Protocol for the use of the Performance Monitoring Tool for the National Expanded Program on Immunization

Abstract

Over the past 10 years, vaccination coverage against all diseases has declined in the Region of the Americas. More recently, as a consequence of the COVID-19 pandemic, the decline has accelerated to a worrisome coverage with the third dose of diphtheria, tetanus, and pertussis vaccine (DTP3) and the third dose of polio vaccine at 80% for each of these vaccines in 2021. These are the lowest coverage estimates in the Region since the elimination of polio in the Americas in 1994. Similarly, quality indicators for the surveillance of vaccine-preventable diseases (VDPDs), such as polio, measles, and rubella have also been affected. Notifications of acute flaccid paralysis (AFP) and rash have declined in virtually all countries during 2020 and 2021. Considering the trends in VPD coverage and surveillance in conjunction with the global situation, it is important to focus efforts on revitalizing the Region's immunization programs and ensuring their continuous improvement.In July 2021, PAHO's Technical Advisory Group (TAG) on VPD made a strong call for effective actions to improve the performance of immunization services in the Region. In 2021, PAHO's 59th Directing Council approved the policy “Revitalizing immunization as a public good for universal health,” which establishes the strategic roadmap for the Region's Expanded Program on Immunization (EPI) for the coming years, aligned with the 2030 Agenda for Immunization (IA2030). The Region faces major challenges in the area of immunizations. Therefore, it is necessary to examine the performance of immunization programs, analyze the reasons behind the drops in coverage that have been observed over the past 10 years, and seek to effectively integrate pandemic response vaccination operations and regular program vaccination.