INTRODUCTION

A national immunization program (NIP) is the organizational component of Ministries of Health

charged with preventing disease, disability, and death from vaccine-preventable diseases in
children and adults. A NIP is a government program that operates within the framework of
overall health policy. The national immunization program is used interchangeably with the
Expanded Program on Immunization (EPI) that originally focused on preventing vaccine-
preventable diseases in children. All countries have a national immunization program to protect
the population against vaccine-preventable diseases.

DEFINITION

The National Program on Immunization (NPI) refers to a government-led initiative that aims to
provide immunization services to the entire population of a country. The goal of such a program
is to protect individuals from various preventable diseases by ensuring widespread access to
vaccines.

GOALS OF IMMUNIZATION PROGRAM

Vaccination policies aim to produce immunity to preventable diseases. Besides individual

protection from getting ill, some vaccination policies also aim to provide the community as a
whole with herd immunity. Herd immunity refers to the idea that the pathogen will have trouble
spreading when a significant part of the population has immunity against it. This protects those
unable to get the vaccine due to medical conditions, such as immune disorders. However, in
order for herd immunity to be effective in a population, a majority of those that are vaccine-
eligible must be vaccinated (Hendrix, 2016). Vaccine-preventable diseases remain a common
cause of childhood mortality with an estimated three million deaths each year (Obasi, 2018).
Each year, vaccination prevents between two and three million deaths worldwide, across all age
groups, from diphtheria, tetanus, pertussis and measles (UNICEF, 2014).

1
The approved immunization schedule by National Program on Immunization (NPI in the
at birth to 18 months

Factors Affecting Routine Immunization in Nigeria

1. Misperceptions of routine immunization

2. Influence of religion
3. Inadequate cold chain equipment
4. Political problems
5. Rejection of routine immunization
6. Shortage of vaccines and immunization supplies

2
KEY ASPECTS OF A NATIONAL PROGRAM ON IMMUNIZATION TYPICALLY
INCLUDE:

1. Vaccination Schedule: The program establishes a schedule for administering vaccines at

various stages of life, from infancy to adulthood. This schedule is designed to provide
immunity against a range of diseases at the most appropriate times.

2. Vaccine Procurement and Distribution: The program coordinates the procurement of

vaccines from manufacturers and ensures their efficient distribution to healthcare
facilities across the country.

3. Healthcare Infrastructure: The program often involves strengthening the healthcare

infrastructure, including training healthcare workers to administer vaccines safely and
efficiently.

4. Monitoring and Surveillance: Monitoring the effectiveness of the vaccines and the
overall program is crucial. This involves tracking vaccination coverage rates, adverse
events following immunization, and disease incidence rates.

5. Public Awareness and Education: Effective communication and public awareness

campaigns are vital to encourage participation in the vaccination program, dispel myths,
and provide accurate information about the importance of immunization.

6. Target Diseases: The specific diseases targeted by a National Program on Immunization

can vary based on the country's healthcare priorities and the prevalence of certain
diseases. Common vaccine-preventable diseases include measles, polio, tetanus,
diphtheria, pertussis (whooping cough), hepatitis B, and influenza.

7. Vaccine Research and Development: National immunization programs can also support
research and development efforts to improve existing vaccines, develop new vaccines,
and stay updated on advancements in immunization technology.

8. Equity and Accessibility: Ensuring that vaccines are accessible to all segments of the
population, including marginalized and remote communities, is a key principle of a
successful immunization program.

3
 9. Partnerships: Collaboration with international organizations, non-governmental
organizations, and other stakeholders is often crucial for funding, technical support, and
expertise.

Immunization programs have been instrumental in reducing the burden of many vaccine-
preventable diseases worldwide. They have played a significant role in improving public health
and preventing outbreaks. It's important for countries to maintain strong immunization programs
and adapt them to evolving healthcare needs and emerging infectious diseases.

TYPES OF NATIONAL PROGRAMS ON IMMUNIZATION

National Programs on Immunization (NPIs) can vary based on the specific healthcare needs,
epidemiological situation, and priorities of each country. While the core principles of NPIs
remain consistent, the types of vaccines included and the strategies employed might differ. Here
are some common types of NPIs:

1. Routine Immunization Programs: These are the foundational NPIs that provide
essential vaccines to individuals at various stages of life according to a predetermined
schedule. These programs often focus on childhood immunizations, including vaccines
against diseases like measles, polio, diphtheria, pertussis, tetanus, and more.

2. Supplementary Immunization Activities (SIAs): SIAs are typically conducted in

addition to routine immunization. They are aimed at providing a targeted vaccination
campaign to address specific needs, such as reaching populations that might have been
missed by routine immunization. SIAs are often used to achieve high coverage rates in a
short period and are commonly used in polio eradication campaigns.

3. Catch-Up Immunization: This type of program is designed to immunize individuals

who have missed their scheduled vaccinations due to various reasons. It targets children
and sometimes adults who might not have received all recommended doses of vaccines.

4. Mass Vaccination Campaigns: These campaigns involve vaccinating a large portion of

the population against a specific disease in a short period. Mass vaccination campaigns
are often used in response to disease outbreaks or in efforts to eliminate specific diseases.

4
 5. Maternal Immunization Programs: These programs focus on providing vaccines to
pregnant women to protect both the mother and the newborn. Vaccines given during
pregnancy can confer immunity to the infant, providing protection in the early stages of
life.

6. Adolescent and Adult Immunization: While childhood immunization is a central

component of NPIs, many programs also incorporate vaccines targeted at adolescents and
adults. Vaccines such as HPV (Human Papillomavirus) for preventing cervical cancer,
influenza vaccines, and vaccines against diseases like meningococcal disease might be
included.

7. Travel Vaccination Programs: Some countries offer specific vaccines to travelers,

especially for diseases that are prevalent in certain regions but not in the home country.
These programs ensure that individuals are protected from diseases they might encounter
during travel.

8. Vaccine Campaigns for Special Populations: Some NPIs focus on specific populations
with higher vulnerability or risk, such as refugees, internally displaced persons, or
marginalized communities. These programs ensure that even the hardest-to-reach
populations receive necessary vaccinations.

9. Research and Development Initiatives: While not a traditional NPI, some countries
invest in research and development efforts related to vaccine technology, new vaccines,
and strategies for improving immunization coverage and effectiveness.

The goal of all these programs remains consistent: to protect individuals and communities from
vaccine-preventable diseases and improve overall public health.

5
SUMMARY/CONCLUSION

In conclusion, the National Program on Immunization (NPI) stands as a cornerstone of public

health initiatives aimed at safeguarding populations from a range of preventable diseases through
targeted vaccination efforts. With a comprehensive approach encompassing vaccine
procurement, distribution, healthcare infrastructure strengthening, monitoring, and education,
NPIs have proven instrumental in drastically reducing the incidence of vaccine-preventable
illnesses globally. By adhering to a predetermined immunization schedule, NPIs ensure that
individuals receive the right vaccines at the right stages of life, effectively fortifying their
immunity.

NPIs encompass diverse forms tailored to unique healthcare needs. Routine immunization forms
the bedrock of NPIs, providing essential vaccines to children and adults alike. Supplementary
Immunization Activities (SIAs) bolster coverage, while catch-up immunization addresses those
who missed earlier doses. Mass vaccination campaigns respond to outbreaks, and maternal
immunization fortifies newborns' defenses. Moreover, programs catering to adolescents, adults,
travelers, and vulnerable populations further extend the reach of immunization efforts.

Amid these efforts, the NPI landscape continually evolves, adapting to emerging diseases,
advances in vaccine research, and global health priorities. These initiatives underscore the
significance of equitable access to vaccines, bolstered by educational campaigns dispelling
myths and misinformation surrounding immunization. The collaboration between governments,
international organizations, healthcare professionals, and communities remains pivotal for
successful NPI implementation.

In summary, the National Program on Immunization stands as a beacon of progress in public

health. It exemplifies the power of proactive measures in preventing diseases that were once
rampant. NPIs stand not just as a testament to medical advancements, but as a testament to
human collaboration, dedication, and resilience in the pursuit of a healthier, safer world for all.

6
REFERENCES

Ankrah V, Nwaigwe F. Immunization system review and training needs assessment in Ekiti
State. February. Ado – Ekiti Ministry of Health. PATHS; 2005

Babalola S, Adewuyi A. Factors Influencing Immunization Uptake in Nigeria: A Theory-based

Research in Six States. Abuja: PATHS; 2005

Doctor HV, Bairagi R, Findley SE, Helleringer S, Dahir T. Northern Nigeria maternal, newborn
and child health programme: selected analyses from population-based baseline
survey. The Open Demography Journal 2011; 4: 11–21 [Google Scholar]

Odusanya OO, Alufohai EF, Meurice FP, Ahonkhai VI. Determinants of vaccination coverage in
rural Nigeria. BMC. Public Health 2008; 8: 381. [PMC free article] [PubMed] [Google
Scholar]

Paul Ntasin (Author), 2019, National Policy on Immunization in Nigeria, Munich, GRIN Verlag,
https://www.grin.com/document/975385