EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data...

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Indonesia 2016 Immunization system highlights There is a comprehensive multi- year plan (cMYP) for immunization covering 2015-2019. A standing national technical advisory group on immunization (NTAGI) fully functional. A national system to monitor adverse events following immunization (AEFI) exists. A national policy for health care waste management including waste from immunization activities exists. All 514 (100%) districts have updated micro-plans that include activities to raise immunization coverage. District coverage survey in 31 districts and 10 provinces was conducted in 2015. 83% spending on routine vaccine financed by the government. 76% spending on routine immunization programme financed by the central government. Out of 514 districts, 328 (64%) districts had > 80% coverage for DTP-Hib-HepB3, 217 (42%) districts had > 90% coverage for MCV1. Source: WHO/UNICEF joint reporting form (JRF) 2015 Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Table 1: Basic information 1 2015 Division/Province/State/Region 34 District 416 City 98 Village 79,411 Population density (per sq. km) 132 Population living in urban areas 52% Population using improved drinking-water sources 85% Population using improved sanitation 59% Total expenditure on health as % of GDP 3.0% Births attended by skilled health personnel 83% Neonates protected at birth against NT 85% Total population 255 461 686 Live births (LB) 4 893 435 Children <1 year 4 794 791 Children <5 years 24 065 506 Children <15 years 69 857 406 Pregnant women 5 382 779 Women of child bearing age (15-49 years) 51 981 127 Neonatal mortality rate 14.4 (per 1000 LB) Infant mortality rate 24.5 (per 1000 LB) Under-five mortality rate 29.3 (per 1000 LB) Maternal mortality ratio 190 (per 100 000 LB) 1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015 Vaccine Age of administration HepB 0 to 7 days of birth BCG 1 month OPV 1 month, 2 months, 3 months, 4 months DTP-Hib-HepB 2 months, 3 months, 4 months, 18 months Measles 9 months, 24 months DT 6 -7 years Td 7-8 years, 8-9 years TT Females 15 to 39 years Vitamin A 6 – 59 months EPI history EPI launched in 1977. HepB vaccine introduced in 1997. AD syringe introduced in 2002. MCV2 introduced in 2004. DTP-HepB vaccine introduced in 2004 (in phases) IPV introduced in one province in 2007. Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in four provinces in 2013 and gradually expended to all provinces by 2014. Type 2 component of OPV withdrawn on 04 April 2016 by switching from tOPV to bOPV. IPV vaccine launched in national routine immunization programme from July 2016. Table 2: Immunization schedule, 2015 Source: cMYP 2015-2019 and EPI/MOH Source: WHO/UNICEF joint reporting form (JRF) 2015 World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization and Vaccine Development South-East Asia Region

Transcript of EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data...

Page 1: EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data Source: SEAR Annual EPI Reporting Form, 2015 ND=No data Source: SEAR annual EPI reporting

Indonesia 2016

Immunization system highlights

� There is a comprehensive multi-year plan (cMYP) for immunization covering 2015-2019.

� A standing national technical advisory group on immunization (NTAGI) fully functional.

� A national system to monitor adverse events following immunization (AEFI) exists.

� A national policy for health care waste management including waste from immunization activities exists.

� All 514 (100%) districts have updated micro-plans that include activities to raise immunization coverage.

� District coverage survey in 31 districts and 10 provinces was conducted in 2015.

� 83% spending on routine vaccine financed by the government.

� 76% spending on routine immunization programme financed by the central government.

� Out of 514 districts, 328 (64%) districts had > 80% coverage for DTP-Hib-HepB3, 217 (42%) districts had > 90% coverage for MCV1.

Source: WHO/UNICEF joint reporting form (JRF) 2015

Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

Table 1: Basic information1 2015Division/Province/State/Region 34

District 416

City 98

Village 79,411

Population density (per sq. km) 132

Population living in urban areas 52%

Population using improved drinking-water sources

85%

Population using improved sanitation 59%

Total expenditure on health as % of GDP 3.0%

Births attended by skilled health personnel 83%

Neonates protected at birth against NT 85%

Total population 255 461 686

Live births (LB) 4 893 435

Children <1 year 4 794 791

Children <5 years 24 065 506

Children <15 years 69 857 406

Pregnant women 5 382 779

Women of child bearing age (15-49 years)

51 981 127

Neonatal mortality rate 14.4 (per 1000 LB)

Infant mortality rate 24.5 (per 1000 LB)

Under-five mortality rate 29.3 (per 1000 LB)

Maternal mortality ratio 190 (per 100 000 LB)

1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015

Vaccine Age of administration

HepB 0 to 7 days of birth

BCG 1 month

OPV 1 month, 2 months, 3 months, 4 months

DTP-Hib-HepB 2 months, 3 months, 4 months, 18 months

Measles 9 months, 24 months

DT 6 -7 years

Td 7-8 years, 8-9 years

TT Females 15 to 39 years

Vitamin A 6 – 59 months

EPI history � EPI launched in 1977.

� HepB vaccine introduced in 1997.

� AD syringe introduced in 2002.

� MCV2 introduced in 2004.

� DTP-HepB vaccine introduced in 2004 (in phases)

� IPV introduced in one province in 2007.

� Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in four provinces in 2013 and gradually expended to all provinces by 2014.

� Type 2 component of OPV withdrawn on 04 April 2016 by switching from tOPV to bOPV.

� IPV vaccine launched in national routine immunization programme from July 2016.

Table 2: Immunization schedule, 2015

Source: cMYP 2015-2019 and EPI/MOHSource: WHO/UNICEF joint reporting form (JRF) 2015

Figure 10: Immunity against measles: Immunity profile by age in 2015*

Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010-2015

Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010-2015

Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012-2015

Table 10: Performance of Laboratory Surveillance, 2012-2015

Figure 14: Laboratory network

Figure 11: Immunity against measles: Immunity profile by age in 2016*

Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010-2015

* Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and Measles SIAs in 180 high risk districts in 2016.

* Modeled using MSP tool ver 2 based on coverage data up to 2015

Source: SEAR annual EPI reporting form

Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked

Source: SEAR Annual EPI Reporting Form, 2015 ND=No data

Source: SEAR Annual EPI Reporting Form, 2015 ND=No data

Source: SEAR annual EPI reporting form

Year

Routine/sporadic cases Outbreak associated cases

No. of suspected

case No. of death

No. of lab-confirmed

measles cases

No. of lab-confirmed

rubella cases

No. of suspected

outbreak

No. of Outbreak

Investigated No. of caseNo. of death

No. of measles

outbreak*

No. of confirmed

measles case*

No. of confirmed

rubella outbreak*

No. of confirmed

rubella cases*

2010 19 111 6 659 750 188 132 3 044 7 90 2 066 40 504

2011 23 282 0 1 175 1 808 356 286 4 993 14 251 3 747 60 586

2012 18 798 4 429 1 565 163 144 2 328 4 65 1 117 76 939

2013 11 521 1 689 707 128 96 1 677 1 71 803 24 310

2014 12 943 7 1471 713 173 119 2 104 21 114 1 285 7 69

2015 8 185 1 818 826 68 34 831 0 19 227 7 108

Year

No. o

f Sus

pect

ed M

easl

es

Case classification (number) Indicators

Measles Rubella

Disc

arde

d n

on-m

easl

es

non-

rube

lla c

ases

Annu

al in

cide

nce

of

confi

rmed

Mea

sles

cas

es

per m

illio

n to

tal p

opul

atio

n

Annu

al in

cide

nce

of

confi

rmed

Rub

ella

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Prop

ortio

n of

all

susp

ecte

d m

easl

es a

nd ru

bella

cas

es

that

hav

e ha

d an

ade

quat

e in

vest

igat

ion

initi

ated

with

in

48 h

ours

of n

otifi

catio

n

Disc

arde

d no

n-m

easl

es

non-

rube

lla in

cide

nce

per

100

000

tota

l pop

ulat

ion

Prop

ortio

n of

sub

natio

nal

adm

inis

trativ

e un

its

repo

rting

at l

east

two

disc

arde

d no

n-m

easl

es n

on-

rube

lla c

ases

per

100

000

to

tal p

opul

atio

n

Prop

ortio

n of

sub

-nat

iona

l su

rvei

llanc

e un

its re

porti

ng

to th

e na

tiona

l lev

el o

n tim

e

Lab-

confi

rmed

Epi-L

inke

d

Clin

ical

ly-c

onfir

med

Lab-

confi

rmed

Epi-L

inke

d

Target - - 80% 2 80% 80%

2012 18 798 429 ND ND 1 565 ND 1 561 1.75 6.18 ND 0.61 ND 64.23

2013 11 521 747 ND ND 742 ND 1 376 3.01 2.93 ND 0.54 ND 60.22

2014 12 943 2 241 ND ND 906 ND 2 606 8.85 3.58 ND 1.03 ND 22.06

2015 8 185 818 ND ND 826 ND 1 434 3.23 3.26 ND 0.57 ND 37.76

Year

% Serum specimen collected from

suspected measles cases

Total Serum Specimen

received in Laboratory

% serum specimens

tested

Specimen Positive for

Measles IgM

Specimen Positive for Rubella IgM

% Results within 4 of

receipt

% Outbreak tested

for viral detection

Genotypes detected

No. % No. % Measles Rubella

2012 25 4 657 89 403 10% 921 25% 68 ND ND ND

2013 45 5 169 100 996 20% 1 042 25% 97 ND ND ND

2014 65 8 448 99 5 194 62% 1 140 36% 60 2 ND ND

2015 142 11 608 99 2 511 22% 4 239 47% 40 ND ND ND

For contact or feedback:

Expanded Program on Immunization

Ministry of Health, Jakarta, Indonesia

Tel : +62 21 4257044, Fax: +62 21 4257044

Email: [email protected] or [email protected]

www.depkes.go.id

Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India

Tel: +91 11 23370804, Fax: +91 11 23370251

Email: [email protected], www.searo.who.int/entity/immunization

0%10%20%30%40%50%60%70%80%90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perce

nt of

popu

lation

Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perce

nt of

popu

lation

Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible

0100200300400500600700800900

2010 2011 2012 2013 2014 2015

<1 year 1-4 years 5-9 years 10-14 years 15+ years

n=1627 n=2617 n=1119 n=365 n=1553 n=227

050

100150200250300350400450500

2010 2011 2012 2013 2014 2015

<1 year 1-4 years 5-9 years 10-14 years 15+ years

n=1107(68%)

n=1468(56%)

n=775(69%)

n=280(77%)

ND ND

Polio, measles & rubella laboratoriesNational Institute of Health Research and Development (NIHRD), JakartaBiofarma, BandungPublic Health Laboratory, Surabaya

Japanese encephalitis laboratory NIHRD, JakartaPublic Health Laboratory, Denpasar

Measles & rubella laboratoryPublic Health Laboratory, YogyakartaPublic Health Laboratory, PalembangPublic Health Laboratory, MakassarPublic Health Laboratory, Jakarta

E P I F a c t S h E E t

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

Page 2: EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data Source: SEAR Annual EPI Reporting Form, 2015 ND=No data Source: SEAR annual EPI reporting

E P I F a c t S h E E t

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

Figure 1: National immunization coverage, 1980-2015

Figure 3: DTP-Hib-HepB3 coverage by province, 2015

Figure 5: Non-polio AFP rate by province, 2015

Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015

Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010-2015

Table 3: OPV supplementary immunization activities (SIA)

Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015

Figure 4: TT2+ coverage1 and NT cases2, 1980–2015

Figure 6: Adequate stool specimen collection percentage by province, 2015

Figure 8: MCV1 coverage by province, 2015

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision

Source: SEAR annual EPI reporting form, 2015 (administrative data)

Source: SEAR annual EPI reporting form, 2015 (administrative data)

* During measles campaign ** Except Yogyakarta Source: WHO/UNICEF JRF

1 Country official estimates, 1980-20152 WHO vaccine-preventable diseases: monitoring system 2016

•  Indonesia achieved the maternal neonatal tetanus (MNT) elimination status in May 2016.

Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

AFP cases 1526 1557 1684 1724 1641 1720 1951 1963 1765 1428

Wild poliovirus confirmed cases 2 0 0 0 0 0 0 0 0 0

Compatible cases 15 4 1 0 0 0 0 0 0 0

AFP rate 2.48 2.52 2.75 2.83 2.62 2.75 2.76 2.74 2.43 2.04

Non-polio AFP rate1 2.45 2.52 2.75 2.83 2.62 2.75 2.76 2.74 2.43 2.04

Adequate stool specimen collection percentage2 83% 85% 84% 86% 85% 91% 92% 88% 89% 92%

Total stool samples collected 2978 3020 3328 3343 3184 3386 3828 3826 3424 2801

% NPEV isolation 12 12 9 8 9 9 9 9 7 7

% Timeliness of primary result reported3 100 100 99 99 100 99 99 99 98 99

Table 4: AFP surveillance performance indicators, 2006–2015

•  The last polio case due to wild polio virus (WPV) was reported from Tenggara district, Aceh on 20 February 2006.

Year Activity Target population (<5 years)

Date of 1st round Date of 2nd round 1st round coverage (%)

2nd round coverage (%)

2002 NID 20 031 168 Sep-2002 Oct-2002 107 109

2005 SNID 6 287 418 May-2005 Jun-2005 104 93

2005 NID 23 426 156 Aug-2005 Sep-2005 95 98

2005 NID 23 620 427 Nov-2005 – 98 –

2006 SNID 3 050 873 Jan-2006 – 98 –

2006 NID 23 620 427 Feb-2006 Apr-2006 99 100

2006 SNID 4 523 187 Jun-2006 Aug-2006 96 98

2006 SNID 6 045 438 Sep-2006 – 92 –

2007 SNID 12 517 699 Feb-2007 Aug-2007 90 92

2009 SNID* 2 052 067 Oct-2009 – 97 –

2010 SNID* 4 322 178 Oct-2010 – 92 –

2011 SNID* 13 958 095 Oct-2011 – 98 –

2016 NID** 23 721 004 Mar-2016 – 97 –

1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.

Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)

Measles Rubella Mumps Japanese Encephalitis

Congenital Rubella Syndrome

2006 2 162 3356 118 (37%) 20 422 105 ND ND ND

2007 0 183 ND 141 (100%) 19 456 168 ND ND ND

2008 0 219 ND 183 (100%) 15 369 340 ND ND ND

2009 0 189 973 158 (68%) 20 818 2090 ND ND ND

2010 0 432 ND 147 (100%) 18 869 1323 ND ND ND

2011 0 806 1941 114 (54%) 21 893 1959 ND ND ND

2012 0 1192 ND 106 15 489 1020 ND ND ND

2013 0 775 2976 78 (35%) 8 419 2355 ND ND ND

2014 0 430 2082 75 (7%) 12 943 3542 ND 72 ND

2015 0 252 1004 69 (ND) 818 826 ND 39 44

Year Activity Age Target Coverage (%)2000 Sub-national 6-12 Y 6 665 950 952003 Sub-national 6-12 Y 1 030 445 952004 Sub-national 6-12 Y 2 180 918 942005 Sub-national 6 M-15 Y 5 515 324 942006 Sub-national 6 M-5 Y 3 978 096 932006 Sub-national 6-12 Y 3 161 323 962007 Sub-national 6 M-12 Y 2 692 912 1062007 Sub-national 6 Y-12 Y 2 569 350 1022007 Sub-national 6-59 M 14 916 592 932008 Sub-national 1-3 Y 11 203 782009 Sub-national 9-59 M 1 763 122 97

2010 Sub-national 9-59 M 3 619 024 92

2011 Sub-national 9-59 M 11 843 093 98

Year Number of districts %

2010 197 40

2011 198 40

2012 269 54

2013 226 45

2014 207 41

2015 137 27

Table 5: Reported cases of vaccine preventable disease, 2006-2015

Table 6: MCV supplementary immunization activities Table 7: Districts with more than 95% MCV1 coverage

Source: WHO/UNICEF JRF ND=No data

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

Source: WHO/UNICEF JRFs

Source: WHO/UNICEF JRF

0

20

40

60

80

100

0

2000

4000

6000

8000

10000

12000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

Year

Diphtheria Cases Pertussis Cases DTP3 Coverage

32999 30014

*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports.

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 61 65 74 77 81 86 88 98 88 86 81 77DTP3 27 60 69 75 72 81 81 83 85 81 81OPV3 13 60 71 72 79 82 81 84 86 82 82MCV1 26 58 63 76 77 78 80 82 81 77 69

0

20

40

60

80

100

% C

over

age

<70% 70%-79% >90%80%-89%0

20

40

60

80

100

0200400600800

1000120014001600

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearNT cases TT2+ Coverage <1 1–1.99 >2 No non -polio AFP case < 60% 60% – 79% > 80% No AFP

92105

0

20

40

60

80

100

05000

100001500020000250003000035000400004500050000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearMeasles Cases MCV1 Coverage MCV2 Coverage

<70% 70% – 79% 80% – 89% >90%

Sporadic measles Outbreak associated measles

0

100

200

300

400

M, SIA (92%) M, SIA (98%)

500

600

Jan-

10

Mar-1

0

May-1

0

Jul-1

0

Sep-

10

Nov-1

0

Jan-

11

Mar-1

1

May-1

1

Jul-1

1

Sep-

11

Nov-1

1

Jan-

12

Mar-1

2

May-1

2

Jul-1

2

Sep-

12

Nov-1

2

Jan-

13

Mar-1

3

May-1

3

Jul-1

3

Sep-

13

Nov-1

3

Jan-

14

Mar-1

4

May-1

4

Jul-1

4

Sep-

14

Nov-1

4

Jan-

15

Mar-1

5

May-1

5

Jul-1

5

Sep-

15

Nov-1

5

No. o

f cas

es

Page 3: EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data Source: SEAR Annual EPI Reporting Form, 2015 ND=No data Source: SEAR annual EPI reporting

E P I F a c t S h E E t

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

Figure 1: National immunization coverage, 1980-2015

Figure 3: DTP-Hib-HepB3 coverage by province, 2015

Figure 5: Non-polio AFP rate by province, 2015

Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015

Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010-2015

Table 3: OPV supplementary immunization activities (SIA)

Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015

Figure 4: TT2+ coverage1 and NT cases2, 1980–2015

Figure 6: Adequate stool specimen collection percentage by province, 2015

Figure 8: MCV1 coverage by province, 2015

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision

Source: SEAR annual EPI reporting form, 2015 (administrative data)

Source: SEAR annual EPI reporting form, 2015 (administrative data)

* During measles campaign ** Except Yogyakarta Source: WHO/UNICEF JRF

1 Country official estimates, 1980-20152 WHO vaccine-preventable diseases: monitoring system 2016

•  Indonesia achieved the maternal neonatal tetanus (MNT) elimination status in May 2016.

Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

AFP cases 1526 1557 1684 1724 1641 1720 1951 1963 1765 1428

Wild poliovirus confirmed cases 2 0 0 0 0 0 0 0 0 0

Compatible cases 15 4 1 0 0 0 0 0 0 0

AFP rate 2.48 2.52 2.75 2.83 2.62 2.75 2.76 2.74 2.43 2.04

Non-polio AFP rate1 2.45 2.52 2.75 2.83 2.62 2.75 2.76 2.74 2.43 2.04

Adequate stool specimen collection percentage2 83% 85% 84% 86% 85% 91% 92% 88% 89% 92%

Total stool samples collected 2978 3020 3328 3343 3184 3386 3828 3826 3424 2801

% NPEV isolation 12 12 9 8 9 9 9 9 7 7

% Timeliness of primary result reported3 100 100 99 99 100 99 99 99 98 99

Table 4: AFP surveillance performance indicators, 2006–2015

•  The last polio case due to wild polio virus (WPV) was reported from Tenggara district, Aceh on 20 February 2006.

Year Activity Target population (<5 years)

Date of 1st round Date of 2nd round 1st round coverage (%)

2nd round coverage (%)

2002 NID 20 031 168 Sep-2002 Oct-2002 107 109

2005 SNID 6 287 418 May-2005 Jun-2005 104 93

2005 NID 23 426 156 Aug-2005 Sep-2005 95 98

2005 NID 23 620 427 Nov-2005 – 98 –

2006 SNID 3 050 873 Jan-2006 – 98 –

2006 NID 23 620 427 Feb-2006 Apr-2006 99 100

2006 SNID 4 523 187 Jun-2006 Aug-2006 96 98

2006 SNID 6 045 438 Sep-2006 – 92 –

2007 SNID 12 517 699 Feb-2007 Aug-2007 90 92

2009 SNID* 2 052 067 Oct-2009 – 97 –

2010 SNID* 4 322 178 Oct-2010 – 92 –

2011 SNID* 13 958 095 Oct-2011 – 98 –

2016 NID** 23 721 004 Mar-2016 – 97 –

1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.

Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)

Measles Rubella Mumps Japanese Encephalitis

Congenital Rubella Syndrome

2006 2 162 3356 118 (37%) 20 422 105 ND ND ND

2007 0 183 ND 141 (100%) 19 456 168 ND ND ND

2008 0 219 ND 183 (100%) 15 369 340 ND ND ND

2009 0 189 973 158 (68%) 20 818 2090 ND ND ND

2010 0 432 ND 147 (100%) 18 869 1323 ND ND ND

2011 0 806 1941 114 (54%) 21 893 1959 ND ND ND

2012 0 1192 ND 106 15 489 1020 ND ND ND

2013 0 775 2976 78 (35%) 8 419 2355 ND ND ND

2014 0 430 2082 75 (7%) 12 943 3542 ND 72 ND

2015 0 252 1004 69 (ND) 818 826 ND 39 44

Year Activity Age Target Coverage (%)2000 Sub-national 6-12 Y 6 665 950 952003 Sub-national 6-12 Y 1 030 445 952004 Sub-national 6-12 Y 2 180 918 942005 Sub-national 6 M-15 Y 5 515 324 942006 Sub-national 6 M-5 Y 3 978 096 932006 Sub-national 6-12 Y 3 161 323 962007 Sub-national 6 M-12 Y 2 692 912 1062007 Sub-national 6 Y-12 Y 2 569 350 1022007 Sub-national 6-59 M 14 916 592 932008 Sub-national 1-3 Y 11 203 782009 Sub-national 9-59 M 1 763 122 97

2010 Sub-national 9-59 M 3 619 024 92

2011 Sub-national 9-59 M 11 843 093 98

Year Number of districts %

2010 197 40

2011 198 40

2012 269 54

2013 226 45

2014 207 41

2015 137 27

Table 5: Reported cases of vaccine preventable disease, 2006-2015

Table 6: MCV supplementary immunization activities Table 7: Districts with more than 95% MCV1 coverage

Source: WHO/UNICEF JRF ND=No data

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

Source: WHO/UNICEF JRFs

Source: WHO/UNICEF JRF

0

20

40

60

80

100

0

2000

4000

6000

8000

10000

12000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

Year

Diphtheria Cases Pertussis Cases DTP3 Coverage

32999 30014

*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports.

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 61 65 74 77 81 86 88 98 88 86 81 77DTP3 27 60 69 75 72 81 81 83 85 81 81OPV3 13 60 71 72 79 82 81 84 86 82 82MCV1 26 58 63 76 77 78 80 82 81 77 69

0

20

40

60

80

100

% C

over

age

<70% 70%-79% >90%80%-89%0

20

40

60

80

100

0200400600800

1000120014001600

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearNT cases TT2+ Coverage <1 1–1.99 >2 No non -polio AFP case < 60% 60% – 79% > 80% No AFP

92105

0

20

40

60

80

100

05000

100001500020000250003000035000400004500050000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearMeasles Cases MCV1 Coverage MCV2 Coverage

<70% 70% – 79% 80% – 89% >90%

Sporadic measles Outbreak associated measles

0

100

200

300

400

M, SIA (92%) M, SIA (98%)

500

600

Jan-

10

Mar-1

0

May-1

0

Jul-1

0

Sep-

10

Nov-1

0

Jan-

11

Mar-1

1

May-1

1

Jul-1

1

Sep-

11

Nov-1

1

Jan-

12

Mar-1

2

May-1

2

Jul-1

2

Sep-

12

Nov-1

2

Jan-

13

Mar-1

3

May-1

3

Jul-1

3

Sep-

13

Nov-1

3

Jan-

14

Mar-1

4

May-1

4

Jul-1

4

Sep-

14

Nov-1

4

Jan-

15

Mar-1

5

May-1

5

Jul-1

5

Sep-

15

Nov-1

5

No. o

f cas

es

Page 4: EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data Source: SEAR Annual EPI Reporting Form, 2015 ND=No data Source: SEAR annual EPI reporting

E P I F a c t S h E E t

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

Figure 1: National immunization coverage, 1980-2015

Figure 3: DTP-Hib-HepB3 coverage by province, 2015

Figure 5: Non-polio AFP rate by province, 2015

Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015

Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010-2015

Table 3: OPV supplementary immunization activities (SIA)

Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015

Figure 4: TT2+ coverage1 and NT cases2, 1980–2015

Figure 6: Adequate stool specimen collection percentage by province, 2015

Figure 8: MCV1 coverage by province, 2015

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision

Source: SEAR annual EPI reporting form, 2015 (administrative data)

Source: SEAR annual EPI reporting form, 2015 (administrative data)

* During measles campaign ** Except Yogyakarta Source: WHO/UNICEF JRF

1 Country official estimates, 1980-20152 WHO vaccine-preventable diseases: monitoring system 2016

•  Indonesia achieved the maternal neonatal tetanus (MNT) elimination status in May 2016.

Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

AFP cases 1526 1557 1684 1724 1641 1720 1951 1963 1765 1428

Wild poliovirus confirmed cases 2 0 0 0 0 0 0 0 0 0

Compatible cases 15 4 1 0 0 0 0 0 0 0

AFP rate 2.48 2.52 2.75 2.83 2.62 2.75 2.76 2.74 2.43 2.04

Non-polio AFP rate1 2.45 2.52 2.75 2.83 2.62 2.75 2.76 2.74 2.43 2.04

Adequate stool specimen collection percentage2 83% 85% 84% 86% 85% 91% 92% 88% 89% 92%

Total stool samples collected 2978 3020 3328 3343 3184 3386 3828 3826 3424 2801

% NPEV isolation 12 12 9 8 9 9 9 9 7 7

% Timeliness of primary result reported3 100 100 99 99 100 99 99 99 98 99

Table 4: AFP surveillance performance indicators, 2006–2015

•  The last polio case due to wild polio virus (WPV) was reported from Tenggara district, Aceh on 20 February 2006.

Year Activity Target population (<5 years)

Date of 1st round Date of 2nd round 1st round coverage (%)

2nd round coverage (%)

2002 NID 20 031 168 Sep-2002 Oct-2002 107 109

2005 SNID 6 287 418 May-2005 Jun-2005 104 93

2005 NID 23 426 156 Aug-2005 Sep-2005 95 98

2005 NID 23 620 427 Nov-2005 – 98 –

2006 SNID 3 050 873 Jan-2006 – 98 –

2006 NID 23 620 427 Feb-2006 Apr-2006 99 100

2006 SNID 4 523 187 Jun-2006 Aug-2006 96 98

2006 SNID 6 045 438 Sep-2006 – 92 –

2007 SNID 12 517 699 Feb-2007 Aug-2007 90 92

2009 SNID* 2 052 067 Oct-2009 – 97 –

2010 SNID* 4 322 178 Oct-2010 – 92 –

2011 SNID* 13 958 095 Oct-2011 – 98 –

2016 NID** 23 721 004 Mar-2016 – 97 –

1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.

Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)

Measles Rubella Mumps Japanese Encephalitis

Congenital Rubella Syndrome

2006 2 162 3356 118 (37%) 20 422 105 ND ND ND

2007 0 183 ND 141 (100%) 19 456 168 ND ND ND

2008 0 219 ND 183 (100%) 15 369 340 ND ND ND

2009 0 189 973 158 (68%) 20 818 2090 ND ND ND

2010 0 432 ND 147 (100%) 18 869 1323 ND ND ND

2011 0 806 1941 114 (54%) 21 893 1959 ND ND ND

2012 0 1192 ND 106 15 489 1020 ND ND ND

2013 0 775 2976 78 (35%) 8 419 2355 ND ND ND

2014 0 430 2082 75 (7%) 12 943 3542 ND 72 ND

2015 0 252 1004 69 (ND) 818 826 ND 39 44

Year Activity Age Target Coverage (%)2000 Sub-national 6-12 Y 6 665 950 952003 Sub-national 6-12 Y 1 030 445 952004 Sub-national 6-12 Y 2 180 918 942005 Sub-national 6 M-15 Y 5 515 324 942006 Sub-national 6 M-5 Y 3 978 096 932006 Sub-national 6-12 Y 3 161 323 962007 Sub-national 6 M-12 Y 2 692 912 1062007 Sub-national 6 Y-12 Y 2 569 350 1022007 Sub-national 6-59 M 14 916 592 932008 Sub-national 1-3 Y 11 203 782009 Sub-national 9-59 M 1 763 122 97

2010 Sub-national 9-59 M 3 619 024 92

2011 Sub-national 9-59 M 11 843 093 98

Year Number of districts %

2010 197 40

2011 198 40

2012 269 54

2013 226 45

2014 207 41

2015 137 27

Table 5: Reported cases of vaccine preventable disease, 2006-2015

Table 6: MCV supplementary immunization activities Table 7: Districts with more than 95% MCV1 coverage

Source: WHO/UNICEF JRF ND=No data

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

Source: WHO/UNICEF JRFs

Source: WHO/UNICEF JRF

0

20

40

60

80

100

0

2000

4000

6000

8000

10000

12000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

Year

Diphtheria Cases Pertussis Cases DTP3 Coverage

32999 30014

*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports.

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 61 65 74 77 81 86 88 98 88 86 81 77DTP3 27 60 69 75 72 81 81 83 85 81 81OPV3 13 60 71 72 79 82 81 84 86 82 82MCV1 26 58 63 76 77 78 80 82 81 77 69

0

20

40

60

80

100

% C

over

age

<70% 70%-79% >90%80%-89%0

20

40

60

80

100

0200400600800

1000120014001600

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearNT cases TT2+ Coverage <1 1–1.99 >2 No non -polio AFP case < 60% 60% – 79% > 80% No AFP

92105

0

20

40

60

80

100

05000

100001500020000250003000035000400004500050000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearMeasles Cases MCV1 Coverage MCV2 Coverage

<70% 70% – 79% 80% – 89% >90%

Sporadic measles Outbreak associated measles

0

100

200

300

400

M, SIA (92%) M, SIA (98%)

500

600

Jan-

10

Mar-1

0

May-1

0

Jul-1

0

Sep-

10

Nov-1

0

Jan-

11

Mar-1

1

May-1

1

Jul-1

1

Sep-

11

Nov-1

1

Jan-

12

Mar-1

2

May-1

2

Jul-1

2

Sep-

12

Nov-1

2

Jan-

13

Mar-1

3

May-1

3

Jul-1

3

Sep-

13

Nov-1

3

Jan-

14

Mar-1

4

May-1

4

Jul-1

4

Sep-

14

Nov-1

4

Jan-

15

Mar-1

5

May-1

5

Jul-1

5

Sep-

15

Nov-1

5

No. o

f cas

es

Page 5: EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data Source: SEAR Annual EPI Reporting Form, 2015 ND=No data Source: SEAR annual EPI reporting

Indonesia 2016

Immunization system highlights

� There is a comprehensive multi-year plan (cMYP) for immunization covering 2015-2019.

� A standing national technical advisory group on immunization (NTAGI) fully functional.

� A national system to monitor adverse events following immunization (AEFI) exists.

� A national policy for health care waste management including waste from immunization activities exists.

� All 514 (100%) districts have updated micro-plans that include activities to raise immunization coverage.

� District coverage survey in 31 districts and 10 provinces was conducted in 2015.

� 83% spending on routine vaccine financed by the government.

� 76% spending on routine immunization programme financed by the central government.

� Out of 514 districts, 328 (64%) districts had > 80% coverage for DTP-Hib-HepB3, 217 (42%) districts had > 90% coverage for MCV1.

Source: WHO/UNICEF joint reporting form (JRF) 2015

Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

Table 1: Basic information1 2015Division/Province/State/Region 34

District 416

City 98

Village 79,411

Population density (per sq. km) 132

Population living in urban areas 52%

Population using improved drinking-water sources

85%

Population using improved sanitation 59%

Total expenditure on health as % of GDP 3.0%

Births attended by skilled health personnel 83%

Neonates protected at birth against NT 85%

Total population 255 461 686

Live births (LB) 4 893 435

Children <1 year 4 794 791

Children <5 years 24 065 506

Children <15 years 69 857 406

Pregnant women 5 382 779

Women of child bearing age (15-49 years)

51 981 127

Neonatal mortality rate 14.4 (per 1000 LB)

Infant mortality rate 24.5 (per 1000 LB)

Under-five mortality rate 29.3 (per 1000 LB)

Maternal mortality ratio 190 (per 100 000 LB)

1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015

Vaccine Age of administration

HepB 0 to 7 days of birth

BCG 1 month

OPV 1 month, 2 months, 3 months, 4 months

DTP-Hib-HepB 2 months, 3 months, 4 months, 18 months

Measles 9 months, 24 months

DT 6 -7 years

Td 7-8 years, 8-9 years

TT Females 15 to 39 years

Vitamin A 6 – 59 months

EPI history � EPI launched in 1977.

� HepB vaccine introduced in 1997.

� AD syringe introduced in 2002.

� MCV2 introduced in 2004.

� DTP-HepB vaccine introduced in 2004 (in phases)

� IPV introduced in one province in 2007.

� Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in four provinces in 2013 and gradually expended to all provinces by 2014.

� Type 2 component of OPV withdrawn on 04 April 2016 by switching from tOPV to bOPV.

� IPV vaccine launched in national routine immunization programme from July 2016.

Table 2: Immunization schedule, 2015

Source: cMYP 2015-2019 and EPI/MOHSource: WHO/UNICEF joint reporting form (JRF) 2015

Figure 10: Immunity against measles: Immunity profile by age in 2015*

Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010-2015

Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010-2015

Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012-2015

Table 10: Performance of Laboratory Surveillance, 2012-2015

Figure 14: Laboratory network

Figure 11: Immunity against measles: Immunity profile by age in 2016*

Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010-2015

* Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and Measles SIAs in 180 high risk districts in 2016.

* Modeled using MSP tool ver 2 based on coverage data up to 2015

Source: SEAR annual EPI reporting form

Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked

Source: SEAR Annual EPI Reporting Form, 2015 ND=No data

Source: SEAR Annual EPI Reporting Form, 2015 ND=No data

Source: SEAR annual EPI reporting form

Year

Routine/sporadic cases Outbreak associated cases

No. of suspected

case No. of death

No. of lab-confirmed

measles cases

No. of lab-confirmed

rubella cases

No. of suspected

outbreak

No. of Outbreak

Investigated No. of caseNo. of death

No. of measles

outbreak*

No. of confirmed

measles case*

No. of confirmed

rubella outbreak*

No. of confirmed

rubella cases*

2010 19 111 6 659 750 188 132 3 044 7 90 2 066 40 504

2011 23 282 0 1 175 1 808 356 286 4 993 14 251 3 747 60 586

2012 18 798 4 429 1 565 163 144 2 328 4 65 1 117 76 939

2013 11 521 1 689 707 128 96 1 677 1 71 803 24 310

2014 12 943 7 1471 713 173 119 2 104 21 114 1 285 7 69

2015 8 185 1 818 826 68 34 831 0 19 227 7 108

Year

No. o

f Sus

pect

ed M

easl

es

Case classification (number) Indicators

Measles Rubella

Disc

arde

d n

on-m

easl

es

non-

rube

lla c

ases

Annu

al in

cide

nce

of

confi

rmed

Mea

sles

cas

es

per m

illio

n to

tal p

opul

atio

n

Annu

al in

cide

nce

of

confi

rmed

Rub

ella

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Prop

ortio

n of

all

susp

ecte

d m

easl

es a

nd ru

bella

cas

es

that

hav

e ha

d an

ade

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e in

vest

igat

ion

initi

ated

with

in

48 h

ours

of n

otifi

catio

n

Disc

arde

d no

n-m

easl

es

non-

rube

lla in

cide

nce

per

100

000

tota

l pop

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ion

Prop

ortio

n of

sub

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nal

adm

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its

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disc

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ases

per

100

000

to

tal p

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atio

n

Prop

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n of

sub

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iona

l su

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llanc

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its re

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to th

e na

tiona

l lev

el o

n tim

e

Lab-

confi

rmed

Epi-L

inke

d

Clin

ical

ly-c

onfir

med

Lab-

confi

rmed

Epi-L

inke

d

Target - - 80% 2 80% 80%

2012 18 798 429 ND ND 1 565 ND 1 561 1.75 6.18 ND 0.61 ND 64.23

2013 11 521 747 ND ND 742 ND 1 376 3.01 2.93 ND 0.54 ND 60.22

2014 12 943 2 241 ND ND 906 ND 2 606 8.85 3.58 ND 1.03 ND 22.06

2015 8 185 818 ND ND 826 ND 1 434 3.23 3.26 ND 0.57 ND 37.76

Year

% Serum specimen collected from

suspected measles cases

Total Serum Specimen

received in Laboratory

% serum specimens

tested

Specimen Positive for

Measles IgM

Specimen Positive for Rubella IgM

% Results within 4 of

receipt

% Outbreak tested

for viral detection

Genotypes detected

No. % No. % Measles Rubella

2012 25 4 657 89 403 10% 921 25% 68 ND ND ND

2013 45 5 169 100 996 20% 1 042 25% 97 ND ND ND

2014 65 8 448 99 5 194 62% 1 140 36% 60 2 ND ND

2015 142 11 608 99 2 511 22% 4 239 47% 40 ND ND ND

For contact or feedback:

Expanded Program on Immunization

Ministry of Health, Jakarta, Indonesia

Tel : +62 21 4257044, Fax: +62 21 4257044

Email: [email protected] or [email protected]

www.depkes.go.id

Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India

Tel: +91 11 23370804, Fax: +91 11 23370251

Email: [email protected], www.searo.who.int/entity/immunization

0%10%20%30%40%50%60%70%80%90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perce

nt of

popu

lation

Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perce

nt of

popu

lation

Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible

0100200300400500600700800900

2010 2011 2012 2013 2014 2015

<1 year 1-4 years 5-9 years 10-14 years 15+ years

n=1627 n=2617 n=1119 n=365 n=1553 n=227

050

100150200250300350400450500

2010 2011 2012 2013 2014 2015

<1 year 1-4 years 5-9 years 10-14 years 15+ years

n=1107(68%)

n=1468(56%)

n=775(69%)

n=280(77%)

ND ND

Polio, measles & rubella laboratoriesNational Institute of Health Research and Development (NIHRD), JakartaBiofarma, BandungPublic Health Laboratory, Surabaya

Japanese encephalitis laboratory NIHRD, JakartaPublic Health Laboratory, Denpasar

Measles & rubella laboratoryPublic Health Laboratory, YogyakartaPublic Health Laboratory, PalembangPublic Health Laboratory, MakassarPublic Health Laboratory, Jakarta

E P I F a c t S h E E t

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

Page 6: EPI Fact ShEEt - searo.who. · PDF fileImmunization system highlights ... 2015 ND=No data Source: SEAR Annual EPI Reporting Form, 2015 ND=No data Source: SEAR annual EPI reporting

Indonesia 2016

Immunization system highlights

� There is a comprehensive multi-year plan (cMYP) for immunization covering 2015-2019.

� A standing national technical advisory group on immunization (NTAGI) fully functional.

� A national system to monitor adverse events following immunization (AEFI) exists.

� A national policy for health care waste management including waste from immunization activities exists.

� All 514 (100%) districts have updated micro-plans that include activities to raise immunization coverage.

� District coverage survey in 31 districts and 10 provinces was conducted in 2015.

� 83% spending on routine vaccine financed by the government.

� 76% spending on routine immunization programme financed by the central government.

� Out of 514 districts, 328 (64%) districts had > 80% coverage for DTP-Hib-HepB3, 217 (42%) districts had > 90% coverage for MCV1.

Source: WHO/UNICEF joint reporting form (JRF) 2015

Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

Table 1: Basic information1 2015Division/Province/State/Region 34

District 416

City 98

Village 79,411

Population density (per sq. km) 132

Population living in urban areas 52%

Population using improved drinking-water sources

85%

Population using improved sanitation 59%

Total expenditure on health as % of GDP 3.0%

Births attended by skilled health personnel 83%

Neonates protected at birth against NT 85%

Total population 255 461 686

Live births (LB) 4 893 435

Children <1 year 4 794 791

Children <5 years 24 065 506

Children <15 years 69 857 406

Pregnant women 5 382 779

Women of child bearing age (15-49 years)

51 981 127

Neonatal mortality rate 14.4 (per 1000 LB)

Infant mortality rate 24.5 (per 1000 LB)

Under-five mortality rate 29.3 (per 1000 LB)

Maternal mortality ratio 190 (per 100 000 LB)

1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015

Vaccine Age of administration

HepB 0 to 7 days of birth

BCG 1 month

OPV 1 month, 2 months, 3 months, 4 months

DTP-Hib-HepB 2 months, 3 months, 4 months, 18 months

Measles 9 months, 24 months

DT 6 -7 years

Td 7-8 years, 8-9 years

TT Females 15 to 39 years

Vitamin A 6 – 59 months

EPI history � EPI launched in 1977.

� HepB vaccine introduced in 1997.

� AD syringe introduced in 2002.

� MCV2 introduced in 2004.

� DTP-HepB vaccine introduced in 2004 (in phases)

� IPV introduced in one province in 2007.

� Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in four provinces in 2013 and gradually expended to all provinces by 2014.

� Type 2 component of OPV withdrawn on 04 April 2016 by switching from tOPV to bOPV.

� IPV vaccine launched in national routine immunization programme from July 2016.

Table 2: Immunization schedule, 2015

Source: cMYP 2015-2019 and EPI/MOHSource: WHO/UNICEF joint reporting form (JRF) 2015

Figure 10: Immunity against measles: Immunity profile by age in 2015*

Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010-2015

Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010-2015

Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012-2015

Table 10: Performance of Laboratory Surveillance, 2012-2015

Figure 14: Laboratory network

Figure 11: Immunity against measles: Immunity profile by age in 2016*

Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010-2015

* Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and Measles SIAs in 180 high risk districts in 2016.

* Modeled using MSP tool ver 2 based on coverage data up to 2015

Source: SEAR annual EPI reporting form

Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked

Source: SEAR Annual EPI Reporting Form, 2015 ND=No data

Source: SEAR Annual EPI Reporting Form, 2015 ND=No data

Source: SEAR annual EPI reporting form

Year

Routine/sporadic cases Outbreak associated cases

No. of suspected

case No. of death

No. of lab-confirmed

measles cases

No. of lab-confirmed

rubella cases

No. of suspected

outbreak

No. of Outbreak

Investigated No. of caseNo. of death

No. of measles

outbreak*

No. of confirmed

measles case*

No. of confirmed

rubella outbreak*

No. of confirmed

rubella cases*

2010 19 111 6 659 750 188 132 3 044 7 90 2 066 40 504

2011 23 282 0 1 175 1 808 356 286 4 993 14 251 3 747 60 586

2012 18 798 4 429 1 565 163 144 2 328 4 65 1 117 76 939

2013 11 521 1 689 707 128 96 1 677 1 71 803 24 310

2014 12 943 7 1471 713 173 119 2 104 21 114 1 285 7 69

2015 8 185 1 818 826 68 34 831 0 19 227 7 108

Year

No. o

f Sus

pect

ed M

easl

es

Case classification (number) Indicators

Measles Rubella

Disc

arde

d n

on-m

easl

es

non-

rube

lla c

ases

Annu

al in

cide

nce

of

confi

rmed

Mea

sles

cas

es

per m

illio

n to

tal p

opul

atio

n

Annu

al in

cide

nce

of

confi

rmed

Rub

ella

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Prop

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n of

all

susp

ecte

d m

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hav

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ion

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ated

with

in

48 h

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of n

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n

Disc

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nce

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100

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Prop

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arde

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on-

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ases

per

100

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tal p

opul

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n

Prop

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n of

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iona

l su

rvei

llanc

e un

its re

porti

ng

to th

e na

tiona

l lev

el o

n tim

e

Lab-

confi

rmed

Epi-L

inke

d

Clin

ical

ly-c

onfir

med

Lab-

confi

rmed

Epi-L

inke

dTarget - - 80% 2 80% 80%

2012 18 798 429 ND ND 1 565 ND 1 561 1.75 6.18 ND 0.61 ND 64.23

2013 11 521 747 ND ND 742 ND 1 376 3.01 2.93 ND 0.54 ND 60.22

2014 12 943 2 241 ND ND 906 ND 2 606 8.85 3.58 ND 1.03 ND 22.06

2015 8 185 818 ND ND 826 ND 1 434 3.23 3.26 ND 0.57 ND 37.76

Year

% Serum specimen collected from

suspected measles cases

Total Serum Specimen

received in Laboratory

% serum specimens

tested

Specimen Positive for

Measles IgM

Specimen Positive for Rubella IgM

% Results within 4 of

receipt

% Outbreak tested

for viral detection

Genotypes detected

No. % No. % Measles Rubella

2012 25 4 657 89 403 10% 921 25% 68 ND ND ND

2013 45 5 169 100 996 20% 1 042 25% 97 ND ND ND

2014 65 8 448 99 5 194 62% 1 140 36% 60 2 ND ND

2015 142 11 608 99 2 511 22% 4 239 47% 40 ND ND ND

For contact or feedback:

Expanded Program on Immunization

Ministry of Health, Jakarta, Indonesia

Tel : +62 21 4257044, Fax: +62 21 4257044

Email: [email protected] or [email protected]

www.depkes.go.id

Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India

Tel: +91 11 23370804, Fax: +91 11 23370251

Email: [email protected], www.searo.who.int/entity/immunization

0%10%20%30%40%50%60%70%80%90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perce

nt of

popu

lation

Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perce

nt of

popu

lation

Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible

0100200300400500600700800900

2010 2011 2012 2013 2014 2015

<1 year 1-4 years 5-9 years 10-14 years 15+ years

n=1627 n=2617 n=1119 n=365 n=1553 n=227

050

100150200250300350400450500

2010 2011 2012 2013 2014 2015

<1 year 1-4 years 5-9 years 10-14 years 15+ years

n=1107(68%)

n=1468(56%)

n=775(69%)

n=280(77%)

ND ND

Polio, measles & rubella laboratoriesNational Institute of Health Research and Development (NIHRD), JakartaBiofarma, BandungPublic Health Laboratory, Surabaya

Japanese encephalitis laboratory NIHRD, JakartaPublic Health Laboratory, Denpasar

Measles & rubella laboratoryPublic Health Laboratory, YogyakartaPublic Health Laboratory, PalembangPublic Health Laboratory, MakassarPublic Health Laboratory, Jakarta

E P I F a c t S h E E t

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region