THE IMPACT OF INACTIVATED POLIO VACCINE INTRODUCTION ON THE OVERALL EXPANDED PROGRAM ON IMMUNIZATION COVERAGE AND TIMELINESS IN YOGYAKARTA PROVINCE

Abstract

Background: Implementation of the expanded program on immunization
(EPI) has been excellent in Yogyakarta Province.
Since September 2007 this province has piloted the introduction
of inactivated polio vaccine (IPV), instead of oral polio vaccine
(OPV). The shifting policy raised concern on the possibility that
the new program would compromise the performance of the
existing EPI. This study was a part of evaluation study on IPV
pilot project in this province 2.5 years after its implementation. It
was aimed to assess the impact of IPV introduction on coverage
and timeliness of immunizations within EPI.
Method: We conducted a cross sectional study using WHO
standard 30-by-7 cluster sampling to evaluate the EPI program
in Yogyakarta Province, both in urban and rural areas. The
subjects included children aged 12-23 months old and their
parents. A questionnaire was used to get information from
parents/caregivers on demographic and socioeconomic characteristics.
Along with data on status and date of IPV vaccination,
we included those of other EPI. The impact of IPV implementation
was evaluated by determining the coverage and
timeliness of all immunizations within EPI. We compared the
current data with those in period before introduction of IPV.
We used Epi InfoTM 2003 software for data entry and analysis.
Result: Coverage of vaccinations within EPI is in overall ranged
from 92-100%. The coverage is similar between urban and
rural areas for all vaccines and doses. There is no difference
in EPI coverage before and after the introduction of the IPV.
Approximately 89% children have received complete immunization.
Average age of immunization for each vaccine was
very close to the recommended schedule. However, only 69%
children received the immunization timely.
Conclusion: The EPI coverage in Yogyakarta Province is excellent
and not compromised by the introduction of IPV. The
proportion of children received timely immunization is relatively
low. We suggest including timeliness, beside the coverage,
when evaluating the performance of immunization program.
Key words: immunization, EPI, IPV, coverage, timeliness