Expanded programme on immunization

Overview

Immunizations today save more than three million lives a year. However, millions of children still do not have access to basic immunization and die from diseases that can be prevented by available vaccines.

WHO in the Western Pacific Region assists countries immunize all children and eligible adults with appropriate vaccines. The Region has had several immunization successes in the last decade—certification of poliomyelitis-free status in 2000, reduction of measles deaths by 95% (compared to the pre-vaccine era), integration of hepatitis B vaccine in routine immunization programmes of all countries, and elimination of neonatal tetanus as a public health problem in all but six countries.

Most countries in the Region have been able to maintain high routine immunization coverage. Of all districts in the Region, 88% reported more than 80% DPT3 coverage and 84% reported more than 90% coverage with the first dose of measles vaccine in 2003. In addition, many countries have expanded their immunization programmes by introducing new vaccines.

The Expanded Programme on Immunization (EPI) was established in the early 1980s in 20 Pacific island countries (PICs).  EPI focuses on seven vaccine preventable diseases including diphtheria, tetanus, pertussis (Whooping cough), poliomyelitis, TB, measles and hepatitis B in all countries while other life-saving vaccines including those against rubella and Haemophilus influenzae type B (Hib) have been integrated into the national Immunization Programmes in some PICs.  Through EPI, over 3,000 child deaths are averted annually and more children can be saved through improving current routine immunization coverage and introducing new life-saving vaccines in the future.  Furthermore by immunizing pregnant women and women of childbearing age many women have been saved from maternal tetanus in addition to the benefit of protecting newborn infants from neonatal tetanus. 

The National Immunization Programmes (NIPs) in the 20 Pacific island countries  (PICs) have achieved many successes in the past two decades:

  • All countries and areas have remained "poliomyelitis-free" after certification in 2000, 
  • Indigenous measles virus transmission has likely been interrupted in 20 PICs, chronic hepatitis B infection rates among children have been reduced substantially, 
  • Incidents of other vaccine preventable diseases such as diphtheria, tetanus, pertussis have been dramatically reduced even hardly to see,
  • And new or underutilized vaccines have been introduced into the national immunization programmes in an increasing number of PICs.

On the other hand, some Pacific island nations have been facing challenges in sustaining previous gains or realizing the full potential offered by the development of the global immunization programme. In recent years, routine immunization coverage levels have decreased in some countries resulting in measles outbreaks following importation of the virus. In addition, some countries have been facing challenges in introducing new or underutilized vaccines due to some key factors such as financial constrains and/or lack of adequate advocacy targeting the decision-makers.

WHO in the South Pacific assists 20 Pacific Island countries and areas in continually strengthening national routine immunization services, not only to sustain the past successes from the traditional EPI vaccines, but also to expand the contribution of the Expanded Programme on Immunization (EPI) to further improve child survival and maternal health, increase its contributions to  Millennium Development Goals (MDG) No. 4 and 5 to reduce child mortality and improve maternal health.


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