In the 30 plus years since the creation of the Expanded Program on Immunization (EPI) in the Americas, polio has been eradicated, the transmission of endemic measles and rubella interrupted, and neonatal tetanus eliminated as a public health problem in more than 99.9% of the municipalities of the Region. The EPI has expanded from providing vaccines against six diseases targeting infants (severe forms of tuberculosis, diphtheria, tetanus, pertussis, polio, and measles) and tetanus toxoid to pregnant women, to providing vaccines against more than 10 diseases (with the addition of vaccines against rubella, mumps, hepatitis B, Haemophilus influenzae type b [Hib], yellow fever, seasonal influenza, and more recently rotavirus and pneumococcus) and targeting virtually all members of the family. Regional coverage rates for basic childhood vaccines in the Americas have risen from an estimated 50% in 1980 to over 90% since 2000. The Immunization Newsletter (formerly: EPI Newsletter), has been a witness to this progress. With the vaccine-preventable disease elimination goals set in the Americas, the increase in vaccination coverage achieved by the countries, and the increasing number of vaccines administered by the program, the complexities of managing the EPI have also multiplied. All the EPI components, namely management of vaccines and syringes, logistics, cold chain, training and supervision, vaccination safety, social mobilization, information systems, epidemiological surveillance, laboratory networks, research, and monitoring and evaluation, have been strengthened as a result.
This compendium of articles published in the Immunization Newsletter, since its creation in 1979, comes to serve as a unique anthology of the EPI in the Americas. It bears witness to milestones in the history of immunization in a continent that is diverse, but that has united in the spirit of equity and solidarity-or Panamericanism- to reach common goals on vaccine-preventable disease control and elimination. Thirty Years of Immunization Newsletter: the History of the Expanded Program on Immunization in the Americas tells a story of multiple successes and challenges. A story of how strategies have been developed, implemented, adapted, and expanded. A story of a program that started from managing a few vaccine doses to one that manages vaccine doses that amount to several millions of dollars. The compendium presents experiences and lessons learned by each country. It talks about the creation and evolution of regional and national immunization advisory groups to guide the EPI on vaccination schedules and strategies, and it describes legislation and other creative mechanisms that have been put in place to ensure program sustainability.
The Immunization Newsletter continues to serve as a forum for countries of the Americas to exchange experiences, knowledge, and information relevant to the EPI. It is published bimonthly in English and Spanish (and also in French, since 2001), and is distributed for free to 7,500 readers worldwide.
You will find "Thirty Years of Immunization Newsletter: the History of the Expanded Program on Immunization in the Americas" to be a useful reference book, that will enable you to discover the history of the EPI in the Americas.
Dr. Mirta Roses Periago
Pan American Health Organization