Expanded Immunization Program and reduction of vaccine-preventable diseases in children under five years: Systematic review
DOI:
https://doi.org/10.66778/LU.e02v07n03.04Abstract
Introduction: vaccine-preventable diseases represent a high-impact public health problem affecting children worldwide. Therefore, in 1974, the World Health Organization and the Pan American Health Organization implemented the Expanded Program on Immunization with the aim of reducing this problem through accessible and equitable vaccination services. Objective: to synthesize the existing scientific evidence on the impact of the implementation of the Expanded Program on Immunization in reducing vaccine-preventable diseases among children under 5 years of age worldwide. Methodology: evidence collection was conducted using the PubMed and SciELO databases, employing MeSH and DeCS descriptors combined through Boolean operators (AND, OR). To ensure the quality of the information, the PRISMA flow diagram and inclusion and exclusion criteria were applied. Results and discussion: out of a total of 248 identified records, 17 articles were selected for the systematic review. The findings indicate that immunization has prevented the deaths of between 101 and 154 million children, as well as contributed to the elimination and control of vaccine-preventable diseases in diverse contexts. However, challenges persist, such as low vaccination coverage, misinformation, and inadequate access to vaccination services. Conclusions: the Expanded Program on Immunization is one of the most costeffective strategies implemented over the past 50 years in favor of child health.
Downloads
References
1. Calderón M, Porras A, Sandoval X, Araujo F. Desafíos y estrategias en la implementación de esquemas de inmunización en comunidades rurales. Scielo. 2026. DOI: https://doi.org/10.5281/ zenodo.17074027
2. Castañeda C, Martínez R, Castro FdJ. Vaccination and its challenges. Scielo. 2021. DOI: https://doi. org/10.46377/dilemas.v9i.3032
3. OMS. Manual Vacunas para enfermedades inmunoprevenibles, 2019. https://dspace.uniandes.edu.ec/ bitstream/123456789/15999/1/MANUAL%20ENI%202019%20%281%29.pdf.
4. Lubanga A, Bwanali A, Kangoma M, Matola Y, Moyo C, Kaonga B. Addressing the re-emergence and resurgence of vaccine-preventable diseases in Africa: A health equity perspective. Human Vaccines & Immunotherapeutics. 2024; 20. DOI: https://doi.org/10.1080/21645515.2024.2375081
5. Castañeda J, Tamez O. Enfermedades prevenibles por vacunación que se creían erradicadas. Revista de Enfermedades Infecciosas en Pediatría. 2019; 32(130): p. 1576-80. https://biblat.unam.mx/hevila/ Revistadeenfermedadesinfecciosasenpediatria/2019/vol31/no130/3.pdf
6. Guerra A, Múgico M, Hernández L. Vacunación Segura. Edición universitaria ed.; 2017. https://udelar. edu.uy/eduper/wp-content/uploads/sites/29/2018/03/vacunacioseg.pdf
7. Ngwa C, Keumatio Doungtsop B, Bihnwi R, Ngoy N, Yang N. Burden of vaccine-preventable diseases, trends in vaccine coverage and current challenges in the implementation of the expanded program on immunization: A situation analysis of Cameroon. Journal of Pharmaceutical Policy and Practice. 2023; 18(1). DOI: https://doi.org/10.1080/21645515.2021.1939620
8. MSP. Lineamientos de la campaña de vacunación y recuperación del esquema regular, 2021. https:// n9.cl/pnfdm.
9. Etienne C. Expanded Program on Immunization in the Americas: 40 years. Revista Panamericana de Salud Pública. 2018 Mayo 3. DOI: https://doi.org/10.26633/RPSP.2017.139
10. César C. Mantener los logros de la vacunación implica también “inmunizar” contra lo que se oponga. Scielo. 2019. DOI: https://doi.org/10.15381/anales.802.16404
11. Juan M, Ortega V, Muñoz F. Design of clinical questions in evidence-based practice. Formulation models. Scielo. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412016000300016
12. Page M, McKenzie J, Bossuyt P, Bourtron I, Hoffman T, Mulrow C, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología. 2021; 74(9): p. 790-799. DOI: 10.1016/j.recesp.2021.06.016
13. Sanabria A, Rigau D, Rotaeche R, Suelva A, Marzo M, Alonso P. Sistema GRADE: metodología para la realización de recomendaciones para la práctica clínica. Atención Primaria. 2015; 47(1): p. 48- 55. DOI: 10.1016/j.aprim.2013.12.013
14. Jhon T, Kompithra R. India’s universal immunization program: A review of successes, challenges, and future directions. Indian Journal of Medical Microbiology. 2025 Abril 17; 55. DOI: https://doi. org/10.1016/j.ijmmb.2025.100854
15. García C, Bassat Q. Vaccines: A global perspective. Vaccine. 2025 Julio 30; 26: p. 1-8. DOI: https:// doi.org/10.1016/j.vacun.2025.500457
16. Song Q, Li Y, Cao L, Hao L, Wen N, Wang F, et al. Impact of National Immunization Strategies on Vaccine Preventable Diseases China, 1950–2021. China CDC Weekly. 2024; 6(16): p. 339-343. DOI: 10.46234/ccdcw2024.064
17. Samarasekera U. 50 years of the Expanded Programme on Immunization. Lancet. 2024 Mayo 18; 403. DOI: https://doi.org/10.1016/S0140-6736(24)01016-X
18. Perugachi S, Lloris R. Analysis of Vaccine Reluctance in the Childhood Population. Metro Ciencia. 2024; 32(4): p. 39-58. DOI: https://doi.org/10.47464/MetroCiencia/vol32/4/2024/39-58
19. Shattock A, Johnson H, Sim S, Carter A, Lambach P, Hutubesy R, et al. Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization. Lancet. 2024 Mayo 25; 403(10440): p. 2307-2316. DOI: 10.1016/S0140-6736(24)00850-X
20. Shahid S, Ahmed S, Qazi M, Ali R, Syed A, Zaidi A, et al. Differential coverage for vaccines in the expanded program on immunization (EPI) among children in rural Pakistan. Vaccine. 2023; 41: p. 2680–2689. DOI: https://doi.org/10.1016/j.vaccine.2023.03.007
21. Arias F, Vásquez G, Arcos M, Hidalgo S, Larcos C, Chasi N, et al. Enfermedades prevenibles por vacunación en Ecuador: un problema de Salud Pública. Revista de Salud Pública. 2023 Junio; XXIX(1). DOI: https://doi.org/10.31052/1853.1180.v29.n1.39725
22. Awutey D, Kweku M, Gyan T, Adjuik M, Amenu J, Gmanyami J, et al. Factors contributing to compliance with Expanded Programme on Immunization and RTS, S/AS01 schedules among children aged 24–40 months in Central Tongu District of Ghana. Malaria Journal. 2025. DOI: https://doi.org/10.1186/s12936-025-05469-5
23. Bahl S, Hirabayashi K, Roesel S, Rutter P, Takashima Y. Immunization and Vaccine-Preventable Diseases in the Asia-Pacific Region. In Plotkin S. Plotkin’s Vaccines.; 2025. p. 1560-1577. DOI: 10.1016/B978-0-323-79058-1.00076-1
24. Funari V, Marino I, Machado J, Nunes B, Mattos M. Impact of childhood vaccination on reducing mortality from vaccine‐preventable diseases: an epidemiological study. International Health Sciences Review. 2025; 1(3): p. 147-152. DOI: https://doi.org/10.70164/ihsr.v1i3.36
25. Talbird S, Carrico J, Carias C, La E, Marshall G, Roberts C, et al. Impact of Routine Childhood Immunization in Reducing Vaccine- Preventable Diseases in the United States. Pediatrics. 2022; 150(3). DOI: 10.1542/peds.2021-056013
26. Baidya A, Willens V, Wonodi C, Moss W. Maintaining Immunizations for Vaccine-Preventable Diseases in a Changing World. Annual Review of Public Health. 2025; 46: p. 389-409. DOI: https:// doi.org/10.1146/annurev-publhealth-071723-111427
27. Carrico J, Mellott C, Talbird S, Bento Abreu A, Merckx B, Vandenhaute J, et al. Public health impact and return on investment of Belgium’s pediatric immunization program. Frontiers in Public Health. 2023 Junio 22. DOI: https://doi.org/10.3389/fpubh.2023.1032385
28. Jit M, Huyenc D, Friberg I, Minhe H, Kiet P, Walker N, et al. Thirty years of vaccination in Vietnam: Impact and cost-effectiveness of the national Expanded Programme on Immunization. Vaccine. 2015;: p. A233–A239. DOI: https://doi.org/10.1016/j.vaccine.2014.12.017
29. Giersing B, Mo A, Hwang A, Baqar S, Earle K, Ford A, et al. Meeting summary: Global vaccine and immunization research forum, 2023. Vaccine. 2025 Febrero 6; 46. DOI: https://doi.org/10.1016/j. vaccine.2024.126686
30. Lindstrand A, Cherian T, Chang-Blanc D, Feikin D, O’Brien K. The World of Immunization: Achievements, Challenges, and Strategic Vision for the Next Decade. The Journal of Infectious Diseases. 2021 Octubre 1; 224(4): p. S452–S467. DOI: https://doi.org/10.1093/infdis/jiab284
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Authors who publish in Revista La Universidad agree to the following terms: Authors continue as owners of their works, non-exclusively assigning dissemination rights to La Universidad Journal under the standards of the Attribution-NonCommercial-ShareAlike License: CC BY-NC-SA 4.0. This license allows the use of a work to create another work or content, modifying or not the original work, as long as the author is cited, the resulting work is shared under the same type of license and has no commercial purposes(https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es).
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
