Routine Immunization Systems Sample Clauses

Routine Immunization Systems. In 1974 the EPI was established to provide global access to childhood immunizations [10, 11]. Since then, global immunization coverage for vaccines that protect against six major communicable diseases has increased from <5% to 84% [12]; vaccines include, BCG, DTP, polio, and measles vaccines. Several new vaccines such as, hepatitis B (HepB), Haemophilus influenzae meningitis conjugate vaccine, pneumococcal conjugate vaccine, and rotavirus vaccine have been introduced into country immunization programs as funding and resources have become available. EPI was initiated in Indonesia in 1977 [2, 13]. Shortly after the start of the program, the impact of immunizations were quickly realized as the annual child morbidity rates from vaccine-preventable diseases plummeted[13]. Additionally, efforts to improve access to immunization services have resulted in the dramatic drop of completely unimmunized children from 32% in 1991 to 9.6% in 2007[14]. The proportion of partially immunized children, however, has not changed during this period and remains the larger issue in Indonesia. Indonesia aims to achieve universal immunization coverage in every village[8, 15]; to reach this goal, a joint effort between public and private sectors may be required to strengthen the immunization program and improve coverage across all regions[16]. In Indonesia, an estimated 7,800 health centers, 22,000 sub-health centers, 6,600 mobile clinics, and public and private hospitals offer immunization services. The village health posts are the main provider of immunization services; approximately 260,000 village health posts provide immunization services to children at the village level monthly [17]. Annually, the under one year birth cohort that are in need of immunization services is more than four million children [16]. Indonesia’s vaccination schedule recommends that children receive vaccines during health facility visits at the following times: 1 dose of HepB vaccine given at birth; 1 dose of BCG and oral polio vaccine (OPV) at age 1 month, and 1 dose of OPV and quadravelent vaccine, containing antigens for diphtheria- tetanus-pertussis-hepatitis B (DTP-HepB) at ages 2, 3, and 4 months; and measles vaccine at age 9 months (table 1). Routine immunizations are manufactured locally in Indonesia and are financed by the Indonesian government, except for new vaccine introduction, which is supported by Gavi, the Vaccine Alliance [17].