40 years of immunization in Mozambique: a narrative review of literature, accomplishments, and perspectives

Abstract

In Mozambique, the Expanded Program on Immunization (EPI) was implemented in 1979 with the objective of reducing child mortality and morbidity through the provision of immunization services. This study aims to describe the characteristics of the EPI and review the available information related to immunization service in Mozambique, its accomplishments and perspectives. A narrative review of the literature was carried out and the electronic databases accessed were VHL, Google Scholar, and PubMed between 1979 and 2019, using descriptors related to the theme. A total of 28 articles and other relevant sources have been consulted for the review. The national immunization coverage in Mozambique between 1997 (47%) and 2015 (66%) improved 19 percentual points; also immunization coverage of children under 12 months has increased from 44.3% (1997) to 57% (2015). The 2015 survey showed that out of the 11 provinces, only the southern and Cabo Delgado province could reach the 80% recommended goal at the provincial level. Zambézia, Nampula, and Tete provinces have been reporting low coverage over the years and Cabo Delgado presents coverage oscillation. The BCG, DPT3, Polio 3, and measles have reached 80% of coverage goal from 1997 to 2015. Our analysis have shown important improvements in national immunization, characterized by an overall increase in the national and provincial coverage and a decrease in the number of children that did not receive any vaccine. Despite these improvements, some provinces have lower coverages than expected and it is necessary to understand the determinants of dropout in children to retain them and provide timely and full immunization.

Community-acquired bacteremia among HIV-infected and HIV-exposed uninfected children hospitalized with fever in Mozambique

“…In Mozambique, the country’s Expanded Program on Immunization has been working since 1979 to increase vaccine coverage ( Shemwell et al, 2017 ). With support from GAVI since 2001, the program has been able to gradually introduce new vaccines, including Hepatitis B and Haemophilus Influenza B in 2008, followed by the pneumococcal conjugate vaccine (PCV-10) in 2013 ( Cassocera et al, 2020 ).…”

Prevalence of hepatitis B virus and immunity status among healthcare workers in Beira City, Mozambique

“…In Mozambique, hepatitis B vaccination in children has been part of the Expanded Programme on Immunization (EPI) since 2001, with the two-three-four months postnatal scheme. Although the current immunization coverage rate is high, with an estimate of 88%, the birth-dose vaccination has yet to be implemented [10,11].…”

Environmental Monitoring for Enteroviruses in Maputo, Mozambique—2018

“…In Mozambique, the last case of paralytic poliomyelitis caused by indigenous polioviruses occurred in 1993, and vaccination coverage against polio has increased in the last few years since its introduction, although it remains below 90% in the country [ 12 ]. Since then, poliomyelitis has been controlled mostly by using the trivalent oral polio vaccine (tOPV) [ 12 ]. In April 2016, the tOPV was replaced by the bivalent oral polio vaccine (bOPV) [ 12 ].…”

“…Since then, poliomyelitis has been controlled mostly by using the trivalent oral polio vaccine (tOPV) [ 12 ]. In April 2016, the tOPV was replaced by the bivalent oral polio vaccine (bOPV) [ 12 ]. Recently, outbreaks related to VDPV have been reported in 16 countries in several African regions, including Mozambique [ 11 , 13 ].…”