Expanded programme on immunization (EPI). Immunization schedules in the WHO eastern Mediterranean region, 1995.



Wkly Epidemiol Rec. 1996 Jun 7;71(23):173-6.


There are 23 countries/areas in this Region (Tables 1-3). BCG is used in all but 3 countries (Cyprus, Jordan and Lebanon). Most countries/areas give BCG vaccine at birth, 2 countries (Bahrain and Tunisia) schedule additional doses at school age and Kuwait uses 1 dose at the age of 3 1/2-4 years. Diphtheria-pertussis-tetanus (DPT) vaccine is used as a primary series of 3 doses in all countries/areas. Fifteen countries/areas use a fourth dose of DPT vaccine in the second year of age or later (Bahrain, Cyprus, Egypt, Iran [Islamic Republic of], Jordan, Kuwait, Lebanon, Libyan Arab Jamahiriya, Oman, Qatar, Saudi Arabia, Syrian Arab Republic, Tunisia, and the United Arab Emirates, the United Nations Relief and Works Agency for Palestine Refugees in the Near East [UNRWA]). Six countries use 5 doses of DPT vaccine, the fifth dose being given at the age of 4-6 years (Bahrain, Cyprus, Iran [Islamic Republic of], Kuwait, Qatar, and Saudi Arabia). One or 2 booster doses of diphtheria-tetanus (DT) vaccine are used in 9 countries/areas from the age of 6-12 years. Td vaccine is used as a booster in Bahrain and Cyprus. Oral poliovirus vaccine (OPV) is used in a primary series of 3 doses simultaneously with DPT vaccine in all countries/areas. Ten countries/areas use an additional dose of OPV at birth (Djibouti, Iran [Islamic Republic of], Iraq, Kuwait, Libyan Arab Jamahiriya, Morocco, Oman, Pakistan, Syrian Arab Republic, and UNRWA). An additional dose of OPV in the second year of life is used in 15 countries, and additional doses of OPV are recommended in some countries. In UNRWA, the first 2 doses of OPV 2 and 3 months of age are given simultaneously with the inactivated poliovirus vaccine (IPV). Measles vaccine is given in most countries/areas at 9-12 months of age, usually in the form of monovalent measles vaccine. The 2-dose policy is implemented in 12 countries. In 8 countries, the second dose is given as measles-mumps-rubella (MMR) vaccine, and in 3 countries as monovalent measles vaccine. The age for the second dose varies. In 10 countries, it is given at 12-15 months of age, and in the Libyan Arab Jamahiriya at 18 months of age. The United Arab Emirates uses 3 doses. Rubella vaccine is scheduled for girls of 12-13 years of age in Bahrain, the United Arab Emirates and UNRWA and for boys and girls in Kuwait at 12 years of age. Hepatitis B vaccine is used in 15 countries/areas. All these countries use 3 primary doses of vaccine in infancy. The immunization time varies from birth (12 countries/areas) to 9 months of age. In Cyprus, hepatitis B vaccine is used in a 4-dose schedule, including a booster dose given to 5 to 6-year-old children. Tetanus toxoid is used for pregnant or non-pregnant women of childbearing age. It is also given to school-children in the Islamic Republic of Iran. The schedule includes 2-5 doses.

Keywords: eastern Mediterranean ,Immunization