Tuesday Feb 7, 2023
Tuesday Feb 7, 2023

Why does Nepal need a better immunization plan?

Nepal faces yet another medical setback due to the measles outbreak but why does it not have an adequate immunization plan?


Nepalnews
2023 Jan 13, 12:06, Kathmandu

The ongoing outbreak of measles in Nepalgunj Sub-metropolitan City has highlighted the importance of conducting immunizations programs in Nepal in order to save the lives of many, especially the young ones.

With successfully implemented immunization programs, Nepal became polio-free in 2010. Now, it aims toward the elimination of measles. Vaccine doses have been made available in district hospitals, primary healthcare centers, and health posts around the country.

According to the World Health Organization, vaccines protect against more than twenty diseases including, cervical cancer, cholera, diphtheria, ebola, hepatitis B, influenza, Japanese encephalitis, measles, meningitis, mumps, pertussis, pneumonia, polio, rabies, rotavirus, ru programs ,typhoid, varicella, yellow fever and COVID-19.

 The National Immunization Program (NIP) is a major priority for the Government. It is one of the successful public health programs of the Ministry of Health and Population (MoHP) and has achieved several milestones contributing to a reduction in morbidity and mortality associated with vaccine-preventable diseases. Currently, many partners including WHO and UNICEF are supporting the MoHP in national immunization programs. The vision of the NIP is to make Nepal a “country free of vaccine-preventable diseases.”

Army Spc. Angel Laureano holds a vial of the COVID-19 vaccine, Walter Reed National Military Medical Center, Bethesda, Md., Dec. 14, 2020. (DoD photo by Lisa Ferdinando)
Army Spc. Angel Laureano holds a vial of the COVID-19 vaccine, Walter Reed National Military Medical Center, Bethesda, Md., Dec. 14, 2020. (DoD photo by Lisa Ferdinando)

The National Immunization Program has a significant role in reducing the death of children under five years in Nepal. The vaccines mandated by the NIP program are shown in the table.


VaccinesAgeDisease Prevention
BCG (Bacillus Calmette Guerin)At birth (1 dose)

Tuberculosis
Pentavalent Vaccine (Diphtheria, Pertussis, Tetanus, Hepatitis B and Hemophilus influenza B)

6, 10 and 14 weeks (3 doses)

Diphtheria, Pertussis, Tetanus, Hepatitis B and Hemophilus Influenza B
OPV (Oral Polio Vaccine)

6, 10 and 14 weeks (3 doses)

Polio

PCV (Pneumococcal Conjugate Vaccine)

6, 10 weeks and 9 months (3 doses)

Pneumococcal diseases (Meninges, ear and chest infections)

Rotavirus Vaccine

6, 10 weeks (2 doses)Rotavirus diarrhea

Fipv (Fractional Injectable Polio Vaccine)

Child under 1 year (14 weeks and 9 months, 2 doses)
Child under 5 years (Missed dose): 2 doses should be separated by 8 weeks

Polio

MR (Measles – Rubella)

9 and 15 months (2 doses)

Measles and Rubella

JE (Japanese Encephalitis)

12 months (1 dose)

Japanese Encephalitis

Typhoid Vaccine15 months (1 dose)Typhoid

Td

Pregnant women: 2 doses of Td one month apart in first pregnancy, and 1 dose in each subsequent pregnancy

Tetanus


According to the preliminary finding of the Nepal Demographic Survey as of 2022, 80 percent of children under five are fully vaccinated in Nepal. However, according to United Nations International Children's Emergency Fund (UNICEF), the COVID-19 pandemic has caused a decline in childhood vaccination. UNICEF is working with JSI Research & Training Institute, Inc. (JSI) and Kathmandu University School of Medical Sciences to help strengthen the capacity of partners to use behavioral science approaches to design and implement behaviorally informed interventions for immunization in Nepal.

Besides the national routine immunization program, the COVID-19 vaccination program introduced in January 2021, has made significant progress in the rollout of COVID-19 vaccines. 82 percent of the total population has been injected with COVID- 19 vaccines. However only 38 percent of people above twelve years are injected with booster doses of COVID-19 vaccination as per the MoHP. Since the COVID-19 pandemic is not over yet, MoHP has highlighted the need to increase the booster dose injected population. Human Papilloma Virus (HPV) vaccine rollout initiative is also going on in Nepal to prevent cervical cancer in women.

Yet, according to the UNICEF, there are many pre-existing challenges to immunization in Nepal, including low awareness amongst people about the urgency of full immunization.

Inadequate human resources and poor recording and reporting system has been a major hurdle for Nepal’s immunization programs. Besides, inadequate vaccine store capacity, waste management, ownership, and coordination are the major challenges of the national vaccination program as mentioned in the recent report of the Department of Health Service. On the matter, national public health expert, Radhika Ghimire says, “Community engagement, continued investment and improvement in data management systems are key to the success of the routine national vaccination program and COVID-19 vaccination in Nepal.”


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