now active in four countries: Russian Federation, Georgia, Azerbaijan, and Armenia. As of November 2008, over 7.5 million children and health care workers had been vaccinated in these countries against such diseases as hepatitis B, measles, mumps and rubella. All programs are either fully self-sustaining or are in a transitional phase leading to self-sustainability.

In May 2006 the RVF marked the completion of a nationwide vaccination program in the Russian Federation against hepatitis B for adolescents, institutionalized orphans and at risk health workers. Over 1.8 million children and nearly 100,000 at-risk health care workers were vaccinated in an initiative that encompassed 22 regions from Kaliningrad bordering Poland in the farthest western corner of the country to Primorsky along the Pacific Ocean in the Russian Far East. Now the Russian Ministry of Health and Social Development is financing this important work with its own resources.

Today the RVF is continuing to update the national immunization calendar of the Russian Federation by introducing the vaccine against Haemophilus influenzae type b (Hib) for children < 2 years of age. Children in Western European countries and the U.S. are routinely vaccinated against Hib, which causes life threatening infections in children. More detailed information about Hib can be found on the WHO's website here.

In the Transcaucasus countries of Georgia, Azerbaijan, and Armenia, the RVF is supporting national immunization programs against measles, mumps and rubella as part of the strategy of the WHO to eliminate measles and prevent congenital rubella syndrome (CRS) throughout the European region. Routine children’s vaccination programs underway in Azerbaijan, Georgia, and Armenia will protect over 2 million children and adolescents.

In March 2006 the RVF, in cooperation with WHO, the United Nations Children's Fund (UNICEF), and the Ministry of Health of Azerbaijan, launched a mass immunization campaign against measles and rubella (MR) in Azerbaijan. By the end of the campaign in December 2006 nearly 2.5 million children and young adults had been vaccinated against MR, thereby greatly accelerating the elimination of measles and prevention of congenital rubella syndrome in the country. The routine vaccination of children against MMR is continuing with the support of both the RVF and the Azerbaijani MOH to ensure that the country remains free of measles and rubella. By 2009 the program will be financed 100% by the MOH.

A mass immunization campaign against measles and rubella was conducted in Armenia in October of 2007. During this campaign, a total of 924,000 individuals ages 6 – 27 years were vaccinated. As in the case of Azerbaijan, the major partners of the mass immunization campaign were the RVF, WHO, UNICEF and the Ministry of Health of Armenia.

A mass immunization campaign against measles and rubella is currently being conducted in Georgia. Over 1 million children and adults have been targeted for vaccination against measles and rubella.

The RVF vaccination initiative is made possible by funding from both the public and private sectors. Donors include the U.S. Department of Agriculture (USDA), the United States Agency for International Development (USAID), corporations such as BP, Total, and L’Oreal, The Teresa & H. John Heinz III Charitable Fund, The Bill and Melinda Gates Foundation, the government of Norway, as well as many individual donors..

The strategy of the children's vaccination initiative is to create mechanisms of sustainability by strengthening the existing health care infrastructure and avoiding the establishment of parallel structures. The RVF works with local health authorities to plan and implement every aspect of the vaccination programs. Each program includes a thorough assessment. Typically, refrigerators, thermal container, and safe injection supplies are provided in addition to vaccines to strengthen the vaccine delivery infrastructure (cold chain). All vaccines are administered by trained local health professionals.

The RVF partners with local pediatricians, epidemiologists, and nurses to promote public awareness of the need for immunization through educational programs in schools and clinics. Excellent vaccination coverage rates, which typically exceed 95%, attest to the popular support for this approach.

Monthly vaccination reports prepared by local health authorities, verification of individual vaccination records through regular site visits, and annual epidemiologic reports of disease incidence rates are the major elements of a monitoring system that has proven to be efficient and reliable.

In the case of Russia, the regions included in the children's vaccination initiative are selected in consultation with the MOH and are based on health indicators, size of population, and an assessment of local resources for vaccine coverage. Therefore, regions with sufficient local resources to provide adequate immunization coverage, such as the city of Moscow and the Moscow oblast, are not part of the initiative.

In the Trans-Caucasus countries (Azerbaijan, Georgia, and Armenia) the RVF works closely with the health ministry of each country to plan and implement nationwide programs.