World Health Organization, South-East Asia Regional Office
Democratic People’s Republic
of Korea 2017
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
WHO supported laboratory network for VPD surveillance
Figure 19
15
WHO South-East Asia Region
Democraic People’s Republic of Korea: 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
24,327,698
342,884
Live births
•
EPI launched in 1980
Children 10% drop-out rate for DTP-Hib-HepB1 to DTP-Hib-HepB3
no district
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
DTP-Hib-HepB3 coverage by province
1607
100
600
Figure 3: 2015
80
400
60
300
40
200
% Coverage
No. of cases
500
20
100
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Source: SEAR annual EPI reporing form, 2015 (administraive data)
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
0
13
0
0
5
66
0
0
2012
0
0
8
0
0
1
11
0
0
2013
0
0
0
0
0
0
0
0
0
2014
0
0
0
0
3
0
0
0
0
2015
0
0
0
0
0
0
0
0
0
2016
0
0
0
0
0
0
0
0
0
Source: WHO/UNICEF JRF, (muliple years)
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 before 2000
3.0
100
80
2.0
60
1.5
40
1.0
No data
0.5
20
0.0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
Year
NT Cases
© Ministry of Public Health/Democraic People’s
Republic of Korea
WHO/UNICEF JRF, Country oicial esimates, 1980-2016
WHO vaccine-preventable diseases: monitoring system 2016 & JRF 2016
1
2
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
2.5
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
The last laboratory conirmed polio case due to WPV was reported in 1996.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
129
125
116
115
99
105
Wild poliovirus conirmed cases
0
0
0
0
0
0
Compaible cases
0
0
0
0
0
0
2.25
2.18
2.02
2.00
1.72
1.83
100%
100%
100%
100%
100%
98%
Total stool samples collected
270
269
226
184
156
194
% NPEV isolaion
10
11
9
11
5
14
% Timeliness of primary result reported3
99
94
92
99
95
93
Non-polio AFP rate
1
Adequate stool specimen collecion percentage2
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
© Ministry of Public Health/Democraic People’s
Republic of Korea
2
No non-polio AFP case
9
Adequate stool specimen collection % by province
Figure 9: 2016
Figure 8: 2015
80%
No AFP
Table 6: OPV and JE SIAs
Year
Vaccine
Geographic
coverage
Target populaion
Coverage (%)
Target age
Round 1
Round 2
Round 1
Round 2
2000
OPV
NID
15 years
< 1 year
1-4 years
5-9 years
10-14 years
> 15 years
< 1 year
1-4 years
5-9 years
10-14 years
> 15 years
< 1 year
1-4 years
5-9 years
10-14 years
> 15 years
5
2011
2012
Immunized
Source: SEAR annual EPI reporing form (2011-2016)
2013
2014
2015
Not immunized/ unknown
2016
13
No. of suspected measles
80%
Proporion of sub-naional
surveillance units reporing
to the naional level on ime
Genotypes
detected
Indicators
80%
Proporion of provinces
reporing at least two
discarded non-measles
non-rubella cases per
100,000 total populaion
Rubella
2
Discarded non-measles
non-rubella incidence per
100,000 total populaion
0
0
Proporion of all suspected
measles and rubella cases
that have had an adequate
invesigaion iniiated within
48 hours of noiicaion
0.27
0.26
80%
100
Annual incidence of
conirmed rubella cases per
million total populaion
100
0
0
0
-
0
0.53
0.32
0.54
Annual incidence of
conirmed measles cases per
million total populaion
0
100
100
100
-
0
0
0
0
Discarded non-measles
non-rubella cases
0
63
0.12
0
0
EPI-linked
65
0
132
73
132
Lab-conirmed
0
0
0
0
0
0
0
0
0
0
Measles
ND
ND
ND
-
-
0
0
0
0
0
2
100
2
0
ND
100
100
100
100
Clinically-conirmed
Case classiicaion (number)
Measles
EPI-linked
Target ➔
0
0
0
0
1
3
0
0
Lab-conirmed
Table 8: Surveillance performance indicators for measles and rubella, 2012-2016
Year
63
66
135
0
0
%
0
2
0
0
0
% Posiive cases
tested for viral
detecion
2013
2014
73
132
No.
0
1
0
0
0
% Results within
4 days of receipt
2012
2016
ND=No data
%
0
0
2
0
0
14
Specimen
posiive for
rubella IgM
2015
No.
0
0
3
0
0
ND=No data
Specimen
posiive for
measles IgM
Source: SEAR annual EPI reporing form (2012-2016)
Serum specimen
received in
laboratory
within 5 days of
collecion
Table 9: Performance of laboratory surveillance, 2012-2016
Year
No (%)
66 (100%)
63 (100%)
135 (100%)
73 (100%)
132 (100%)
No (%)
66 (100%)
135 (100%)
63 (100%)
2014
73 (100%)
132 (100%)
2012
2015
2013
2016
Source: SEAR annual EPI reporing form (2012-2016)
Serum specimen
collected from
suspected
measles cases
100
100
100
96
100
Rubella
ND
ND
ND
-
-
Figure 19: WHO supported laboratory network for VPD surveillance
Central hygiene epidemic insituion
- Naional polio laboratory
- Naional measles & rubella laboratory
15
For contact or feedback:
Expanded Programme on Immunizaion
Ministry of Public Health, Pyongyang, DPR Korea
Phone: +850-2-3814077, Fax: +850-2-44104416
Email: bogon.moph@star-co.net.kp
Immunizaion and Vaccine Development (IVD)
WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India
Tel: +91 11 23370804, Fax: +91 11 23370251
Email: SearEpidata@who.int
www.searo.who.int/enity/immunizaion
of Korea 2017
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
WHO supported laboratory network for VPD surveillance
Figure 19
15
WHO South-East Asia Region
Democraic People’s Republic of Korea: 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
24,327,698
342,884
Live births
•
EPI launched in 1980
Children 10% drop-out rate for DTP-Hib-HepB1 to DTP-Hib-HepB3
no district
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
DTP-Hib-HepB3 coverage by province
1607
100
600
Figure 3: 2015
80
400
60
300
40
200
% Coverage
No. of cases
500
20
100
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Source: SEAR annual EPI reporing form, 2015 (administraive data)
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
0
13
0
0
5
66
0
0
2012
0
0
8
0
0
1
11
0
0
2013
0
0
0
0
0
0
0
0
0
2014
0
0
0
0
3
0
0
0
0
2015
0
0
0
0
0
0
0
0
0
2016
0
0
0
0
0
0
0
0
0
Source: WHO/UNICEF JRF, (muliple years)
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 before 2000
3.0
100
80
2.0
60
1.5
40
1.0
No data
0.5
20
0.0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
Year
NT Cases
© Ministry of Public Health/Democraic People’s
Republic of Korea
WHO/UNICEF JRF, Country oicial esimates, 1980-2016
WHO vaccine-preventable diseases: monitoring system 2016 & JRF 2016
1
2
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
2.5
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
The last laboratory conirmed polio case due to WPV was reported in 1996.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
129
125
116
115
99
105
Wild poliovirus conirmed cases
0
0
0
0
0
0
Compaible cases
0
0
0
0
0
0
2.25
2.18
2.02
2.00
1.72
1.83
100%
100%
100%
100%
100%
98%
Total stool samples collected
270
269
226
184
156
194
% NPEV isolaion
10
11
9
11
5
14
% Timeliness of primary result reported3
99
94
92
99
95
93
Non-polio AFP rate
1
Adequate stool specimen collecion percentage2
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
© Ministry of Public Health/Democraic People’s
Republic of Korea
2
No non-polio AFP case
9
Adequate stool specimen collection % by province
Figure 9: 2016
Figure 8: 2015
80%
No AFP
Table 6: OPV and JE SIAs
Year
Vaccine
Geographic
coverage
Target populaion
Coverage (%)
Target age
Round 1
Round 2
Round 1
Round 2
2000
OPV
NID
15 years
< 1 year
1-4 years
5-9 years
10-14 years
> 15 years
< 1 year
1-4 years
5-9 years
10-14 years
> 15 years
< 1 year
1-4 years
5-9 years
10-14 years
> 15 years
5
2011
2012
Immunized
Source: SEAR annual EPI reporing form (2011-2016)
2013
2014
2015
Not immunized/ unknown
2016
13
No. of suspected measles
80%
Proporion of sub-naional
surveillance units reporing
to the naional level on ime
Genotypes
detected
Indicators
80%
Proporion of provinces
reporing at least two
discarded non-measles
non-rubella cases per
100,000 total populaion
Rubella
2
Discarded non-measles
non-rubella incidence per
100,000 total populaion
0
0
Proporion of all suspected
measles and rubella cases
that have had an adequate
invesigaion iniiated within
48 hours of noiicaion
0.27
0.26
80%
100
Annual incidence of
conirmed rubella cases per
million total populaion
100
0
0
0
-
0
0.53
0.32
0.54
Annual incidence of
conirmed measles cases per
million total populaion
0
100
100
100
-
0
0
0
0
Discarded non-measles
non-rubella cases
0
63
0.12
0
0
EPI-linked
65
0
132
73
132
Lab-conirmed
0
0
0
0
0
0
0
0
0
0
Measles
ND
ND
ND
-
-
0
0
0
0
0
2
100
2
0
ND
100
100
100
100
Clinically-conirmed
Case classiicaion (number)
Measles
EPI-linked
Target ➔
0
0
0
0
1
3
0
0
Lab-conirmed
Table 8: Surveillance performance indicators for measles and rubella, 2012-2016
Year
63
66
135
0
0
%
0
2
0
0
0
% Posiive cases
tested for viral
detecion
2013
2014
73
132
No.
0
1
0
0
0
% Results within
4 days of receipt
2012
2016
ND=No data
%
0
0
2
0
0
14
Specimen
posiive for
rubella IgM
2015
No.
0
0
3
0
0
ND=No data
Specimen
posiive for
measles IgM
Source: SEAR annual EPI reporing form (2012-2016)
Serum specimen
received in
laboratory
within 5 days of
collecion
Table 9: Performance of laboratory surveillance, 2012-2016
Year
No (%)
66 (100%)
63 (100%)
135 (100%)
73 (100%)
132 (100%)
No (%)
66 (100%)
135 (100%)
63 (100%)
2014
73 (100%)
132 (100%)
2012
2015
2013
2016
Source: SEAR annual EPI reporing form (2012-2016)
Serum specimen
collected from
suspected
measles cases
100
100
100
96
100
Rubella
ND
ND
ND
-
-
Figure 19: WHO supported laboratory network for VPD surveillance
Central hygiene epidemic insituion
- Naional polio laboratory
- Naional measles & rubella laboratory
15
For contact or feedback:
Expanded Programme on Immunizaion
Ministry of Public Health, Pyongyang, DPR Korea
Phone: +850-2-3814077, Fax: +850-2-44104416
Email: bogon.moph@star-co.net.kp
Immunizaion and Vaccine Development (IVD)
WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India
Tel: +91 11 23370804, Fax: +91 11 23370251
Email: SearEpidata@who.int
www.searo.who.int/enity/immunizaion