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WHO
Collaborative Programme
Other
vaccinations
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Situation Analysis:
Routine immunization activities are sustained with high coverage rates. In 1998, the coverage rates among children under one year of age were 93% for DPT3/OPV3, and 88% for measles.
Since January 1997, MMR vaccine has replaced the second dose of measles. In 1998, Hepatitis B vaccine was included in the EPI (BCG and TT vaccines are not included among the EPI vaccines). After the national measles/rubella campaign, the National Immunization Calendar has been updated as follows: The first dose of MMR vaccine has been changed to the first year of life, and the second for the 4-5 years of age while the 9th month dose of measles has been canceled.
The official national agenda for Immunization includes:
- OPV, DPT (3 primary doses, two boosters)
- Act Hib (3 primary doses, one booster, 1 and 4-5 years)
- MMR (one primary dose, one booster)
- Hepatitis B (3 doses at: birth , one month and 4 months)
- DT (one booster at 10-12 years)
The private sector is also immunizing, on elective basis, against Varicella, TB, Typhoid and Hepatitis A.
It is important to note that MOH is planning to introduce the hepatitis B vaccine by the end of 2002.
A considerable proportion of immunizations is made by the private sector (50%), however, these immunizations are not reported to the MOH and coverage surveys are the only reliable sources for estimation of coverage. These surveys are expensive and emphasizing proper reporting by the private sector is required. The occurrence of the EPI target diseases is currently very low and the surveillance system is fairly sensitive; however, there is still a room for further improvement as the private sector, which is very active, is not reporting properly.
The most important in the biennium 2002-2003 for WHO is to support improvement of the levels of routine vaccination and maintain the improvement, aiming ultimately at stopping the immunization days and campaigns.
In the past biennium, efforts were made to update the national guide for the EPI programme, and observation of side effects of the vaccines . More efforts need to be deployed in this area.
Objective:
Achieve and maintain over 90% routine immunization coverage against diphtheria, pertussis, tetanus, poliomyelitis, measles and hepatitis among children under one year of age.
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