[The regional vaccination program in Europe (1991-1993)].

The European region is passing through a period of rapid transition with the most dramatic changes in the countries of central and eastern Europe (CCEE) and the former USSR. These countries are now facing serious economic problems, a dramatic rise in unemployment and social unrest which has had an impact on the development of the regional immunization programme. The provision of an adequate vaccine supply has become a priority for many States in the region in their efforts to sustain immunization activities. New operational targets for the EPI in Europe in the 1990s were established by the European Advisory Group (Copenhagen, February 1993). These operational targets identify the steps to be followed by countries in order to achieve, by the year 2000, no indigenous cases of poliomyelitis, diphtheria, neonatal tetanus, measles, mumps and congenital rubella. They also include a sustained and continuing reduction in the incidence and adverse consequences of other communicable diseases, notably HIV infection (European target 5). Immunization coverage is generally high and stable in the Region. It was observed in 1990-1992 that pockets of non-immunized persons in any country can lead to outbreaks of disease. Most Member States, however, do not yet use immunization coverage for operational purposes despite being encouraged to monitor by geographical unit. Insufficient protection against pertussis has been observed in countries including Italy, the Russian Federation and Sweden (where pertussis immunization is not obligatory) and represents the build-up of a large susceptible population.(ABSTRACT TRUNCATED AT 250 WORDS)