The Expanded Program on Immunization (EPI) has made considerable progress towards immunizing the world's women and children, preventing 3.2 million child death episodes per year from measles, neonatal tetanus, and pertusis, as well as 440,000 cases of paralytic poliomyelitis. Vaccinations provided through the EPI are believed to be one of the most cost-effective child survival interventions at a cost between $5 and $10 per child. However, variation exists in the average cost per fully immunized child, depending upon the type of vaccine technology and delivery strategy utilized, the scale of operation, and country and environmental characteristics. Recent evidence on the cost-effectiveness of immunization strategies raise concerns over the affordability of national immunization programs by governments and highlights the need for continued donor support, identification of other financing mechanisms, or reconsideration of policies aimed toward accelerating and maintaining immunization coverage. © 1994.
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