Ethiopia’s Expanded Program on Immunization: A Cornerstone of Public Health

Ethiopia’s Expanded Program on Immunization (EPI) has been a vital public health intervention since 1980, significantly reducing morbidity and mortality associated with vaccine-preventable diseases (VPDs). The program continues to evolve, introducing latest vaccines and strengthening its infrastructure to reach even the most vulnerable populations.

A History of Success and Expansion

Initially launched in 1980, the EPI has progressively expanded its scope, now offering twelve different antigens in its routine immunization program [1]. This expansion reflects a commitment to protecting the population against a wider range of VPDs.

Key Milestones in Vaccine Introduction

• 2007: Introduction of Hemophilus influenza type b (Hib) and Hepatitis B (Hep B) vaccines, combined with Diphtheria-Tetanus-Pertussis (DTP) as a pentavalent combination vaccine (DTP‐Hib‐Hep B) [1].
• 2011: Introduction of Pneumococcal Conjugate Vaccine with 10 Serova lent (PCV‐10) [1].
• 2013: Introduction of Rotavirus vaccines [1].
• 2015: Introduction of Inactivated Polio Vaccine (IPV) in preparation for the switch from trivalent Oral Polio Vaccine (tOPV) to bivalent Oral Polio vaccine (bOPV) [1].
• 2016: Completion of the switch from tOPV to bOPV [1].
• 2017: Completion of a two-year demonstration project for the national introduction of Human Papillomavirus (HPV) vaccine for girls aged 9 years old [1].

Strengthening Program Management and Coordination

Ethiopia has established robust structures to guide and coordinate the EPI. These include:

• National Immunization Technical Advisory Group (NITAG): An independent body of experts providing guidance on vaccines and vaccination strategies [1].
• Interagency Coordination Committee (ICC): Facilitates coordination and decision-making among partner organizations [1].
• Immunization Taskforce and Technical Sub-Working Groups: Implement activities aligned with the approved plan [1].

The Future of Immunization in Ethiopia

The Ethiopia National Expanded Program on Immunization continues to adapt and improve, as outlined in the Comprehensive Multi-Year Plan (cMYP) for 2021-2025 [2]. The program is focused on strengthening immunization systems, reaching underserved populations, and incorporating a life-course approach to immunization, extending beyond childhood to adolescence and adulthood [3]. Recent policy implementation guidelines emphasize second-dose measles vaccination (MCV2) and HPV vaccination for adolescent girls [4].

The EPI remains one of the most cost-effective public health interventions available, and its continued success is crucial for protecting the health and well-being of the Ethiopian population.