An Assessment of the Expanded Program on Immunization (EPI) in the Philippines: Supply-side Challenges and Ways Forward

The Philippine Expanded Program on Immunization (EPI) has been in existence since 1976, providing Filipino children access to safe and effective vaccines to protect them from diseases like measles, diphtheria, tetanus, and whooping cough. EPI is one of the major programs of the Department of Health and has achieved many milestones. Mortality and morbidity due to vaccine-preventable diseases have declined precipitously over the years, saving the lives of many Filipino children. Moreover, polio and maternal and neonatal tetanus were eliminated in 2000 and 2017, respectively. Despite this progress, basic vaccine coverage hovered at only 70–80 percent in the last 30 years, and EPI has never achieved its target to fully immunize at least 95 percent of children. Hence, this study assesses the performance of EPI in the Philippines. Central to this assessment is the policy question: Why has the country struggled to maintain immunization coverage and repeatedly failed to achieve its national immunization target? While demand factors like vaccine confidence have contributed to the weak performance of the program, the sharp decline in immunization coverage in recent years is caused mainly by deep-seated supply-side system issues. In particular, leadership, planning, and supply chain problems led to recurring vaccine stockouts in the past decade.