Expanded programme on immunization. Global Advisory Group--Part III
Releve Epidemiologique Hebdomadaire 67(5): 27-30
1992
ISSN/ISBN: 0049-8114 PMID: 1536751 Document Number: 381984
The Global Advisory Group recommends the continued widespread use of whole-cell pertussis vaccine, because the risk of disease far outweighs that of severe reactions to the vaccine. Routine monitoring of vaccine efficacy is highly desirable, recommended schedule is 3 doses before 6 months of age and possibly boosters.The health impact of rubella and congenital rubella syndrome (CRS) should determine whether there is a place for rubella control in developing countries. Unless a very high coverage of rubella (or measles-mumps-rubella) vaccine can be assured, the potential exists for a mere shift of the infection rate to older groups and for an increase in cases of CRS.Effective systems for disease surveillance should be in place by the end of 1992 to reach the subsequent goals of measles reduction, neonatal tetanus elimination and poliomyelitis eradication. However, the group is alarmed that much of the vaccine in use today (for example, 75% of tetanus toxoid and >50% of oral polio vaccine) does not comply with WHO requirements or is of unknown quality.The EPI programme provides useful opportunities also for supplementation of the child's diet with micronutrients, vitamin A and iodine; likewise, iron supplements can be given to pregnant women when they receive tetanus toxoid.Although advising the use of re-usable syringes and steam sterilizers as the equipment of first choice, the Group commends the supply of auto-destruct syringes in the place of standard disposable syringes. Also noted is the wastage of vaccine when 20-dose vials are used at sessions for <10 children because 5-dose or 10-dose vials have not been ordered.N.W. Preston.