a healthy diet.

 Combating Vaccine Hesitancy in Armenia 2023-2028. Vaccine hesitancy is defined as the delay in acceptance or refusal of vaccines despite availability of vaccination services. The goal of this comprehensive program, which is also in its development stage and aimed at the community and healthcare professionals, will be to increase trust in vaccines as an effective tool to prevent infectious diseases and to increase the demand for new and existing vaccines.