February Vax Corner: Legacy & Future of the Expanded Program on Immunization

Amidst the current challenges to public health legislation and the debate surrounding vaccines, it is crucial to remember the profound benefits vaccines have brought to our nation and the world. Let us celebrate one of modern medicine’s greatest achievements — the Expanded Program on Immunization!

Expanded Program on Immunization at 50 Years: Its Legacy and Future
Excerpt from The Lancet, Volume 403, Issue 10441, 25–31 May 2024, Pages 2265-2267

The Expanded Program on Immunization (EPI) was launched by the WHO in 1974 to make lifesaving vaccines available to all globally. To mark the 50th anniversary of EPI, we sought to quantify the public health impact of vaccination globally since the program’s inception.

Since 1974, vaccination has averted 154 million deaths, including 146 million among children younger than five years of whom 101 million were infants younger than one year. For every death averted, 66 years of full health were gained on average, translating to 10.2 billion years of full health gained. We estimate that vaccination has accounted for 40 percent of the observed decline in global infant mortality, including 52 percent in the African region. In 2024, a child younger than 10 years was 40 percent more likely to survive to their next birthday relative to a hypothetical scenario of no historical vaccination. Increased survival probability is observed even well into late adulthood.

We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. Our results show that equitable universal access to immunization remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality.

— Maria Huang, MD, FAAP, Vaccines Committee Co-Chair, Washington Chapter of the American Academy of Pediatrics