The expanded programme on immunization: A lasting legacy of smallpox eradication
The expanded programme on immunization: A lasting legacy of smallpox eradication
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DOI：
10.1016/j.vaccine.2012.01.080
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发表时间：
2011-12-30
期刊：
影响因子：
5.5
通讯作者：
Cherian, Thomas
中科院分区：
文献类型：
--
作者：
Okwo-Bele, Jean-Marie;Cherian, Thomas
20世纪70年代中期以来，扩大免疫规划（EPI）的广泛制定和实施，在世界范围内控制疫苗可预防疾病方面取得了显著成就。如今，接受免疫接种的儿童比以往任何时候都多。大多数国家已阻断脊髓灰质炎传播；麻疹、破伤风、白喉和百日咳造成的死亡率已降至历史最低水平。此外，越来越多的疫苗被用于婴儿和老年人，如甲型肝炎和乙型肝炎、乙型流感嗜血杆菌、轮状病毒、肺炎球菌、脑膜炎球菌、人乳头瘤病毒（HPV）和水痘疫苗。EPI的设计在很大程度上反映了1966-1977年期间实施强化消灭天花运动所积累的经验。当时，大多数国家现有的卫生基础设施和网络不足以为大多数人提供社区范围的免疫规划。因此，我们努力培训专门的卫生人员，并为规划的协调和实施分配专门的资源。随着 EPI 的建立，重点逐渐从使用流动团队的疫苗接种运动战略转向提供免疫服务，作为卫生机构常规卫生服务的一部分。然而，运动和外展战略都需要覆盖常规卫生服务未覆盖的人群，并加速实现根除脊髓灰质炎和消除麻疹等疾病控制举措。虽然根除天花运动是一项特殊且有时限的工作，但 EPI 需要采取长期可持续的方法来通过疫苗接种保护新的易感人群，并通过高质量监测监测疾病控制的趋势和进展。 (C) 2012 Elsevier Ltd. 保留所有权利。
Since the mid-1970s, the widespread establishment and implementation of the Expanded Programme on Immunization (EPI) has led to remarkable achievements in controlling vaccine preventable diseases worldwide. Today, more children than ever are being reached with immunization; interruption of poliomyelitis transmission has occurred in most countries; mortality due to measles, tetanus, diphtheria and pertussis has been reduced to record low levels. In addition, increasing numbers of vaccines are being used for infants and older age persons, such as vaccines against hepatitis A and hepatitis B, Haemophilus influenzae type b, rotavirus, pneumococcus, meningococcus, human papilloma virus (HPV) and varicella.The design of EPI reflects in large part the experience accumulated during the implementation of the intensified campaign for smallpox eradication during the period 1966-1977. At that time, the existing health infrastructure and network was found inadequate to reach most individuals with community wide immunization programmes in most countries. Thus, efforts were made to train dedicated health personnel and allocate specific resources for programme coordination and implementation. With the establishment of EPI, there was a gradual shift in emphasis from vaccination campaign strategies using mobile teams to the delivery of immunization services as part of routine health services of health facilities. Both the campaign and the outreach strategies are nevertheless required to reach those segments of the population not reached by the routine health services and to accelerate the achievement of disease control initiatives such as polio eradication and measles elimination.Whilst the campaign for smallpox eradication was set up as special and time-limited effort, the EPI requires long-term sustainable approaches to protect new cohorts of susceptible persons with vaccination and monitor trends and progress towards disease control with high quality surveillance. (C) 2012 Elsevier Ltd. All rights reserved.