Making EPI an 'Essential Program for Immunization' – Careers Ready

Reference

By the World Health Organization (WHO) in the year 2024 Expanded Program on Immunization (EPI) 50 years of its launch is being celebrated, it is known that this program was started in the year 1974.

Expanded Program on Immunization (EPI)

• Introduction: EPI was initiated in 1974, when the smallpox eradication program was underway and vaccination infrastructure and a trained workforce were needed to expand the available vaccines.
• India started EPI in the year 1974, which was renamed in the year 1985. universal vaccination program (Universal Immunization Programme- UIP) It has been done.

• Important Progress: There has been significant progress in vaccination and the effectiveness of vaccines globally and in India.
  • Vaccination rates have increased at the national and state levels in India over the past few years.
  • In 1974, vaccines were available to prevent six diseases, but Now vaccines against 13 diseases These vaccines are recommended universally and in certain circumstances for 17 additional diseases.
  • The 13 universally recommended vaccines include Bacillus Calmette-Guerin (BCG), diphtheria, pertussis, tetanus, Haemophilus influenzae type B (HiB), hepatitis Hepatitis B, Polio, Measles, Rubella, Pneumococcal Disease (PNC), Rotavirus, Human Papillomavirus (HPV) and COVID-19 (adults). For) is included.

Importance and achievements of the Expanded Program on Immunization

• DPT: The number of children taking three doses of DPT is increasing.
  • In the early 1970s, about 5% of children in low- and middle-income countries were given three doses of DPT, which is the highest worldwide. Increase to 84% in the year 2022 Has occurred.
• Elimination of diseases: Smallpox has been completely eradicated. Polio has been eradicated from all but two countries and many vaccine-preventable diseases have almost been eradicated.
• High Coverage: Since the introduction of EPI, studies have shown that vaccines have saved millions of lives.
  • Vaccination programs have been successful in almost all low- and middle-income countries, including India, and have reached more people than any other health program.
  • There has been a continuous increase in the area covered by vaccination in India and Year 76% children between 2019-21 Has been certified vaccination.
• cost effective: Based on economic analyses, it has been estimated that vaccines are highly cost-effective and ensure seven to eleven times the return on expenditure on vaccination programmes.
• Better use: In mixed health systems providing services from both the public and private sectors, vaccination generally proves to be more useful than in the government sector.
  • For example, the private sector accounts for about two-thirds of overall health services in India, although almost all vaccines are produced. 85% to 90% government facilities Is distributed by.
• Indicators: Generally, experts argue that vaccination coverage is an indicator of the highest level of healthcare coverage that can be ensured by government initiatives.

Vaccine development and background

• 1798: The first vaccine for smallpox was invented in the year 1798.
• Late nineties: 1880s to mid-1890s Rabies, Cholera and Typhoid The vaccine was developed primarily for adults.
• 1897: in the world plague development of the first vaccine against in India in the year 1897 happened.
• 1951: BCG vaccine (against tuberculosis) was first introduced as a nationwide campaign in the year 1951.
• 2023: By the end of 2023, India 'TB eradication' As part of the efforts, a primary initiative for adult BCG vaccination has been launched. COVID-19 vaccination of adult citizens has sensitized the public about the need and benefits of adult vaccination.
• Availability for all age groups
  • Vaccines have been available for individuals of all ages, including adults, since the year 1798.
  • plague vaccine Was available to people of all age groups.
  • to adult population BCG Was also vaccinated.
  • influenza vaccines Has always been applied to adults and children alike.
  • priority for children
    • Children are most vulnerable to vaccine-preventable diseases, so they have been prioritized for vaccination.
    • Additionally, until a few decades ago, the supply of vaccines was limited and governments lacked financial resources and trained human resources. For this reason, vaccines were targeted at reaching populations that needed them most, for example children.

growing challenges

• UNICEF Report: Published by UNICEF in early 2023 'The State of the World's Children' The report has revealed worryingly that in the last decade till now Decline in vaccination of children for the first time in the year 2021 Has come.
• Zero Dose: Projected globally in the year 2022 14.3 million children not given a single dose given (no recommended vaccine received), while another 6.2 million children have been partially vaccinated.
• Reason: There have been persistent disparities in access among people based on geography, socio-economic status and other parameters, which urgently needs to be addressed.

the way forward

• Policy and technical discussions: Some preliminary policy and technical discussions are necessary regarding access to vaccination for underserved populations.
• Expanding reach: The Government of India needs to consider making the recommended vaccines available to a wider section of the adult and elderly population.
  • The recent initiative on HPV vaccines for teenage girls is a good start.
  • The introduction of new vaccines into national programs leads to gains in access to existing vaccinations. It is therefore likely that expanding access to vaccines to adults and the elderly will improve vaccination of children.
• cost effective: Vaccines are generally cost-effective and are recommended by the National Technical Advisory Group on Immunization (NTAGI), following which vaccines should be made available free of cost by the government for all age groups.
• Vaccine Use Recommendations: Recommendations regarding the use of vaccines in India are made by NTAGI, which should issue separate vaccination guidelines for adults and the elderly.
  • A vaccine should be recommended at least once by a government body, so that the government can better ensure people have access to the vaccines and people have a positive attitude.
• Addressing vaccine hesitancy: Many times myths and misconceptions are spread regarding vaccines, which should be actively addressed.
  • Government to deal with rumors and myths Help of communication organizations Should be considered.
  • For this, citizens Learn and educate yourself about these vaccines from reliable sources There is also a need to do.
• Raising Awareness: Various associations in the medical field (community medical specialists, family physicians and pediatricians) should work to increase awareness about vaccines among adults and the elderly.
  • Doctors treating patients suffering from any disease should use this opportunity to make them aware about vaccines.
• Collection of evidence: Medical schools and research institutions should accumulate evidence on diseases occurring in the adult population in India.
• Focused Policies: Government policies need to focus on vaccination of adults and the elderly, as the process is effectively underway in many other countries.

conclusion

India's EPI has led to significant progress in the health sector and there is certainly a need for a national level review of the UIP in India, involving key stakeholders and international experts. The vaccination program will be rolled out with a focus on children with zero doses, addressing disparities in access to vaccines, and for adults and the elderly in India. At present, EPI should be made an 'essential program for vaccination'.