Immunization is among the most cost-effective public health interventions available. One study estimated immunization might have averted at least 37 million deaths between 2000 and 2019. Since the establishment of the Expanded Programme on Immunization in 1974, global vaccination coverage increased and the coverage gap between rich and poor countries decreased.
Creation of Gavi, the Vaccine Alliance, in 2000 allowed the poorest countries in the world to benefit from new, life-saving vaccines and expand the breadth of protection against an increasing number of vaccine-preventable diseases. Despite this progress, inequities in access to and uptake of vaccines persist. Opportunities to realize the full potential of vaccines are within reach but require focused, tailored and committed action by Governments and immunization stakeholders.
China’s National Immunization Program (NIP) has made remarkable progress in reducing vaccine-preventable diseases over the past 46 years. The burden of vaccine-preventable diseases in China has decreased dramatically since the establishment of the NIP. There is evidence showing that the incidence of 11 monitored vaccine-preventable diseases was 1723 per 100 000 populations in 1959, and has decreased markedly since 1978, remaining at low incidence since 1990.
Despite progress, the NIP faces challenges of expanding the number of vaccine-preventable diseases prevented by programme vaccines and realising more effective implementation, including limited financing, substantial regional disparities in vaccination procedures and vaccine distribution, low coverage in high risk or vulnerable adult population groups, and lack of incentive for the local vaccine R&D.
The COVID-19 vaccination campaign was by far the largest expansion of China’s NIP since the inclusion of five new vaccines in 2008. With strong, multi-sectoral collaboration, the campaign extended the national program into new territory: new vaccines, new universal target populations, and new vaccine delivery platforms. The capacity of vaccine distribution, cold-chain transport and grass-roots vaccination services has been continuously upgraded, and public awareness of the importance of vaccines and the willingness to vaccinate have also increased significantly, which provides a new opportunity for the expansion and optimization of China’s NIP.
Recommended Resources
1. 50th anniversary of the Expanded Programme on Immunization (EPI). (2024, January 1). https://www.who.int/news-room/events/detail/2024/01/01/default-calendar/50th-anniversary-of-the-expanded-programme-on-immunization-(epi)
2. Lindstrand A, Cherian T, Chang-Blanc D, Feikin D, O’Brien KL. The World of Immunization: Achievements, Challenges, and Strategic Vision for the Next Decade. J Infect Dis. 2021 Sep 30;224(12 Suppl 2): S452-S467. doi: 10.1093/infdis/jiab284. PMID: 34590130; PMCID: PMC8482029.
3. Chen, S., Yao, L., Wang, W., & Tang, S. (2022). Developing an effective and sustainable national immunisation programme in China: issues and challenges. The Lancet. Public Health,7(12), e1064–e1072. https://doi.org/10.1016/s2468-2667(22)00171-2
4. Rodewald, L.E. Accelerating into Immunization Agenda 2030 with momentum from China’s successful COVID-19 vaccination campaign during dynamic COVID Zero. Infect Dis Poverty 12, 96 (2023). https://doi.org/10.1186/s40249-023-01151-7
