World Health Organization, South-East Asia Regional Office
Myanmar 2017
Expanded Programme on Immunization (EPI)
FACT SHEET
Acronyms
AD
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MCV1
First dose measles containing vaccine
AEFI
Adverse events following immunization
MCV2
Second dose measles containing vaccine
AFP
Acute flaccid paralysis
MICS
Multiple indicator cluster survey
BCG
Bacillus Calmette-Guérin vaccine
MMR
Measles mumps rubella vaccine
CES
Coverage evaluation survey
MNT
Maternal and neonatal tetanus
cMYP
Comprehensive multi-year plan
MR
Measles rubella vaccine
CRS
Congenital rubella syndrome
NCIP
National committee on immunization practices
DHS
Demographic health survey
NID
National immunization day
DT
Diphtheria tetanus toxoid, pediatric
NTAGI
National technical advisory group on immunization
DTP
Diphtheria – tetanus – pertussis vaccine
NPEV
Non-polio enterovirus
DTP-Hib-HepB
Pentavalent vaccine
NT
Neonatal tetanus
DTP-Hib-HepB3 3rd dose pentavalent vaccine
OPV
Oral poliovirus vaccine
EPI
Expanded programme on immunization
bOPV
Bivalent OPV
GDP
Gross domestic product
tOPV
Trivalent OPV
HCW
Health care worker
PCV
Pneumococcal conjugate vaccine
HepB
Hepatitis B vaccine
SEAR
WHO South-East Asia Region
Hib
Haemophilus influenzae type b
SIA
Supplementary immunization activities
HPV
Human papilloma virus
SNID
Subnational immunization day
IgM
Immunoglobulin M
Td
Tetanus diphtheria toxoid; older children, adults
IPV
Inactivated poliovirus vaccine
TT
Tetanus toxoid
JE
Japanese encephalitis
TT2+
2 or more doses TT
JE_Live-Atd
JE live attenuated vaccine
VDPV
Vaccine derived poliovirus
JRF
WHO UNICEF joint reporting form
VPD
Vaccine preventable diseases
LB
Live birth
WCBA
Women of child bearing age
M
Measles
WPV
Wild poliovirus
Contents
Page
No.
Impact of rouine immunizaion
EPI history
5
Basic informaion 2016
MCV1 and MCV2 coverage, measles and rubella cases, 1980-2016
Table 1
5
Immunizaion schedule 2016
MCV supplementary immunizaion aciviies
Table 2
5
Naional immunizaion coverage 1980 - 2016
Figure 1
6
Immunizaion system highlights
Table 3
6
DTP3 coverage, diphtheria and pertussis cases 1980 - 2016
Figure 2
7
Reported cases of vaccine preventable diseases 2011 - 2016
Table 4
7
DTP-Hib-HepB3 coverage by province 2015
Figure 3
7
DTP-Hib-HepB3 coverage by province 2016
Figure 4
7
Page
No.
Maternal and neonatal tetanus eliminaion is sustained
TT2+ coverage and NT cases 1980 - 2016
Figure 5
8
Page
No.
Polio-free status is maintained
AFP surveillance indicators 2011 - 2016
Table 5
9
Non-polio AFP rate by province 2015
Figure 6
9
Non-polio AFP rate by province 2016
Figure 7
9
Adequate stool specimen collecion percentage by province 2015
Figure 8
10
Adequate stool specimen collecion percentage by province 2016
Figure 9
10
OPV supplementary immunizaion aciviies
Table 6
10
Page
No.
Towards measles eliminaion and rubella/congenital rubella
syndrome control
Figure 10
11
Table 7
11
MCV1 coverage by province 2015
Figure 11
12
MCV1 coverage by province 2016
Figure 12
12
MCV2 coverage by province 2015
Figure 13
12
MCV1 coverage by province 2016
Figure 14
12
Immunity against measles – immunity proile by age in 2016
Figure 15
12
Subnaional risk assessment for measles and rubella
Figure 16
12
Sporadic and outbreak associated measles cases by month 2011 - 2016
Figure 17
13
Immunizaion status of conirmed (laboratory and Epi linked) measles outbreak
associated cases by age 2011 – 2016
Figure 18
13
Quality of ield and laboratory surveillance for measles and rubella 2012 - 2016
Table 8
14
Performance of laboratory surveillance 2012 - 2016
Table 9
14
Network of WHO supported surveillance medical oicers and laboratories for
VPD surveillance
Figure 19
15
WHO South-East Asia Region
Myanmar: region and state level map
Disclaimer: The boundaries and names shown and the designaions used on all the maps do not imply the expression of any opinion whatsoever on the part of the
World Health Organizaion concerning the legal status of any country, territory, city or area of its authoriies, or concerning the delimitaion of its froniers or boundaries.
4
Impact of routine immunization
Table 1: Basic information1 2016
EPI history
Total populaion
52,088,703
Division/Province/State/Region
Live births
1,009,793
Township/District
17
330/69
•
EPI launched in 1978
Children 10% drop-out rate for DTP-Hib-HepB1 to DTP-Hib-HepB3
34 districts (10%)
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
26878
DTP-Hib-HepB3 coverage by province
0
10238
100
8000
Figure 3: 2015
7000
No. of cases
5000
60
4000
40
3000
2000
% Coverage
80
6000
20
1000
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Pertussis Cases
Source: SEAR annual EPI reporing form, 2015 (administraive data)
DTP3 Coverage
WHO/UNICEF esimates of naional immunizaion coverage, July 2017 revision
WHO vaccine-preventable diseases: monitoring system 2016
1
2
Figure 4: 2016
Table 4: Reported cases of vaccine preventable diseases, 2011-2016
Year
Polio
Diphtheria
Pertussis
NT
(% of all Tetanus)
Measles
Rubella
Mumps
JE
CRS
2011
0
7
5
32 (18%)
2,046
103
ND
20
ND
2012
a
0
19
2
29 (39%)
2,175
21
ND
14
ND
2013
0
38
14
39 (53%)
1,010
23
ND
3
ND
2014
0
29
5
32 (44%)
122
30
ND
50
ND
2015
0
87
5
30 (ND)
6
34
ND
113
ND
2016
0
136
2
21 (11%)
266
10
ND
393
ND
b
a
Excludes one type 1 VDPV
Source: WHO/UNICEF JRF (muliple years)
b
Excludes two type 2 cVDPVs
ND=No data
Source: SEAR annual EPI reporing form, 2016 (administraive data)
90%
Maternal and neonatal tetanus elimination is sustained
Figure 5: TT2+ coverage1 and NT cases2, 1980-2016
MNT eliminaion in 2010
100
120
80
80
60
60
40
40
20
20
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
Year
NT Cases
WHO/UNICEF JRF, Country oicial esimates, 1980-2016
WHO vaccine-preventable diseases: monitoring system 2016
1
2
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
100
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
•
•
Last polio case due to indigenous WPV reported from Rakhine province in February 2000.
Last polio case due to imported WPV reported from Rakhine province in May 2007.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
418
457
404
389
336
466
Wild poliovirus conirmed cases
0
0
0
0
0
0
Compaible cases
0
0
0
0
0
0
2.02
2.21
1.91
1.82
2.34
3.38
Adequate stool specimen collecion percentage
94%
97%
95%
96%
93%
96%
Total stool samples collected
834
916
808
772
672
932
14
14
11
13
13
12
92
93
94
94
95
96
1
Non-polio AFP rate
2
% NPEV isolaion
3
% Timeliness of primary result reported
Number of discarded AFP cases per 100,000 children under 15 years of age.
2
Percent with 2 specimens, at least 24 hours apart and within 14 days of paralysis onset.
3
Results reported within 14 days of sample received at laboratory.
1
Non-polio AFP rate by province
Figure 6: 2015
Figure 7: 2016
© WHO/Myanmar/F Maurizio
2
No non-polio AFP case
9
Adequate stool specimen collection % by province
Figure 8: 2015
Table 6: OPV SIAs
Target populaion
Coverage (%)
Year
Anigen
Geographic
coverage
Target age
Round 1
Round 2
2002
OPV
NID
Expanded Programme on Immunization (EPI)
FACT SHEET
Acronyms
AD
Auto disable
MCV1
First dose measles containing vaccine
AEFI
Adverse events following immunization
MCV2
Second dose measles containing vaccine
AFP
Acute flaccid paralysis
MICS
Multiple indicator cluster survey
BCG
Bacillus Calmette-Guérin vaccine
MMR
Measles mumps rubella vaccine
CES
Coverage evaluation survey
MNT
Maternal and neonatal tetanus
cMYP
Comprehensive multi-year plan
MR
Measles rubella vaccine
CRS
Congenital rubella syndrome
NCIP
National committee on immunization practices
DHS
Demographic health survey
NID
National immunization day
DT
Diphtheria tetanus toxoid, pediatric
NTAGI
National technical advisory group on immunization
DTP
Diphtheria – tetanus – pertussis vaccine
NPEV
Non-polio enterovirus
DTP-Hib-HepB
Pentavalent vaccine
NT
Neonatal tetanus
DTP-Hib-HepB3 3rd dose pentavalent vaccine
OPV
Oral poliovirus vaccine
EPI
Expanded programme on immunization
bOPV
Bivalent OPV
GDP
Gross domestic product
tOPV
Trivalent OPV
HCW
Health care worker
PCV
Pneumococcal conjugate vaccine
HepB
Hepatitis B vaccine
SEAR
WHO South-East Asia Region
Hib
Haemophilus influenzae type b
SIA
Supplementary immunization activities
HPV
Human papilloma virus
SNID
Subnational immunization day
IgM
Immunoglobulin M
Td
Tetanus diphtheria toxoid; older children, adults
IPV
Inactivated poliovirus vaccine
TT
Tetanus toxoid
JE
Japanese encephalitis
TT2+
2 or more doses TT
JE_Live-Atd
JE live attenuated vaccine
VDPV
Vaccine derived poliovirus
JRF
WHO UNICEF joint reporting form
VPD
Vaccine preventable diseases
LB
Live birth
WCBA
Women of child bearing age
M
Measles
WPV
Wild poliovirus
Contents
Page
No.
Impact of rouine immunizaion
EPI history
5
Basic informaion 2016
MCV1 and MCV2 coverage, measles and rubella cases, 1980-2016
Table 1
5
Immunizaion schedule 2016
MCV supplementary immunizaion aciviies
Table 2
5
Naional immunizaion coverage 1980 - 2016
Figure 1
6
Immunizaion system highlights
Table 3
6
DTP3 coverage, diphtheria and pertussis cases 1980 - 2016
Figure 2
7
Reported cases of vaccine preventable diseases 2011 - 2016
Table 4
7
DTP-Hib-HepB3 coverage by province 2015
Figure 3
7
DTP-Hib-HepB3 coverage by province 2016
Figure 4
7
Page
No.
Maternal and neonatal tetanus eliminaion is sustained
TT2+ coverage and NT cases 1980 - 2016
Figure 5
8
Page
No.
Polio-free status is maintained
AFP surveillance indicators 2011 - 2016
Table 5
9
Non-polio AFP rate by province 2015
Figure 6
9
Non-polio AFP rate by province 2016
Figure 7
9
Adequate stool specimen collecion percentage by province 2015
Figure 8
10
Adequate stool specimen collecion percentage by province 2016
Figure 9
10
OPV supplementary immunizaion aciviies
Table 6
10
Page
No.
Towards measles eliminaion and rubella/congenital rubella
syndrome control
Figure 10
11
Table 7
11
MCV1 coverage by province 2015
Figure 11
12
MCV1 coverage by province 2016
Figure 12
12
MCV2 coverage by province 2015
Figure 13
12
MCV1 coverage by province 2016
Figure 14
12
Immunity against measles – immunity proile by age in 2016
Figure 15
12
Subnaional risk assessment for measles and rubella
Figure 16
12
Sporadic and outbreak associated measles cases by month 2011 - 2016
Figure 17
13
Immunizaion status of conirmed (laboratory and Epi linked) measles outbreak
associated cases by age 2011 – 2016
Figure 18
13
Quality of ield and laboratory surveillance for measles and rubella 2012 - 2016
Table 8
14
Performance of laboratory surveillance 2012 - 2016
Table 9
14
Network of WHO supported surveillance medical oicers and laboratories for
VPD surveillance
Figure 19
15
WHO South-East Asia Region
Myanmar: region and state level map
Disclaimer: The boundaries and names shown and the designaions used on all the maps do not imply the expression of any opinion whatsoever on the part of the
World Health Organizaion concerning the legal status of any country, territory, city or area of its authoriies, or concerning the delimitaion of its froniers or boundaries.
4
Impact of routine immunization
Table 1: Basic information1 2016
EPI history
Total populaion
52,088,703
Division/Province/State/Region
Live births
1,009,793
Township/District
17
330/69
•
EPI launched in 1978
Children 10% drop-out rate for DTP-Hib-HepB1 to DTP-Hib-HepB3
34 districts (10%)
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
26878
DTP-Hib-HepB3 coverage by province
0
10238
100
8000
Figure 3: 2015
7000
No. of cases
5000
60
4000
40
3000
2000
% Coverage
80
6000
20
1000
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Pertussis Cases
Source: SEAR annual EPI reporing form, 2015 (administraive data)
DTP3 Coverage
WHO/UNICEF esimates of naional immunizaion coverage, July 2017 revision
WHO vaccine-preventable diseases: monitoring system 2016
1
2
Figure 4: 2016
Table 4: Reported cases of vaccine preventable diseases, 2011-2016
Year
Polio
Diphtheria
Pertussis
NT
(% of all Tetanus)
Measles
Rubella
Mumps
JE
CRS
2011
0
7
5
32 (18%)
2,046
103
ND
20
ND
2012
a
0
19
2
29 (39%)
2,175
21
ND
14
ND
2013
0
38
14
39 (53%)
1,010
23
ND
3
ND
2014
0
29
5
32 (44%)
122
30
ND
50
ND
2015
0
87
5
30 (ND)
6
34
ND
113
ND
2016
0
136
2
21 (11%)
266
10
ND
393
ND
b
a
Excludes one type 1 VDPV
Source: WHO/UNICEF JRF (muliple years)
b
Excludes two type 2 cVDPVs
ND=No data
Source: SEAR annual EPI reporing form, 2016 (administraive data)
90%
Maternal and neonatal tetanus elimination is sustained
Figure 5: TT2+ coverage1 and NT cases2, 1980-2016
MNT eliminaion in 2010
100
120
80
80
60
60
40
40
20
20
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
Year
NT Cases
WHO/UNICEF JRF, Country oicial esimates, 1980-2016
WHO vaccine-preventable diseases: monitoring system 2016
1
2
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
100
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
•
•
Last polio case due to indigenous WPV reported from Rakhine province in February 2000.
Last polio case due to imported WPV reported from Rakhine province in May 2007.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
418
457
404
389
336
466
Wild poliovirus conirmed cases
0
0
0
0
0
0
Compaible cases
0
0
0
0
0
0
2.02
2.21
1.91
1.82
2.34
3.38
Adequate stool specimen collecion percentage
94%
97%
95%
96%
93%
96%
Total stool samples collected
834
916
808
772
672
932
14
14
11
13
13
12
92
93
94
94
95
96
1
Non-polio AFP rate
2
% NPEV isolaion
3
% Timeliness of primary result reported
Number of discarded AFP cases per 100,000 children under 15 years of age.
2
Percent with 2 specimens, at least 24 hours apart and within 14 days of paralysis onset.
3
Results reported within 14 days of sample received at laboratory.
1
Non-polio AFP rate by province
Figure 6: 2015
Figure 7: 2016
© WHO/Myanmar/F Maurizio
2
No non-polio AFP case
9
Adequate stool specimen collection % by province
Figure 8: 2015
Table 6: OPV SIAs
Target populaion
Coverage (%)
Year
Anigen
Geographic
coverage
Target age
Round 1
Round 2
2002
OPV
NID