Routine immunization: an essential but wobbly platform

Robert Steinglass

doi:10.9745/GHSP-D-13-00122

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Re-thinking the role of immunisation
Jacob John, T

Published on: 22 November 2013

Published on: (22 November 2013)
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Re-thinking the role of immunisation
Jacob John, T, Retired
While I agree that routine immunization is an essential element in health protection, we need to expand our own vision as ardent advocates and activists. Polio eradication has a specific goal and monitoring tools all the way to the finish line of the sprint. The rest of routine immunization may be a marathon, but its problem is its goal has not been clearly articulated nor the progress towards the goal being monitored. S...
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While I agree that routine immunization is an essential element in health protection, we need to expand our own vision as ardent advocates and activists. Polio eradication has a specific goal and monitoring tools all the way to the finish line of the sprint. The rest of routine immunization may be a marathon, but its problem is its goal has not been clearly articulated nor the progress towards the goal being monitored. So, why should we run? Cant we just walk?
We must build on the platform. Disease control is the goal. Countries must document and measure the occurrence and incidence of diphtheria, tetanus, pertussis and every other disease on the routine vaccines list. Once immunization is reassigned its role in childhood diseases control, then the basic step towards establishing a public health system would be taken.
EPI was designed to fit into countries without public health infrastructure; the EPI platform must be redesigned as basic public health prevention of diseases -- then expand to control of other childhood infectious diseases and adult infectious diseases. Thus the focus must be shifted from the ritualization of immunization to it being an essential ingredient of disease control. Vaccine preventable diseases surveillance must be designed and implemented. That should gradually expand to include nationally relevant other diseases. Unless we learn the primary school lessons of public health in controlling single etiology vaccine- preventable infectious diseases, how will we graduate to the high school of public health, so essential everywhere in the 21st century, addressing chronic non-communicable diseases with multiple causative factors including human behavior?
These ideas may be found expanded in our paper: John TJ, Plotkin SA, Orenstein WA. Building on the success of the Expanded Program on Immunization: Enhancing the focus on disease prevention and control. Vaccine 2011; 29: 8835 - 8837.
Conflict of Interest:
None declared
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Competing Interests: None declared.