Is there a problem with lack of immunization in the asean region?
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Summary
4 papers analyzed
These studies suggest that while ASEAN countries have made progress in immunization, there are still significant challenges in advocacy, research, surveillance, urban health systems, and managing outbreaks.
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Immunization Challenges in the ASEAN Region
National Immunization Programs and Vaccine Coverage
The ASEAN region has made significant strides in improving immunization coverage through national immunization programs (NIPs). However, several challenges persist. Despite progress towards the Global Vaccine Action Plan (GVAP), some ASEAN countries still have fragile healthcare systems that struggle with insufficient vaccine coverage for basic Expanded Program on Immunization (EPI) antigens. Additionally, many countries lack national coverage for newer and underused vaccines, and securing funds for expanding NIPs remains a significant hurdle. There is also a notable deficiency in research on the disease burden of vaccine-preventable diseases and in surveillance efforts, which hampers the effectiveness of immunization programs.
Adult Immunization: A Neglected Issue
Adult immunization is particularly neglected in Southeast Asia, leading to unnecessary morbidity and mortality from vaccine-preventable diseases among adults. While childhood vaccination rates for diseases like diphtheria, tetanus, and pertussis are high, many adults remain unvaccinated or undervaccinated, leaving them vulnerable to infections. Catch-up immunization for adults, especially for hepatitis B, hepatitis A, varicella, influenza, and pneumococcal infections, is crucial to reduce disease burden and associated healthcare costs. Specific groups, such as women of child-bearing age and high-risk occupational groups like healthcare workers, also require targeted immunization strategies.
Immunization Services for the Urban Poor
Urbanization in Asia has led to disparities in health and immunization coverage, particularly among the urban poor. While urban health standards generally surpass those in rural areas, significant gaps exist within socio-economic groups in urban settings. These disparities have resulted in outbreaks of vaccine-preventable diseases in urban slums and peri-urban areas. Innovative strategies are needed to improve access to immunization and related health services for these marginalized populations. This includes developing municipal models of primary healthcare with clear authority, adequate resources, and community engagement to address the unique challenges faced by the urban poor.
Concurrent Outbreaks: Dengue and COVID-19
The ASEAN region faces the dual challenge of managing dengue outbreaks alongside the COVID-19 pandemic. The region has one of the highest rates of dengue globally, and the pandemic has exacerbated the situation by disrupting dengue prevention programs and delaying medical management due to co-infections and misdiagnoses. Lockdowns and social distancing measures have further limited the effectiveness of dengue control strategies. It is crucial to maintain awareness and implement robust vector control strategies, leveraging digitalization and remote surveillance to manage dengue outbreaks effectively. Concurrently, controlling the spread of COVID-19 through vaccination is essential to mitigate the pandemic's impact.
Conclusion
The ASEAN region faces significant challenges in achieving comprehensive immunization coverage. While progress has been made, fragile healthcare systems, insufficient adult immunization, disparities among the urban poor, and concurrent outbreaks of diseases like dengue and COVID-19 highlight the need for sustained efforts and innovative strategies. Strengthening research, surveillance, and funding mechanisms, along with targeted immunization programs for vulnerable populations, are critical steps towards improving public health outcomes in the region.
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