Immunization Essentials: A Practical Field Guide

"Changing the behavior of health workers and clients may be the most important step required to make injections safe."

Like its predecessor, EPI Essentials (1988), this manual has been written for immunisation programme managers at national and sub-national levels in developing countries and for people who support these managers, particularly field staff of donor agencies. The intention is to provide information that is practical as well as technically and operationally sound. For readers who would like to explore topics in greater depth, additional references are provided.

In revising EPI Essentials, the authors have tried to listen to readers' feedback, which was generally positive. Users appreciated: "having such a variety of practical information in one compact volume; the user-friendly format with many photos, forms, tables, and quotations; the accessible writing style; and, at times, the authors' provocative attitude."

The United States Agency for International Development (USAID) decided to revise the earlier volume because it had long been out of print and because immunisation programmes had undergone a number of significant changes. "These include new objectives (e.g., accelerated disease control for polio, measles, and neonatal tetanus), new vaccines (e.g., hepatitis B and Hib), new procedures to solve old problems (e.g., injection safety), new technologies for vaccine delivery and coldchain, and health sector reforms. Such changes underscore the need for constant attention, sharing of experience, creativity, and flexibility in responding to problems."

This manual provides managers and other decision-makers with scientifically based principles, policies, and standards; technical specifications for vaccines and equipment; and operational considerations that they must weigh to devise the best solutions for their circumstances. Examples in the manual draw on real-life experiences to illustrate how technical and operational issues can be addressed in the field.

USAID views the provision of a primary series of vaccines in the first year of life (often called "routine immunisation" - or "RI") as the cornerstone of all immunisation efforts and other primary health care efforts. According to USAID, the fact that immunisation gives each child five contacts with the health system before the age of one year is "a tremendous opportunity" that is often underutilised. While the necessity for RI for every birth cohort remains constant, immunisation programmes are "anything but static". Decentralisation, integration, and other changes in primary health service delivery "pose a continual challenge, and public health personnel must be ever vigilant to make sure that the tremendous promise of immunization is sustained."

Table of Contents:

• Preface
• Acknowledgements
• Acronyms
• Introduction
• Immunization Program Management
• Delivery of Immunization Services
• Monitoring, Evaluation, and Information Management
• Vaccine Supply and Quality
• The Cold Chain and Logistics
• Injection Safety
• Disease Surveillance
• The Role of Behavior Change
• Costs and Financing
• New Vaccines and Technologies
• Vaccines and Vaccine-Preventable Diseases

Chapters 3, 4, and 9 in particular have a focus on communication and change. For example, Chapter 9 notes that: "In country after country, studies have shown that most people will use immunization services as long as they to know when and where to bring their children, and those services are available, accessible, reliable, and friendly. Thus, the role of communication activities in achieving these conditions is important but not sufficient. Dissemination of information, training, supervision, and other ways of improving services need to be employed in a mutually supportive way to promote complete and timely immunization of women and children."

Click here for the 275-page resource in English in PDF format.
Click here for the 277-page resource in French in PDF format.
Click here for the 318-page resource in Spanish in PDF format.