From One Country to the World: How Immunization Programs Grew

Established by the Ministry of Health in 1973 after the smallpox eradication campaign, this program gathered vaccination work that had been scattered across agencies under one national command and was given legal force by a 1975 law. It grew from four products to 48, and its results include Brazil being certified free of wild poliovirus circulation.

Launched in 1978 after the World Health Organization called on member states to set up immunization programs, it began with four vaccines: BCG, oral polio, measles and DTwP. Coverage of 85 percent was reached at provincial level in 1988 and township level in 1995, and the program later reported over 95 percent coverage of children under six with 14 vaccines.

Set up in 1980 as KEPI, it made Kenya the second African country after Nigeria to roll out a full nationwide program. National surveys found 43 percent of children fully immunized before it began and 51 percent by 1987, a reminder that early gains were real but uneven between regions.

Created in 1983, the program was stalled by conflict in the early 1980s and relaunched by President Museveni in 1987. Its path shows how political instability can undo immunization coverage and how funding, workforce and cold chain limits kept shaping delivery afterward.

Launched by India in 1985 as an expansion of an earlier 1978 program, it delivers free vaccines through government facilities and outreach sessions. It targets roughly 26 million newborns and 30 million pregnant women each year, which makes it one of the largest public health programmes by volume.

Consolidated in 1991 after a presidential decree created a National Vaccination Council, it built on a 1973 program and has since extended beyond childhood to adolescents, adults and older adults. A 2002 review credits it with eradicating polio, diphtheria, and neonatal tetanus within Mexico.

This United States program began in 1994 after a measles resurgence from 1989 to 1991 showed that cost was leaving low-income children under-vaccinated. It supplies free vaccines to eligible children and now accounts for roughly half of the doses given to children there.

Begun in 1995 with support from WHO and UNICEF, it used repeated National Immunization Days and house-to-house rounds to reach every child under five. India recorded its last wild poliovirus case in January 2011 and was certified polio-free in March 2014.

In 2011 Rwanda became the first African country to run a national HPV vaccination program, reaching 93 percent coverage of sixth-grade girls within twelve months. Delivered mostly through schools alongside routine immunization, it shows how an established national program can absorb a new vaccine.

Endorsed by all 194 member states of the World Health Assembly in 2012, this framework set out to prevent millions of deaths by 2020 through more equitable access to existing vaccines. A later WHO-commissioned review found many 2020 targets were missed, though more children were vaccinated each year than ever before.

The successor strategy for 2021 to 2030, endorsed by the World Health Assembly on 1 April 2020, aims to halve the number of children who receive no vaccines, introduce 500 new or under-used vaccines in low and middle income countries and reach ninety percent coverage for key vaccines.