The Essential Program on Immunization is 50: Milestones, achievements, and future directions

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The Essential Program on Immunization is 50: Milestones, achievements, and future directions
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Each year, the World Health Organization (WHO) partakes in World Immunization Week, a period of reflection, raising awareness, and future planning surrounding global action required to combat vaccine-preventable illness.1

By Antonia Du Bois, MScReviewed by Lily Ramsey, LLM Each year, the World Health Organization partakes in World Immunization Week, a period of reflection, raising awareness, and future planning surrounding global action required to combat vaccine-preventable illness.1

The EPI began with a moderate portfolio of vaccinations for six childhood illnesses including diphtheria, tetanus, and pertussis.2,3 Building on fundamentals of health systems like governance, service delivery, information systems, vaccine formulation, and financing,5 this program has expanded to a total of thirteen vaccinations and includes older children and adults.

Challenges faced and overcome One of the primary challenges with large-scale immunization programs is the requirement for sustained long-term investment.5 Previous initiatives have run into problems with prioritizing increasing coverage over establishing sustainable healthcare systems.5 This can result in the diversion of funding and the masking of low local coverage rates, negatively affecting the overall program progress.

To address this disharmony, the past ten years have seen sustained efforts to establish coordinated organizations such as National Immunization Technical Advisory Groups and Interagency coordinating committees to improve stakeholder communication and resource distribution.5EPI and the COVID-19 pandemic The unprecedented nature of the SARS-CoV-2 pandemic required a coordinated, swift, and effective immunization response at a global level with the EPI playing a significant role.

The future of immunization: Innovations and strategies The past 50 years of EPI operations have established that a faulty health system can cripple the benefits of even the best vaccine. As seen in the aforementioned coverage dips in the 1990s, addressing vaccine access inequities and strengthening the foundation of healthcare systems is essential for the continued success of the EPI.5

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