Expanding Horizons: Increasing Injectable Vaccine in the Expanded Program on Immunization

Abstract

The World Health Organization started the Expanded Program on Immunization in 1974, including 6 antigens with up to 8 vaccine doses for childhood vaccination. The number of antigens has now increased to 11 antigens in 21 vaccines. The expansion of vaccination programs to include more antigens and doses has led to concerns about the burden of multiple injections on infants and children, as well as factors such as fear of adverse reactions, pain, and overall acceptability of vaccines. To address these challenges, there's a call for research to focus on developing combined vaccines that can be administered through more acceptable routes, such as oral, nasal, or needleless administration. This approach could potentially reduce the number of injections required and increase the willingness of individuals to receive vaccines. We highlight the importance of ongoing research and innovation in vaccine development and delivery methods to ensure that vaccination programs remain effective, efficient, and acceptable to the communities they serve, particularly in resource-limited settings.

Keywords: expanded program on immunization; immunization; injection; vaccine.

Figure 1. Number of injections by country from birth to 24 months.

Figure 2. Vaccines recommended in the WHO immunization schedule for infants and toddlers.

BCG=Bacillus Calmette-Guerin Vaccine, HepB=Hepatitis B Vaccine, OPV=Oral Polio Vaccine, IPV=Injectable Polio Vaccine, Rota=Rotavirus Vaccine, Penta=Pentavalent Vaccine, Pneumo=Pneumococcal Vaccine, MenA=Meningococcal A vaccine, ETEC=Enterotoxicogenic E.Colli