Mangla Hospital and Research Center, Shakti Chowk, Bijnor, Uttar Pradesh, 246 701, India.
Indian Pediatr. 2012 May;49(5):357-61. doi: 10.1007/s13312-012-0081-x.
Vaccines have made a major contribution to public health but vaccines-preventable diseases (VPDs) are still responsible for significant deaths of under-five children. Despite Global efforts, the coverage in two WHO regions namely Africa and South-East Asia (SEA) still remain short of set targets for 2010. As a result, the SEA Regional Director has declared 2012 as the Year for Intensifying Routine Immunization (RI) in the Region. The recent immunization coverage surveys in India have shown gradual albeit a slow progress in the performance of RI in India over last few years but in some states the coverage is still quite low. Several new initiatives like introduction of Hepatitis B vaccine, second dose of Measles vaccine and pentavalent vaccine (two states), JE vaccine rounds, framing of the National Vaccine Policy, etc. are welcome steps. The challenges and barriers to achieve high immunization rates in the country are well recognized. Almost non-existence of an effective VPD surveillance system in the country has further compounded the problem. The need is to address all the barriers to achieve high RI rates, which should include induction of innovative methods, proper monitoring of the program, improving operational efficiency and reaching every community, and integrated delivery of health interventions along with immunization. The development of an efficient VPDs surveillance, adverse event following immunization (AEFI) monitoring and post-marketing surveillance systems will go a long way in ensuring satisfactory performance of the health system. The decades old Expanded Program of Immunization (EPI), which was adopted in India as universal Immunization Program (UIP) also needs a revamp with inclusion of certain new vaccines. Decisions on implementing new and underutilized vaccines require scientific evidence and data, a reliable supply of affordable vaccines, which are adapted to the country's immunization schedule, and an integrated disease monitoring and surveillance system.
疫苗为公共卫生做出了重大贡献，但疫苗可预防疾病（VPD）仍然导致大量 5 岁以下儿童死亡。尽管全球做出了努力，但在世界卫生组织（WHO）的两个区域，即非洲和东南亚（SEA），疫苗接种覆盖率仍未达到 2010 年设定的目标。因此，该区域主任宣布 2012 年为加强常规免疫接种（RI）年。最近在印度进行的免疫接种覆盖率调查显示，过去几年印度的 RI 表现虽然有所进展，但进展缓慢，但在一些邦，覆盖率仍然相当低。一些新举措，如引入乙型肝炎疫苗、麻疹疫苗第二剂和五联疫苗（两个邦）、日本脑炎疫苗接种、制定国家疫苗政策等，都是受欢迎的举措。要在全国范围内实现高免疫接种率，面临的挑战和障碍是众所周知的。该国几乎不存在有效的 VPD 监测系统，使问题更加复杂。需要解决实现高 RI 率的所有障碍，其中包括引入创新方法、适当监测该计划、提高运营效率并覆盖每个社区，以及整合卫生干预措施和免疫接种。建立有效的 VPD 监测、疫苗接种后不良事件（AEFI）监测和上市后监测系统，将有助于确保卫生系统的满意表现。作为印度通用免疫计划（UIP）采用的几十年历史的扩大免疫规划（EPI）也需要进行改革，纳入某些新疫苗。实施新疫苗和未充分利用疫苗的决策需要科学证据和数据、可负担疫苗的可靠供应，这些疫苗必须适应国家免疫计划，以及综合疾病监测和监测系统。
