The National Institute of Hygiene and Epidemiology's director, Nguyen Tran Hien, spoke to Suc khoe & Doi song (Health and Life) newspaper about the National Expanded Programme on Immunisation.
Can you describe the results of vaccine implementation in the National Expanded Programme on Immunisation (EPI) ?
Vaccines are an effective tool for preventing transmittable diseases. Unlike other treatments, vaccines help protect people from diseases and help create healthy generations. Currently, around 30 infectious diseases can be prevented by vaccines.
Vaccines have also helped reduce illness, treatment periods, disability, loss of working ability and mental or physical development for children. Vaccination was seen as key for achieving the Millennium Development Goals. Investment in vaccinations is an investment in the future.
Thanks to the EPI, the rate of infectious diseases has reduced dramatically year by year. From 1985 to 2013, around 6.7 million children were prevented from contracting harmful diseases and 43,000 children successfully recovered from suffering diseases that could be prevented by vaccines; such as tuberculosis, polio, tetanus, pertussis and hepatitis B.
What new vaccines will be used in the EPI in future?
According to the Global Alliance for Vaccines and Immunisation (GAVI), around 5 million children have been saved from hepatitis B and haemophilus influenza type B related fatalities because of vaccination programmes in developing countries. New vaccines, including rubella, yellow fever and Rota-virus diarrhoea will be added to immunisation programmes in countries aiming to save the lives of 4.2 million children world-wide by 2015.
Viet Nam is making plans to request GAVI to help add new vaccines to the EPI in coming years. A GAVI funded combined vaccine against measles and rubella will be vaccinated for children under the EPI in 2014.
Can you outline the target for eliminating measles?
Measles infections were reduced by 152 times from nearly 88,000 cases in 1984 to 578 cases in 2012. No measles fatalities have been reported since 2003. Viet Nam, along with 32 other countries in the region, are collecting information on the elimination of the disease.
The criteria for eliminating measles are: having no measles outbreak or have the disease spread within three years, as well as keeping the infection rate under 1 per 1 million. Starting the process of eliminating measles in Viet Nam would be a milestone in the country's integration into the region.
In order to eliminate measles, two doses of measles vaccines should be regularly given to over 95 per cent of children aged 9 months and 18 months nationwide. In fact, combined measles and rubella vaccines will be given to around 23 million children aged between 9 months and 14 years old, with support from GAVI, in 2014. The measles vaccine will be administered to high risk subjects while measles supervision will be strengthened by medical units and hospitals.
We would also need to mobilise the support of the Party, Government and locality authorities, the health sector and financial and technical support from local and international organisations for measles elimination.
What are the difficulties facing these EPI activities?
The programme has faced challenges in maintaining vaccination rates above 95 per cent and ensuring vaccine quality. Wild polio, that still remains in some areas of the world, is also a risk for Viet Nam.
Many others risks, such as difficult access to those living in mountainous and remote areas, high home-birth rates and poor hygiene conditions, immigration and globalisation, impact the EPI results achieved so far.
The EPI needs to make use of the best human resources from central to local levels, providing training and technical supervision support. The yearly increases from the State budget has met the country's demand requiring big investment for new and safer vaccines, including Rubella, Rotavirus and cervical vaccines.
The declining trend of international assistance to Viet Nam due to the country becoming a middle-income country, has presented some difficulties. — VNS