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Expanded Programme on

Immunization

Expanded Programme on Immunization has been implementing the reduction of morbidity and

mortality due to vaccine preventable diseases among the children aged 1 to 5 years with the aim

of reduction of under five mortality by the year 2015, to the two-third of 1990, thereby

achieving the MDG 4.

As one of the unit under Department of Health, Central Expanded Programme on Immunization

is taking the responsible for setting policy and multi-year planning for National Immunization

Progrmme, management of vaccine and cold chain, distribution of logistics, monitoring the

immunization activities of Regions and States, Surveillance of Vaccine Preventable Diseases

and Response to Vaccine Preventable Diseases outbreaks including Supplementary

Immunization Activities (SIA).

The main partners of the Programme are WHO, UNICEF, Global Alliance for Vaccine (GAVI)

and national and international Non-governmental Organizations and Civil Service Organizations

like Myanmar Maternal and Child Welfare Association (MMCWA), Myanmar Women Affairs’

Federation (MWAF) and Myanmar Medical Association (MMA).

The Objective of the Expanded Programme on Immunization is to reduce and eliminate the

morbidity and mortality of vaccine preventable diseases. According to Global Immunization

Vision and Strategy-GIVS, EPI has set the following specific objectives.

• To achieve the coverage at least 80% in all townships and 95% nationally

• To sustain the country status of

elimination and eradication of vaccine

preventable diseases from the public

health problem

• To achieve polio eradication by the year

2013 and measles elimination by the year

2015 to be in line with regional goal

• To introduce new appropriate vaccine/

vaccines by the year 2013 thereby

reducing the morbidity and mortality

among under 5 children Routine Immunization Coverage

(1990-2010)

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Strategies of Regional Strategic Plan

for Measles Elimination

• Improving and sustaining routine

immunization coverage

• Improving measles surveillance

• Second dose of measles vaccine

(catch-up immunization campaigns &

routine second dose/ campaigns)

• Improving case management including

administration of vitamin A

Mass Measles Campaign (2012)

Mass Measles Campiagn (2012) had been

conducted in March 2012 from 22nd to 31st for 10

days in all Regions and States. It is according to one

of the 4 strategies for Regional Measles Elimination.

Other justification for MMC (2012) had been

identified as

• National Measles coverage in 2010 was 88%.

• There had been increased measles cases and

outbreaks with deaths in 2011

• Surveillance findings were warning the

immunity gaps; Pocket of low measles

coverage and gaps in routine immunization

• The last follow up campaign for Measles was

in 2007

• There were accumulation of susceptible

children and thus to protect all susceptible

children especially under 5 children

• The progress towards Measles elimination and

MDG-4 is to be accelerated.

• The immunization system is to be experienced

and strengthened specifically for capacity

building of health workers on Injection safety,

micro-planning and cold chain management.

Routine Measles coverage 2006-2010

<1 Year

8%

1-4 Years31%

5-9 Years24%

10-14 Years18%

15+ Years

17%

Unknown

2%

Age Distribution of Measles Cases

(Total Cases – 1869)

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Coverage of

Mass Measles Campaign (2012)

The Launching Ceremony of Mass Measles Campaign (2012) was held on 26th March 2012 at

Ministry of Health in Nay Pyi Taw.

The Ministry of Health has employed new and traditional channels of communication to alert

parents to the measles campaign, from radio and television adverts to announcements made

through loudspeakers mounted on vans. The invitation cards were distributed to ensure the

measles campaign reaches its targeted 6.4 million under-fives.

Altogether about 6.4 millions of

the children who are between the

age of 9 months to 5 years had

been vaccinated against Measles.

The nationwide coverage is 97.4%.

Professor Dr. Pe Thet Khin, Union Minister for Health,

delivered an Inaugural speech at Launching Ceremony of Mass Measles Campaign 2012

80% - 89%

90% & above

<80%

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Intensification of Routine Immunization:

Framework for increasing and sustaining coverage

The High-Level Preparatory (HLP) Meeting, held in the Regional Office in New Delhi from

27th to 30th June 2011, had made the important recommendations concerning increasing and

sustaining coverage in SEAR countries. High Level Ministerial Meeting had committed 2012 as

a Year of Intensification of Routine Immunization.

Although National coverage for DPT3 has been increased to 90% in 2009 and 2010, the EPI

programme is also facing, as in other SEAR countries, with big challenge in sub-national

President of MMCWA, Dr. Mon Mon Aung,

cheering the child getting measles vaccine

Dr. H.S.B Tennakoon,

WHO Representative to Myanmar,

giving presents to the child

Representative from UNICEF,

giving presents to the child

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routine immunization coverage. Many barriers resulting in limitation in service delivery and

other socio-economic barriers threaten the routine immunization coverage.

The National Plan for Intensification of Routine Immunization, developed by EPI, had been

approved by Ministry of Health in June 2011. In July 2011, Ministry of Health has been

formulated the plan for strengthening routine immunization in country as soon as the immunity

gaps have been identified through the evaluation of the programme and surveillance system of

vaccine preventable diseases. It is also in line with National Health Plan (2011-2016) and

according to CMYP (2012-2016). The following prioritized activities are being determined in

the identified areas in specified timeline.

• Advocacy to the new State and Regional governments

• Increasing EPI workforce by assigning the Public Health Supervisors Grade II as

vaccinators

• Modified immunization policy focusing in quantity of service

• Strengthening the cold chain management (stock and vaccine)

• Capacity building of mid level managers for EPI (Township Medical Officers)

• Health promotion by awareness raising and demand generation through mass media and

IEC with ethnic Languages

• More participation of local NGOs and INGOs in each step of immunization activities

As on the accomplishment of filling the gaps of immunization coverage with the increased

political commitment and investment, Myanmar will keep its honor for the commitments in

2012 as a year of intensification of routine immunization with the modification of existing

country’s policy for 2012 to be in line with the regional policy.

Introduction of New Vaccines (Pentavalent Vaccine and Measles second dose)

Government of Myanmar has decided to support EPI by co-financing with GAVI for

Pentavalent vaccine in routine immunization programme. Government has spent US$1.3 million

per year to introduce 5 in 1 Pentavalent vaccine (containing DPT, Hepatitis B and Hemophilus

Influenza b) to be used as new vaccine in the country for the basic of 5 years. Pentavalent

vaccine will be started in July, 2012, replacing DPT and Hepatitis B vaccine in Routine

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Immunization Programme together with the second dose of Measles vaccine, for the age of 18

months old children.

EVM assessment

Effective Vaccine Management (EVM) was conducted in July-August 2011 and the

improvement plan was developed. As per EVM assessment, Myanmar has adequate storage

capacity at all level for introduction of new vaccines which are Pentavalent and Measles second

dose.

Conducting EVM Assessment (2011)