LUIS EDUARDO CHAPARRO DAMMERTMÉDICO PEDIATRA-PERU

“CURRENT SITUATION OF INMUNIZATIONS IN PERÚ”

Impact of Immunizations and Vaccination Schemes in Perú

VACCINATION SCHEDULE < 5 YEARS OLDPERU 1976 – 1996 : 06 Vaccines

Age / Vaccine

Newborn2

months4

months6

months9

months

BCG 1

DwPT* 1 2 3

Oral Polio

1 2 3

Measles 1

THUS WE BEGAN

1977: Eradication of smallpox on the World(Somalia).

1991: Last case of wild polio in Peru (Western Hemisphere) (Pichanaki)

1996: Introduction of Hepatitis B vaccine in children 0-1 years old in hyperendemic areas.

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*DwPT: Diphtheria, Whole cell Pertussis, Tetanus

VACCINATION SCHEDULE < 5 YEARS OLDPERU 2000 – 2004 : 09 Vaccines

Age / Vaccine

Newborn2

months4

months6

months9

months

BCG 1

DwPT 1 2 3

Oral Polio

1 2 3

Measles (MMR*)

1

Yellow Fever

1

2003: Vaccine introduction

2000: Last case of indigenous measles

Since June 20, 2003, Peru has a General Vaccine Law: “28010”

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* MMR: Measles, Mumps and Rubella

VACCINATION SCHEDULE < 5 AÑOSPERU 2005 – 2006 : 11 Vaccines

Age/Vaccine

Newborn2

months3

months4

months9

months

BCG 1

Hep B 1 2 3

H. Inf B 1 2 3

DwPT 1 2 3

Oral Polio 1 2 3

MMR* 1

Yellow Fever

1 Ach

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ts 2005: Introduction of Hepatitis “B” and Hib vaccines in the NIP.

2006: Booster doses were introduced in the immunizations calendar.

2006: Campaign to eradicate rubella and congenital rubella. 19 million people were vaccinated in 6 weeks.

Vaccine Introduction

VACCINATION SCHEDULE < 5 YEARS OLD PERU 2007: 13 Vaccines

Age/Vaccine Newborn

2 month

4 month

6 month

12 month

18 month

4- 6 years

BCG 1

Hepatitis B 1 2 3 4

H. Influenza B (Hib)

1 2 3

Pentavalent DwPT

1 2 3R1 R2

Oral Polio 1 2 3

MMR 1 2

Yellow fever 1

R: Booster dose of vaccine

Introduction of Pentavalent Vaccine (Hepatitis B, Diphtheria, Pertussis, Tetanus, Haemophilus Influenza b)

Introduction of booster doses of DwPT and MMR

Achievements

VACCINATION SCHEDULE PERU 2008-2012Age/Vacuna

Newborn2

months4

months6

months12

months15

months18

months4

years9

years9 years

1 months9 years

6 months

BCG 1

Hepatitis B 1 2 3 4

H. Influenza B 1 2 3

PentavalentDwPT

1 2 3R1 R2

Oral Polio 1 2 3

MMR 1 2

Yellow fever 1

Pneumococcus 1 2 3

Rotavirus 1 2

HPV 1 2 3

Influenza 7 - 8 m

TOTAL 14 vaccines 1 vaccine

Vaccine Introduction

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ts2008: introduction of vaccines against pneumococcus and rotavirus, in areas of extreme poverty.

2008: introduction of seasonal influenza vaccine , children and adults at risk.

February 2008: under the Slogan: “VACCINES IS NOT EXPENDED IS INVESTMENT”

2008: purchase of 52 cold chambers for the whole country.

2008: campaign against Hepatitis “B”

2009: vaccines against pneumococcus and rotavirus, in all children under 2 years of age.

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ts2010: Pandemic H1N1 vaccine, pregnant women and people with associated risk.

ESNI 2010 budget, approximately: 480 million soles. In addition 61 million for operating expenses.

The immunizations budget is assured: Law and strategy that meets its programming.

2010: Pilot for the Introduction of the HPV Vaccine: Ucayali, Piura and Ayacucho

2011: Introduction throughout the country with HPV vaccine Girls in Educatives Inst.

Vaccine Introduction

Age/Vaccine

Newborn2

months4

months6

months12

months15

months18

months4-

yearsGirls 5th grade education

(9 years old)

BCG 1

Hepatitis B 1 2 3 4

H. Influenza B 1 2 3

Pentavalent 1 2 3

DwPT R1 R2

Oral Polio 1 2 3

IPV* 1 2

MMR 1 2

Yellow fever 1

Pneumococcus 1 2 3

Rotavirus 1 2

HPV 1 2 3

Influenza 7 – 8 m

TOTAL 14 vaccines 1 vaccine

VACCINATION SCHEDULE PERÚ 2013-2016

* IPV: Inactivated Polio Vaccine

VACCINES IN THE NATIONAL SCHEME OF PERÚ 2017-2018 17

vacunas

1. BCG (Tuberculosis)2. Hepatitis B3. Pentavalent (Diphtheria, whole

cell Pertussis, Tetanus, Hib, Hepatitis B)

4. DT (Pediatric diphtheria and tetanus toxoids)

5. Hib (Haemophilus influenzae b) 6. Rotavirus7. PCV (Pneumococcal Conjugate

Vaccine) 8. MMR (Measles, Mumps and

Rubella)9. DPT (Diphtheria, Pertussis and

Tetanus)10. Influenza Adult and Pediatric11. IPV (Inactivated Polio Vaccine)12. OPV (Oral Polio Vaccine, Sabin)13. HPV (Human Papilloma Virus)14. MR (Measles and Rubella)15. Td (Adult tetanus and diphtheria

toxoids)

2017201815

vaccines

from 1 year –

FINANCING

14,959,457

81,501,127

139,741,733

313,239,430

477,521,418

0 100000000 200000000 300000000 400000000 500000000 600000000

2000

2005

2010

2015

2017

Presupuesto para Vacunas y Jeringas Años 2000 al 2017 en soles

Investment in Cold Chain: Equipment and Accessories for Cold Chain

40,793,386

3,147,337

-

5,000,000

10,000,000

15,000,000

20,000,000

25,000,000

30,000,000

35,000,000

40,000,000

45,000,000

2012 2018

Inversión en Cadena de Frío en SolesInvestment in Cold Chain (soles)Budget for Vaccines and SyringesYears 2000 to 2027 (soles)

2018• 80 solar refrigerators, for localities without light and

indigenous communities• Complements of Cold Chain for 8,000 EESS: Conveyor

boxes, Thermos portable vaccines, Data logger etc.

Solar Refrigerators for native communities and Populated Centers of Peru

COBERTURAS DE VACUNACION EN PERÙ

2010 2011 2012 2013 2014 2015 2016

BCG 95% 91% 95% 95% 94% 91% 90%

DPT3 93% 91% 95% 88% 88% 90% 89%

NEUMO3 82% 89% 85% 86% 90% 85%

POLIO3 92% 91% 94% 71% 78% 87% 85%

ROTAVIRUS 75% 84% 91% 86% 86% 87% 87%

MMR1 91% 96% 94% 85% 89% 92% 88%

0%

20%

40%

60%

80%

100%

Coverage of the MMR1 vaccine in 1 year old children by Department, until July 2018

Fuente: OGTEI/MINSA January to july

69.07

61.4259.67

57.3356.82 56.30 55.56 54.82 54.32 53.51 53.34 53.25 53.06 51.80 51.38 50.73

49.06 48.24 47.66 47.50 47.4646.31 44.42 45.16 43.26

34.12

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PERÚ: MMR1 = 49.06%

CHALLENGES:

Guarantee high and homogenous coverages ( = > 95%) by type of vaccine in each District

Guarantee High Quality of Surveillance and Research Systems timely in case of an immunopreventable disease

Implement rapid response to imported cases, following standard mechanisms to prevent thereestablishment of endemic transmission.

CHALLENGES:

Achieve the extension of the vaccination program to other priority age groups

The modernization of the vaccination program

Continous education programs in immunopreventable diseases

THANKS