Imminent Public Health Risk: Colombia’s Expanded Program on Immunizations (EPI) at Risk

By Gerson David Hincapié, journalist from Cali

There is an imminent Public Health risk for the entire population if the Expanded Program on Immunizations (EPI) does not return to the necessary coverage. These were the conclusions reached by health professionals who are experts on the subject.

The EPI is, in simple words, the free vaccination scheme that applies mainly to early childhood. All Colombians have access to it from the moment they are born and it protects citizens from a series of diseases that can be very serious.

These are all the vaccines contained in the Expanded Program on Immunizations (EPI), including those that are not aimed at early childhood. | Photo: El País

“As of October, coverage was set at 79%, however, coverage was not achieved in any of the population groups. Of main concern are departments such as Cundinamarca and Valle del Cauca, where vaccination against tuberculosis is at 41%,” revealed Viviana Mora, delegate attorney for the Defense of the Rights of Children, Adolescents, the Family and Women of the Attorney General’s Office.

The panorama is complex considering that, according to the guidelines for the administration of the PAI program in 2023, the goal is to achieve more than 95% coverage in the populations targeted by the scheme.

“The PAI is a joint action of the nations of the world and international organizations with the aim of reducing mortality and morbidity rates caused by vaccine-preventable diseases,” says the document from the Ministry of Health.

Eduardo López, epidemiologist and scientific director of the Center for Studies in Pediatric Infectology (Ceip), explained that if compliance with vaccine coverage remains low, this will lead, sooner or later, to an increase in infections in the community.

“Colombia’s EPI is very complete, it is one of the best in Latin America, and the scientific evidence is very conclusive that, over time, it has protected our children from infections that are potentially fatal,” he declared.

From the moment of birth, vaccinations against different diseases begin, such as the one that prevents hepatitis B and severe forms of tuberculosis (BCG). | Photo: El País

“That term was not used much again because let’s say that this protection does not only depend on the vaccination coverage. It also has to do with other aspects such as the types of viruses, the risk factors of the population and so on. You always play with these other variables, but what is unquestionable is that the greater the coverage, the greater the protection in the entire population,” said the health professional.

What’s going on?

Epidemiologists tried to decipher what is behind the decrease in coverage. Eduardo López maintained that it is a hitherto irremediable consequence of Covid-19. “After the pandemic, we have very unfortunately reduced the interest and efforts of parents to maintain this high coverage, and we are seeing this in infections that had recently almost disappeared.”

The other issue is that parents have been consuming malicious content in this regard through digital environments for some time now. This was argued by the infectious diseases epidemiologist and professor at the Universidad del Valle, Lyda Osorio.

“There are various barriers to vaccination, but something that has been affecting us more recently is the fake news about vaccines that spreads through social networks. It is very important that mothers and families do not believe everything that comes to them online and consult directly with health personnel with any questions they have regarding vaccines,” indicated the doctor.

This is just one of the pathologies that can be avoided with EPI vaccines and that pose a significant risk to the population. The Scientific Director of Ceip made an x-ray detailing the main dangers to which citizens are exposed.

“Infections that can be prevented through EPI are potentially fatal; We are talking about poliomyelitis, for example, a paralyzing infection that prevents children from walking; We are talking about infections such as meningitis, which generate very serious neurological complications in the brain and with long-term consequences that are irreversible; We are talking about measles, which can cause very complex pneumonia, skin lesions; also chickenpox, generally very serious complications,” described Eduardo López.

This has an aggravating factor, added the epidemiologist, and is the “unusual increase” in respiratory infections that, although they have always been in the environment, in recent years they have reduced their presence due to the limited physical contact between people and the limitations circulation due to Covid-19.

“But the children now, who are attending school again and leading a normal life, are receiving, having and suffering all of them at the same time,” he evidenced.

The vaccines included in the national vaccination scheme are safe and effective, which is why they have the support of the Colombian Society of Pediatrics. | Photo: J.TRIANA

The concern in the region arises from the fact that Valle del Cauca, according to the Attorney General’s Office, is among the four departments with a call for attention due to its low coverage.

How is the coverage in Cali?

The Cali Health Secretariat delivered a positive balance of coverage so far this year. The entity maintained that, according to the programmatic goal of the Ministry of Health, coverage by November should be at 87%.

According to a table shared with this medium, the BCG, Pentavalent and A-Polio vaccines have a reach of 87% with a cut-off for that month. Meanwhile, the 18-month Triple Viral SRP accumulates 87.6% and the Triple Viral SRP applied after one year is at 96.6%.

However, the Secretariat did not provide details of the coverage in the other biologicals (see vaccine table).

In fact, the Mayor’s Office explained that “in the year 2023 there will be a drop in monthly coverage, despite the efforts made by the PAI, carrying out rapid coverage monitoring in all Child Development Centers (CDI). ) and the Social Transformation Units (UTS)”.

For its part, 7,411 second doses against HPV have been applied, for a coverage of 48.8% in this section.

2023-12-18 01:37:32
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