Celebrating World Immunization Week: A legacy of saving Lives and Strengthening Communities in Bangladesh

World Immunization Week serves as a powerful reminder of the life-saving impact of vaccines and the relentless efforts of health systems across the globe. In Bangladesh, this celebration holds special significance due to the nation's remarkable journey in expanding access to immunization and protecting generations from vaccine-preventable diseases (VPDs).

The Expanded Program on Immunization (EPI) was launched globally in May 1974 with the goal of ensuring that every child receives essential vaccinations. Bangladesh officially adopted the EPI on April 7, 1979, coinciding with World Health Day. Since then, it has grown to become one of the most successful public health initiatives in the country.

The program became fully operational in 1985 when Bangladesh committed to the Global Universal Child Immunization Initiative, aiming for universal child immunization by 1990. By 1989, efforts were extended to include urban areas such as Dhaka City to improve access in densely populated zones.

Over the last 45 years, Bangladesh has made tremendous progress in controlling and eliminating VPDs. Once lagging with less than 2% coverage in 1984, the EPI underwent strategic intensification from 1985 to 1990. During this period, services expanded across 476 Upazilas, 92 municipalities, and 6 city corporations, reaching all target groups, including infants and pregnant mothers, by 1990.

In 2003, the "Reach Every District" (RED) strategy was introduced, followed by its evolution into the "Reach Every Community" (REC) strategy in 2017, highlighting a shift towards equity in vaccine delivery.

Bangladesh's immunization program started with six conventional vaccines—BCG, DPT, OPV, TT, and Measles—in 1979. Since then, the vaccine schedule has expanded significantly, introducing Hepatitis B (2003), Hib (2009), Rubella (2012), PCV and IPV (2015), MR second dose (2015), and fIPV (2017). Most recently, the HPV vaccine was successfully launched on October 2, 2023. Plans are already underway to introduce additional vaccines soon.

These milestones have been instrumental in transforming public health outcomes. Bangladesh recorded its last wild poliovirus case in 2006 and was declared polio-free in 2014. The country also met its rubella control target in 2018. The EPI's outstanding achievements earned GAVI Best Performance Awards in 2009 and 2012, and in 2019, Bangladesh got Vaccine Hero Award.

Each year, more than 3.7 million children in Bangladesh receive at least 11 antigens through routine immunization. For several consecutive years, coverage has remained consistently high, above 90%—a testament to the program's efficiency. However, disparities persist, particularly in hard-to-reach (HTR) and high-risk (HR) areas, where factors such as geographical isolation, socioeconomic status, and maternal education impact access and uptake.

Challenges remain, including human resource shortages, inadequate vaccine supply, transportation difficulties in remote areas, and limited budget allocations. Moreover, with Gavi funding expected to phase out by 2029, Bangladesh must prepare for a transition to self-financing to ensure sustainability.

Short-term priorities include establishing a national coordination mechanism to review immunization progress, developing service delivery strategies, engaging key partners—including CSOs, NGOs, the private sector, and development partners—and filling critical HR vacancies.

Medium-term actions should focus on strengthening recruitment, enhancing monitoring and surveillance, and improving coordination at all levels.

Long-term goals must include implementing an effective organogram for EPI with necessary HR, advancing supply chain management, refining microplanning, ensuring vaccine availability, and strengthening surveillance for VPDs and AEFIs (Adverse Events Following Immunization), while upgrading cold-chain infrastructure nationwide.

With sustained commitment, coordinated action, and shared responsibility, Bangladesh is well on its way to achieving 100% immunization coverage, becoming a global example of a vaccine-preventable disease-free nation.