Coverage of the expanded program on immunization in Vietnam: Results from 2 cluster surveys and routine reports

The Expanded Program on Immunization (EPI) in Vietnam began in 1981 and reached a 87% national coverage rate in 1987. To investigate the vaccination coverage and trends in time of the EPI in Vietnam, 2 vaccine coverage cluster surveys have been conducted in 2003 and 2009. Information on EPI-vaccine coverage in children (aged 0-23 months - 7 y of age), in women of childbearing age and in pregnant women, was collected through '30 cluster surveys' in 2003 and 2009 (according to the World Health Organization (WHO) methodology) and through routine annual EPI coverage reports for the period 2001-2008. By comparing both cluster survey studies with each other, as well as with routinely collected data, we aim to improve future evaluation of the vaccination coverage in Vietnam and deduce recommendations for the immunization program. According to both methods, the national targets were reached for most of the vaccines: over 90% of children are fully immunized by 1 y of age, 80% Tetanus Toxoid 2 Plus (TT2+) coverage is reached for pregnant women, and 90% TT2+ for childbearing aged women. The cluster surveys identified higher coverage rates compared to the routinely reported data in some provinces regarding the percentage of fully immunized children by the age of 1 year, and confirmed a low coverage rate for hepatitis B birth dose vaccination in all surveyed sites.

Both methods of coverage assessment suggest that national targets are reached, for most but not all vaccines and not in all regions. Managing stock pile issues, addressing safety issues and tailoring policy for remote areas, are important elements to maintain and further improve these coverage figures.