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Expanded Programme On Immunization
Expanded Programme On Immunization
Expanded Programme On Immunization
The Expanded Programme on Immunization (EPI) was launched in Pakistan in 1978 to protect
children by immunizing them against childhood tuberculosis, poliomyelitis, diphtheria, pertussis,
tetanus and measles. Later, with the support of development partners, a number of new vaccines
e.g. hepatitis B, haemophilus influenzae type b (Hib) and pneumococcal vaccine (PCV10) were
introduced in 2002, 2009 and 2012, and inactivated polio vaccine in 2015, respectively.
It also aims to protect mothers and newborn against tetanus. Immunizing children with these
vaccines may avert up to 17% of childhood mortality in Pakistan and thus help contribute towards
achieving Sustainable Development Goal (SDG) 3, on reducing child morbidity and mortality. The
programme also plans to introduce rotavirus vaccine in 2017, which will prevent one cause of fatal
diarrhoea due to rotavirus (Table 1).
Table 1. Pakistan's EPI vaccination schedule
OPV1: 6 weeks
OPV2: 10 weeks
OPV3: 14 weeks
IPV 1 IPV-I: 14 weeks
Measles2: 15months
Diarrhoea due to rotavirus Virus *Rotavirus 2 Rota 1: 6 weeks
Rota 2: 10 weeks
The national immunization programme has contributed tosignificantly decreasing childhood morbidity
and mortality due to vaccine preventable diseases. A child needs only 5 visits during the first year
and one visit during the second year of his/her life to complete the vaccination with 6 visits against 9
dreadful diseases.
Programme objectives
Despite significant efforts by the Government and its partners, Pakistan’s immunization indicators
have yet to reach the expected benchmarks. The key goals of polio eradication, and measles, have
not been achieved. However Punjab is the first province to achieve elimination of maternal and
neonatal tetanus in 2016.The current EPI coverage for fully immunized based on PDHS (2012–
2013) and PSLM (2014–2015) surveys is 65% and 88%, respectively.
Pakistan is third among countries with the most unvaccinated and under-vaccinated children. Of the
3.8 million infants who did not receive their third dose of DTP3 vaccine in the Region in 2015, 40% of
those were in Pakistan.
Figure 2. The 10 countries wth the most under- and un-vaccinated children (based on
coverage with the first and third doses of DTP-containing vaccine), 2015
Figure 3. 3.8 million infants have not received their third dose of DTP vaccine in the Region;
97% of these children are in conflict-affected countries
For strengthening the EPI services WHO supported the development of comprehensive multiyear
plan (cMYPs) for federal and provincial EPI programmes and based on it the PC-1s and annual plan
of action are developed. Capacity- building is ongoing from mid-level managers to field staff,
including vaccinators and lady health workers. Effective vaccine management is also supported by
the partners. Steps are being taken to improve the data quality by periodic data quality assessments
and programme review.