World Health Organization, South-East Asia Regional Office
Indonesia 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
Page
No.
Towards measles eliminaion and rubella/congenital rubella
syndrome control
5
Basic informaion 2016
MCV1 and MCV2 coverage, measles and rubella cases, 1980-2016
Figure 11
11
Table 1
5
Immunizaion schedule 2016
MCV supplementary immunizaion aciviies
Table 7
11
Table 2
5
Naional immunizaion coverage 1980 - 2016
MCV1 coverage by province 2015
Figure 12
12
Figure 1
6
Immunizaion system highlights
MCV1 coverage by province 2016
Figure 13
12
Table 3
6
DTP3 coverage, diphtheria and pertussis cases 1980 - 2016
MCV2 coverage by province 2015
Figure 14
12
Figure 2
7
Reported cases of vaccine preventable diseases 2011 - 2016
MCV1 coverage by province 2016
Figure 15
12
Table 4
7
DTP-Hib-HepB3 coverage by province 2015
Immunity against measles – immunity proile by age in 2016
Figure 16
12
Figure 3
7
DTP-Hib-HepB3 coverage by province 2016
Subnaional risk assessment for measles and rubella
Figure 17
12
Figure 4
7
Sporadic and outbreak associated measles cases by month 2011 - 2016
Figure 18
13
Immunizaion status of conirmed (laboratory and EPI linked) measles outbreak
associated cases by age 2011 – 2016
Figure 19
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
WHO supported laboratory network for VPD surveillance
Figure 20
15
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
Environmental surveillance sites for polio detecion
Figure 8
10
Adequate stool specimen collecion percentage by province 2015
Figure 9
10
Adequate stool specimen collecion percentage by province 2016
Figure 10
10
OPV supplementary immunizaion aciviies
Table 6
10
WHO South-East Asia Region
Indonesia: province 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
258,704,986
Division/Province/State/Region
34
Live births
4,858,600
District
514
98
•
EPI launched in 1977
Children 10% drop-out rate for DTP-Hib-HepB1 to DTP-Hib-HepB3
55 districts (11%)
Assessment of vaccine hesitancy at naional level
2013
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
DTP-Hib-HepB3 coverage by province
30014
32999
100
12000
Figure 3: 2015
80
8000
60
6000
40
4000
% Coverage
No. of cases
10000
Source: SEAR annual EPI reporing form, 2015 (administraive data)
20
2000
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Pertussis Cases
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
806
1,941
114 (54%)
21,893
1,959
ND
ND
ND
2012
0
1,192
ND
106
15,489
1,020
ND
ND
ND
2013
0
775
2,976
78 (35%)
8,419
2,355
ND
ND
ND
2014
0
430
2,082
75 (7%)
12,943
3,542
ND
72
ND
2015
0
252
1004
69 (ND)
9,863
826
ND
39
44
2016
0
342
826
33 (6%)
6,962
1,238
ND
43
174
Source: WHO/UNICEF JRF (muliple years)
ND=No data
7
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 May 2016
100
1400
80
1000
800
60
600
40
400
20
200
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
© WHO/Indonesia
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
1200
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
The last polio case due to WPV was reported from Tenggara district, Aceh on 20 February 2006.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
1,720
1,951
1,963
1,765
1,428
1,398
Wild poliovirus conirmed cases
0
0
0
0
0
0
Compaible cases
0
0
0
0
0
0
Non-polio AFP rate
2.75
2.76
2.74
2.43
2.04
1.89
Adequate stool specimen collecion percentage2
91%
92%
88%
89%
92%
87%
Total stool samples collected
3,386
3,828
3,826
3,424
2,801
2,683
1
% NPEV isolaion
9
9
9
7
7
7
% Timeliness of primary result reported3
99
99
99
98
99
97
Number of discarded AFP cases per 100,000 children under 15 years of age.
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
2
Non-polio AFP rate by province
Figure 6: 2015
Figure 7: 2016
© WHO/Indonesia
2
No non-polio AFP case
9
Figure 8: Environmental surveillance sites for poliovirus detection
Adequate stool specimen collection % by province
Figure 9: 2015
Figure 10: 2016
Yogyakarta - 1 site
Jakarta - 1 site
West Java - 1 site
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
Page
No.
Towards measles eliminaion and rubella/congenital rubella
syndrome control
5
Basic informaion 2016
MCV1 and MCV2 coverage, measles and rubella cases, 1980-2016
Figure 11
11
Table 1
5
Immunizaion schedule 2016
MCV supplementary immunizaion aciviies
Table 7
11
Table 2
5
Naional immunizaion coverage 1980 - 2016
MCV1 coverage by province 2015
Figure 12
12
Figure 1
6
Immunizaion system highlights
MCV1 coverage by province 2016
Figure 13
12
Table 3
6
DTP3 coverage, diphtheria and pertussis cases 1980 - 2016
MCV2 coverage by province 2015
Figure 14
12
Figure 2
7
Reported cases of vaccine preventable diseases 2011 - 2016
MCV1 coverage by province 2016
Figure 15
12
Table 4
7
DTP-Hib-HepB3 coverage by province 2015
Immunity against measles – immunity proile by age in 2016
Figure 16
12
Figure 3
7
DTP-Hib-HepB3 coverage by province 2016
Subnaional risk assessment for measles and rubella
Figure 17
12
Figure 4
7
Sporadic and outbreak associated measles cases by month 2011 - 2016
Figure 18
13
Immunizaion status of conirmed (laboratory and EPI linked) measles outbreak
associated cases by age 2011 – 2016
Figure 19
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
WHO supported laboratory network for VPD surveillance
Figure 20
15
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
Environmental surveillance sites for polio detecion
Figure 8
10
Adequate stool specimen collecion percentage by province 2015
Figure 9
10
Adequate stool specimen collecion percentage by province 2016
Figure 10
10
OPV supplementary immunizaion aciviies
Table 6
10
WHO South-East Asia Region
Indonesia: province 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
258,704,986
Division/Province/State/Region
34
Live births
4,858,600
District
514
98
•
EPI launched in 1977
Children 10% drop-out rate for DTP-Hib-HepB1 to DTP-Hib-HepB3
55 districts (11%)
Assessment of vaccine hesitancy at naional level
2013
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
DTP-Hib-HepB3 coverage by province
30014
32999
100
12000
Figure 3: 2015
80
8000
60
6000
40
4000
% Coverage
No. of cases
10000
Source: SEAR annual EPI reporing form, 2015 (administraive data)
20
2000
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Pertussis Cases
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
806
1,941
114 (54%)
21,893
1,959
ND
ND
ND
2012
0
1,192
ND
106
15,489
1,020
ND
ND
ND
2013
0
775
2,976
78 (35%)
8,419
2,355
ND
ND
ND
2014
0
430
2,082
75 (7%)
12,943
3,542
ND
72
ND
2015
0
252
1004
69 (ND)
9,863
826
ND
39
44
2016
0
342
826
33 (6%)
6,962
1,238
ND
43
174
Source: WHO/UNICEF JRF (muliple years)
ND=No data
7
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 May 2016
100
1400
80
1000
800
60
600
40
400
20
200
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
© WHO/Indonesia
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
1200
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
The last polio case due to WPV was reported from Tenggara district, Aceh on 20 February 2006.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
1,720
1,951
1,963
1,765
1,428
1,398
Wild poliovirus conirmed cases
0
0
0
0
0
0
Compaible cases
0
0
0
0
0
0
Non-polio AFP rate
2.75
2.76
2.74
2.43
2.04
1.89
Adequate stool specimen collecion percentage2
91%
92%
88%
89%
92%
87%
Total stool samples collected
3,386
3,828
3,826
3,424
2,801
2,683
1
% NPEV isolaion
9
9
9
7
7
7
% Timeliness of primary result reported3
99
99
99
98
99
97
Number of discarded AFP cases per 100,000 children under 15 years of age.
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
2
Non-polio AFP rate by province
Figure 6: 2015
Figure 7: 2016
© WHO/Indonesia
2
No non-polio AFP case
9
Figure 8: Environmental surveillance sites for poliovirus detection
Adequate stool specimen collection % by province
Figure 9: 2015
Figure 10: 2016
Yogyakarta - 1 site
Jakarta - 1 site
West Java - 1 site
Table 6: OPV SIAs
Target populaion
Coverage (%)
Year
Anigen
Geographic
coverage
Target age
Round 1
Round 2
2002
OPV
NID