Expanded Program On Immunization - Implementation

Implementation

In each of the United Nations’ member states, the individual national governments create and implement their own policies for vaccination programs following the guidelines set by the EPI. Setting up an immunization program is multifaceted and contains many complex components including a reliable cold chain system, transport for the delivery of the vaccines, maintenance of vaccine stocks, training and monitoring of health workers, outreach educational programs to inform the public, and a means of documenting and recording which child receives which vaccines.

Each distinct region has slightly varying ways of setting up and implementing their own immunization programs based on their existing level of health infrastructure. Some areas will have fixed sites for vaccination: healthcare facilities such as hospitals or health posts that include vaccination along with many other health care activities. But in areas where the number of structured health facilities is small, mobile vaccination teams consisting of staff members from a health facility can deliver vaccines straight to individual towns and villages. These ‘outreach’ services are often scheduled throughout the year. However, in especially under-developed countries where proper communication and infrastructure is absent, cancellation of the planned immunization visits leads to deterioration of the program. A better strategy in such countries is the ‘pulse immunization’ technique, where ‘pulses’ of vaccines are given to children in annual vaccination campaigns.

Additional strategies are needed if the area of the immunization program consists of poor urban communities because such areas tend to have low uptake of vaccination programs. Door-to-door canvassing, also referred to as channeling, is used to increase uptake in such hard to reach groups. Finally, periodic national level mass vaccination campaigns are being increasingly included in the immunization programs.