About the immunization programme
Immunization is one of the most successful and cost-effective health interventions and prevents between two and three million deaths every year globally. Immunization protects against diseases such as diphtheria, measles, pertussis (whooping cough), pneumonia, polio, rotavirus diarrhoea, rubella and tetanus. The benefits of immunization are increasingly being extended from infants to children, adolescents, adults, and older adults providing protection against life-threatening diseases such as influenza, meningitis, and cancer (cervical and liver).
Facts and figures - Vaccine
- Prevents illness, disability and death from vaccine-preventable diseases.
- Have the power not only to save but also to transform lives, giving children a chance to grow up healthy, go to school and improve their life prospects.
- Can protect populations from disease during outbreaks, including after natural disasters.
- Benefits are much greater than the minimal risks. Most side-effects are minor and temporary.
Facts and figures - Programme
- The Region has been maintaining a polio-free status since the year 2000. The 19th meeting of the Regional Certification Commission of Poliomyelitis Eradication in the Western Pacific held in November 2013 concluded that the Region retains its polio-free status.
- Eighty percent reduction in measles cases from 2008 to 2013 and 49% from 2009 to 2013. In 2012, measles incidence reached a historic low, decreasing by 83% from 34.0 (in 2009) to 5.9 cases per million populations. Thirty-four out of 37 countries and areas in the region are likely to have interrupted transmission of indigenous measles virus.
- Rubella control has been accelerated in the Region, through synergizing measles- and rubella-related immunization and surveillance activities. In 2012 and 2013, at least two countries in the Region have experienced large outbreaks resulting in increased numbers of children born with Congenital Rubella Syndrome (CRS). Only three countries and areas in the Region have not yet introduced rubella vaccine into their immunization programme.
- The Region, as a whole and at least 30 countries and areas of the Region, have reduced chronic infection rates of hepatitis B in children to <2%, the milestone set for 2012. A total of 11 countries have been verified to have achieved the Regional goal of reducing hepatitis B infection rates in children to less than 1% (Australia, Brunei, China, Cook Islands, Hong Kong, Macao, Malaysia, Mongolia, New Zealand, Palau and Republic of Korea).
- Maternal and neonatal tetanus elimination is considered to be eliminated in 34 of 37 WPR countries and areas. In December 2013, WHO and UNICEF validated that Lao People's Democratic Republic had achieved the elimination level of maternal and neonatal tetanus while Cambodia, Papua New Guinea and the Philippines have not yet validated elimination.
- More than half of the global burden of Japanese encephalitis – estimated at 67 900 cases per year – occurs in countries of the Western Pacific Region. Recent increases in the availability of Japanese encephalitis vaccines provide the opportunity to accelerate control of this devastating disease.
The estimated percentage of infants in the Region being fully vaccinated with diphtheria-tetanus-pertussis vaccine has increased to 97% in 2012 from 96% in 2011. However, even after the above successes and efforts to achieve the Regional goals and targets, many infants are not fully immunized with routine vaccines and die from diseases that could be prevented by existing vaccines. More than 600 000 and 750 000 children were missed to receive three doses of diphtheria-pertussis-tetanus/Pentavalent vaccine and first dose of measles containing vaccine respectively in countries in the Western Pacific Region.
Further efforts are needed to ensure that people in all countries in the Region are protected from vaccine-preventable diseases. Therefore, it is highly important to strengthen the routine immunization, especially in countries with the highest number of unvaccinated and/or incompletely vaccinated children. It will substantially reduce the number of susceptible children worldwide and limit the occurrence and spread of outbreaks of vaccine-preventable diseases.
Current levels of access to recommended vaccines
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Tuberculosis is a chronic disease caused by Mycobacterium tuberculosis. Primary infection often goes unnoticed. Clinically, tuberculin sensitivity appears within few weeks and lesions commonly become inactive. It may progress to pulmonary tuberculosis, milliary tuberculosis or meningitis. The only vaccine available for the prevention of tuberculosis is bacille Calmette-Guérin vaccine, which was first developed in 1920s and one of the oldest vaccines.
Measles is a highly contagious disease caused by a virus, which usually results in high fever and rash, and can lead to blindness, encephalitis or death. In 2005, the Member States of the Region decided to eliminate measles by 2012. Only four countries or areas of the Region have not yet included a routine second dose of measles vaccine as part of routine immunization by end 2013 (Lao People's Democratic Republic, Papua New Guinea, Solomon Islands and Vanuatu).
Rubella is a viral disease which is usually mild in children, but infection during early pregnancy may cause fetal death or CRS, which can lead to defects of the brain, heart, eyes and ears. Three countries and areas have not yet introduced rubella vaccine into their immunization programme (Papua New Guinea, Vanuatu and Viet Nam).
Diphtheria is a potentially acute disease caused by exotoxin-producing Corynebacterium diphtheriae. Morbidity and mortality result from the bacterial toxin that may cause obstructive pseudo-membranes in the upper respiratory tract (croup) or damage to myocardium and other tissues. Devastating diphtheria epidemics affecting mainly children have been described from many countries throughout history. Diphtheria toxoid is one of the oldest vaccines currently in use.
Pertussis (whooping cough) caused by Bordetella pertussis is an important public health concern even in countries with high vaccination coverage. The clinical outcome of pertussis depends on factors such as age and vaccination status. Although most cases of clinically recognizable pertussis occur in older children, adolescents and adults, pertussis is often unrecognized because of its frequent atypical course. However, older age groups represent an important source of infection for susceptible infants. The main aim of pertussis vaccination is to reduce the risk of severe pertussis in infancy. Pertussis vaccine is one of the oldest vaccines being used in the National Immunization Programme.
Tetanus is caused by a bacterium which grows in the absence of oxygen, e.g. in dirty wounds or in the umbilical cord if it is not kept clean. It produces a toxin which can cause serious complications or death. The vaccine to prevent maternal and neonatal tetanus had been introduced in all the countries even before.
Polio is a highly infectious viral disease that can cause irreversible paralysis. The Region has been maintaining a polio-free status since the year 2000 and since 2013, has been implementing polio endgame strategies.
Hepatitis B is a viral infection that attacks the liver. Hepatitis B vaccine for infants had been introduced nationwide in all countries and areas in the Region since2005 and Regional coverage with three doses of hepatitis B vaccine is estimated at 96%.
Haemophilus influenzae type b (Hib) causes meningitis and pneumonia. A total of 34 of 36 countries and areas had introduced the Hib vaccine by the end of 2013.
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. HPV can cause cervical cancer and other types of cancer and genital warts in both men and women. HPV vaccine was introduced in 19 countries and areas in the Region by the end of 2013.
Pneumococcal diseases include pneumonia, meningitis and febrile bacteraemia, as well as otitis media, sinusitis and bronchitis. Pneumococcal vaccine had been introduced in 20 countries and areas in the Region by the end of 2013.
Rotavirus is the most common cause of severe diarrhoeal disease in young children throughout the world. Rotavirus vaccine had been introduced in nine countries and areas in the Region by the end of 2013.
Expanded Programme on Immunization
Regional Office for the Western Pacific
World Health Organization
P.O. Box 2932
Tel. no. (+63 2) 5288001
Fax no. (+63 2) 5211036, 5260279