In the year 1798, Edward Jenner first demonstrated that vaccination offered protection against smallpox. He used cowpox (poxvirus bovis) for the immunization of man against the smallpox virus (poxvirus varialae). For the last 200 years, the use of vaccines has continued to reduce the burden of many bacterial and viral diseases.
Smallpox itself has been eradicated, and poliomyelitis in the verge of eradication. In Sri Lanka, the last case of virologically confirmed poliomyelitis patient was reported in 1993.
In Sri Lanka, the introduction of routine immunization has generally reduced the incidence of several vaccine preventable diseases. Similar success in disease reduction has been demonstrated by immunization programmes in many other countries. The World Health Organization’s (WHO) Expanded Programme on Immunization (EPI), with assistance from the United Nation’s Children’s Fund (UNICEF) and other donors, has made great strides in extending these benefits to developing countries. Immunizations permitted the global eradication of smallpox, and may do the same for poliomyelitis and some other diseases.
Immunizing a child not only protects that child but also other children by increasing the general level of immunity and minimising the spread of infection.
History of Immunization in Sri Lanka
The history of immunization in Sri Lanka goes back to the 19th century. The law relating to compulsory vaccination (against smallpox) is referred to in the Vaccination Ordinance of 1886.
The Expanded Programme on Immunization (EPI) established in 1978, has continued to make excellent progress over the past two decades, most notably in terms of achieving high immunization coverage and disease control. The milestones of immunization in Sri Lanka are given below.
Vaccination against smallpox introduced under the Vaccination Ordinance
BCG Vaccination introduced against tuberculosis
“Triple” vaccination introduced against diphtheria, whooping cough and tetanus
Oral polio vaccine introduced
BCG vaccination of newborn introduced
Tetanus Toxoid administration to pregnant mothers introduced
Launching of the Expanded Programme on Immunization
Measles vaccination introduced
Revision of Tetanus Toxoid schedule
First National Immunization Days conducted.
Introduction of Rubella vaccine
Introduction of revised National Immunization Schedule with MR and ATd
Introduction of Hepatitis B Vaccine on phase basis
Introduction of Hib containing Pentavalent vaccine
With the commencement of the EPI Programme in 1978 focus was to control childhood T.B., tetanus, whooping cough, diphtheria, polio and neo-natal tetanus. In 1988, the focus shifted to disease elimination. In 1991, a fifth dose of OPV was introduced at school entry to facilitate the polio eradication process. Rubella, Hepatitis B and Hib containing Pentavalent vaccines introduced to the programme gradually over the years. The present EPI vaccination schedule is given in annex below. JE vaccine was introduced to high-risk areas in 1987. Primary Immunization against JE consists of 3 doses at an interval of 2 – 4 weeks between the first and second doses and one year between the second and third. A booster dose is given every 4 years after the primary immunization. JE immunization is offered children below the age of ten years living in identified high-risk areas.
Objectives of the National Immunization Programme
To achieve the above objectives, immunity has to be create in population against the specific organisms causing above diseases by administering potent vaccines in correct dosage using correct technique and according to the national immunization schedule.
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