Expanded Program on Immunization: Ensuring that all children benefit from life-saving vaccines

Fifty years ago, the World Health Organization (WHO) launched the Expanded Program on Immunization (EPI) “to ensure that all children in all countries, benefited from life-saving vaccines.”

“Today every country in the world has a national immunization program and vaccines are viewed as one of the safest, most cost-effective, and successful public health interventions to prevent deaths and improve lives,” WHO said.

As a cornerstone of public health, vaccines prevent the spread of deadly diseases, saving countless lives. We are not too far away from the pandemic to forget how the Covid vaccine saved many lives and led to the reopening of economies around the world.

The EPI started by focusing on protecting all children against six childhood illnesses, including tuberculosis, diphtheria, tetanus, pertussis, polio, and measles, and today “this has grown to 13 universally recommended vaccines across the life course, and 17 additional vaccines with context dependent recommendations.”

EPI’S 50th anniversary stands on key milestones, the most significant of which is the eradication of smallpox in 1980. Another milestone is reducing polio “by more than 99 percent.”

Still another milestone is global childhood immunization levels which reached 80 percent in the early 1990s, the result of governments and partners cooperating in moving what WHO calls the “greatest logistical mobilization in peacetime history” to immunize every child against preventable diseases.

“This year World Immunization Week (April 24 to 30) will celebrate 50 years of the EPI (now called the Essential Program on Immunization) – recognizing our collective efforts to save and improve countless lives from vaccine-preventable diseases and calling on countries to ramp up investments in immunization programs to protect the next generations.”

In the Philippines today, the Department of Health (DOH) is actively implementing immunization programs, especially with the recent increase in measles and pertussis cases.

Early this month (from April 1 to 12), a major immunization drive started to reach over 1.3 million children in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM). The program was in response to the surge in measles cases with 77 per cent of the confirmed cases in the country reported from this region. The region had officially reported 592 cases of measles from January 1 to March 20 although it is believed that the total number could be higher because of unreported cases.

DOH data from Jan. 1 to March 30, 2024 shows a total of 1,112 cases of pertussis, (almost 34 times that of the same period last year, at only 32 cases), with 54 deaths recorded.

There are many reasons for the delay in having children immunized. The Covid-19 pandemic lockdowns had delayed routine vaccination and caused the rise in measles and pertussis cases in many countries, the WHO regional office in the Western Pacific (WPRO) said.

Another reason was traced to vaccine hesitancy. Manila Bulletin columnist Dr. Raymundo Lo, quoting The Vaccine Confidence Project, said: “There has been a marked decline in vaccine acceptance in the Philippines from a high of 93 percent acceptance in 2015 to a low of 32 percent in 2018” which traced this to the Dengvaxia controversy.

Secretary Teodoro Herbosa said the DOH aims to vaccinate at least 90 percent of the high-risk population, especially children from six months to 10 years of age, to control measles.

The DOH reminded the public to get the free pentavalent Diphtheria, Pertussis and Tetanus, Hepatitis B, and Haemophilus influenza type B (DPT-HEPB-HIB) and Measles, Mumps and Rubella (MMR) vaccines at local health centers.

No child should die of a disease that can be prevented by a vaccine.