Expanded programme on Immunization (EPI) factsheet 2023: DPR Korea

World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. ACCELERATE. INNOVATE. EXPANDED PROGRAMME ON IMMUNIZATION (EPI) FACTSHEET 2023 DPR KOREA Table 1: EPI History Year Milestone 1980 EPI launched 2003 HepB vaccine introduced 2003 AD syringes introduced 2004 HepB birth dose introduced 2006 DTP-HepB vaccine introduced 2008 MCV2 introduced 2012 DTP-Hib-HepB vaccine introduced 2015 IPV vaccine introduced 2016 tOPV to bOPV switched on 18 April 2019 MR2 introduced in November Source: cMYP 2016-2020 and EPI/MOPH Table 2: Basic information 2022 Table 3: Immunization schedule, 2022 Table 4: Immunization system highlights Total population 25,652,687 Live births1 305,571 Children <1 year1 302,701 Children <5 years1 1,569,405 Children <15 years1 4,941,881 Pregnant women1 305,004 WCBA1 (15-49 years) 6,268,080 Neonatal mortality rate2 8.25 (per 1,000 LB) Infant mortality rate2 10.1 (per 1,000 LB) Under-five mortality rate2 15.4 (per 1,000 LB) Maternal mortality ratio2 107 (per 100,000 LB) Division/Province/State/Region 13 District 211 Population density (per sq. km)1 210 Population living in urban areas3 61% Population using at least basic drinking- water services2 94% Population using at least basic sanitation services2 85% Total expenditure on health as % of GDP2 ND Births attended by skilled health personnel2 100% Neonates protected at birth against NT2 98% Children not covered by immunization programme (zero dose children)4 201,811 1 SEAR annual EPI reporting form, 2022 2 WHO, Global Health Observatory (GHO) data http://apps.who. int/gho/data accessed on 03 August 2023 3 Central Bureau Statistics (CBS), DPR Korea 4 DTP1 coverage from WHO and UNICEF estimates of immunization coverage and UN estimated under one population Figure 1: National immunization coverage, 2013-2022* Figure 16: Immunity against measles - immunity profile by age in 2022* Figure 20: Vaccination status of confirmed (laboratory, Epi linked and clinically compatible) measles cases, by age in 2021 and 2022 Figure 21: Vaccination status of confirmed (laboratory and Epi linked) rubella cases, by age in 2021 and 2022 Table 9: Summary of measles surveillance indicators, 2020-2022 Figure 22: Network of WHO supported surveillance and immunization medical officers and laboratories Figure 18: Confirmed measles cases* by month 2020-2022 Figure 17: Immunity against rubella through vaccination - immunity profile by age in 2022* Figure 19: Confirmed rubella cases* by month 2020-2022 *Modelled using WHO and UNICEF estimates and JRF (multiple years) and does not include immunity due to natural infection *Includes laboratory confirmed, epidemiologically linked and clinically compatible cases Source: SEAR measles case-based data *Includes laboratory confirmed and epidemiologically linked cases Source: SEAR measles case-based data *Modelled using MSP tool ver 2 Source: SEAR measles case-based data Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Source: SEAR measles case-based data For contact or feedback: Expanded Programme on Immunization Ministry of Public Health, Pyongyang, DPR Korea Phone: +850-2-3814077, Fax: +850-2-44104416 Email: bogon.moph@star-co.net.kp Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India Tel: +91 11 23370804, Fax: +91 11 23370251 Email: SearEpidata@who.int www.who.int/southeastasia/health-topics/immunization Source: WHO and UNICEF estimates of immunization coverage * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 Indicator Target 2020 2021 2022 Number of suspected measles cases 526 508 492 Confirmed measles cases 0 0 0 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Clinically-compatible 0 0 0 0 Confirmed rubella cases 0 0 0 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Discarded non-measles non-rubella cases 526 508 492 Percentage of suspected cases with adequate investigation initiated within 48 hours of notification ≥ 80% 100 100 99 Reporting rate of non-measles non-rubella cases to national level per 100,000 population ≥ 2 2 2.07 1.99 Percentage of second-level administrative units reporting at least 2 non-measles non-rubella cases per 100,00 population ≥ 80% 100 100 ND Percentage of surveillance units reporting measles and rubella data to the national level on time, even in the absence of cases ≥ 80% 100 100 100 Percentage of specimens received at the laboratory within 5 days of collection ≥ 80% 100 100 100 Percentage of IgM results reported to the national public health authorities by the laboratory within 4 days of receipt of specimens ≥ 80% 100 100 98 Genotypes detected Measles - - - Rubella - - - Vaccine Age of administration BCG Birth HepB Birth DTP-Hib-HepB 6 weeks, 10 weeks and 14 weeks OPV 6 weeks, 10 weeks and 14 weeks IPV 14 weeks Measles (MR) 9 months and 15 months Td 3 months and 4 months of pregnancy Vitamin A 6 - 11 months, 12 - 59 months Source: WHO/UNICEF JRF, 2022 Central Hygiene Anti Epidemic Institution à National polio laboratory à National measles & rubella laboratory Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. cMYP for immunization 2020-2024 NITAG fully functional Spending on vaccines financed by the government ND Spending on routine immunization programme financed by the government ND Updated micro-plans that include activities to improve immunization coverage 211 districts (100%) National policy for health care waste management including waste from immunization activities in place National system to monitor AEFI in place Most recent EPI CES National Immunization Coverage Survey 2017 >80% coverage for DTP-Hib-HepB3 None >90% coverage for MCV1 None >90% coverage for MCV2 None >10% drop-out rate for DTP-Hib- HepB1 to DTP-Hib-HepB3 none Source: WHO/UNICEF JRF, 2022 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. 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Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2022* Table 5: Reported cases of vaccine preventable diseases, 2016-2022 Table 6: AFP surveillance performance indicators, 2016-2022 Figure 10: HepB3 and HepB birth dose immunization coverage1, 2000-2022 Figure 11: MCV1 & MCV2 coverage1 and measles, rubella cases2, 1980-2022 Table 7: OPV and JE SIAs Table 8: MCV/MR SIAs Figure 3: TT2+ coverage1 and NT cases2, 1980-2022* 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 1 Country official estimates, 1980-2022 2 WHO vaccine-preventable diseases: monitoring system 2022 * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 Non-polio AFP rate by province Adequate stool specimen collection % by province MR1 coverage by province MR2 coverage by province Source: WHO/UNICEF JRF (multiple years) ND=No data Source: SEAR annual EPI reporting form, 2021 (administrative data) Source: SEAR annual EPI reporting form, 2022 (administrative data) Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: WHO/UNICEF JRF (multiple years) Source: WHO/UNICEF JRF (multiple years) Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 2016 0 0 0 0 0 0 0 0 0 2017 0 0 0 0 0 0 0 0 0 2018 0 0 0 0 0 0 0 0 0 2019 0 0 0 0 0 0 0 0 0 2020 0 ND ND ND 0 0 ND ND 0 2021 0 ND ND ND 0 0 ND ND 0 2022 0 0 0 0 0 0 0 0 0 Indicator 2016 2017 2018 2019 2020 2021 2022 AFP cases 105 104 130 122 128 134 132 Wild poliovirus confirmed cases 0 0 0 0 0 0 0 Compatible cases 0 0 0 0 0 0 0 Non-polio AFP rate1 1.83 1.76 2.21 2.07 2.23 1.9 1.93 Adequate stool specimen collection percentage2 98% 97% 100% 100% 100% 100% 100% Total stool samples tested in laboratory 194 202 257 244 256 267 258 % NPEV isolation 14 14 13 13 13 10 10.3 % Timeliness of primary result reported3 93 95 98 100 98 100 100 • The last laboratory confirmed polio case due to WPV was reported in 1996 1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset. 3 Results reported within 14 days of sample received at laboratory. 1 WHO and UNICEF estimates of immunization coverage 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 6: 2021 Figure 8: 2021Figure 7: 2022 Figure 9: 2022 Figure 12: 2021 Figure 14: 2021 Figure 15: 2022Figure 13: 2022 <1 1 – 1.99 >2 No non-polio AFP case<70% 70% - 79% 80% - 89% >90% <60% 60% - 79% >80% No AFP Year Antigen Geographic coverage Target age Target population Coverage (%) Round 1 Round 2 Round 1 Round 2 2000 OPV NID <5 years 2,147,929 99.6 99.7 2001 OPV NID <5 years 2,120,380 98.8 99.5 2002 OPV NID <5 years 2,098,940 99.7 99.8 2009 JE SNID 12 to 23 months and 4 to 5 years 1,500,000 99.5 <80% 80% - 89% 90% - 94% > 95% Year Antigen Geographic Coverage Target group Target Coverage (%) 2007 M nationwide 6 months to 45 years 16,123,376 99.9 2019 MR nationwide 9 months to 15 years boy and girls and 16 years to 18 years female 5,873,914 99.7 Figure 4: 2021 DTP-Hib-HepB3 coverage by province Figure 5: 2022 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. 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Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2022* Table 5: Reported cases of vaccine preventable diseases, 2016-2022 Table 6: AFP surveillance performance indicators, 2016-2022 Figure 10: HepB3 and HepB birth dose immunization coverage1, 2000-2022 Figure 11: MCV1 & MCV2 coverage1 and measles, rubella cases2, 1980-2022 Table 7: OPV and JE SIAs Table 8: MCV/MR SIAs Figure 3: TT2+ coverage1 and NT cases2, 1980-2022* 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 1 Country official estimates, 1980-2022 2 WHO vaccine-preventable diseases: monitoring system 2022 * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 Non-polio AFP rate by province Adequate stool specimen collection % by province MR1 coverage by province MR2 coverage by province Source: WHO/UNICEF JRF (multiple years) ND=No data Source: SEAR annual EPI reporting form, 2021 (administrative data) Source: SEAR annual EPI reporting form, 2022 (administrative data) Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: WHO/UNICEF JRF (multiple years) Source: WHO/UNICEF JRF (multiple years) Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 2016 0 0 0 0 0 0 0 0 0 2017 0 0 0 0 0 0 0 0 0 2018 0 0 0 0 0 0 0 0 0 2019 0 0 0 0 0 0 0 0 0 2020 0 ND ND ND 0 0 ND ND 0 2021 0 ND ND ND 0 0 ND ND 0 2022 0 0 0 0 0 0 0 0 0 Indicator 2016 2017 2018 2019 2020 2021 2022 AFP cases 105 104 130 122 128 134 132 Wild poliovirus confirmed cases 0 0 0 0 0 0 0 Compatible cases 0 0 0 0 0 0 0 Non-polio AFP rate1 1.83 1.76 2.21 2.07 2.23 1.9 1.93 Adequate stool specimen collection percentage2 98% 97% 100% 100% 100% 100% 100% Total stool samples tested in laboratory 194 202 257 244 256 267 258 % NPEV isolation 14 14 13 13 13 10 10.3 % Timeliness of primary result reported3 93 95 98 100 98 100 100 • The last laboratory confirmed polio case due to WPV was reported in 1996 1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset. 3 Results reported within 14 days of sample received at laboratory. 1 WHO and UNICEF estimates of immunization coverage 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 6: 2021 Figure 8: 2021Figure 7: 2022 Figure 9: 2022 Figure 12: 2021 Figure 14: 2021 Figure 15: 2022Figure 13: 2022 <1 1 – 1.99 >2 No non-polio AFP case<70% 70% - 79% 80% - 89% >90% <60% 60% - 79% >80% No AFP Year Antigen Geographic coverage Target age Target population Coverage (%) Round 1 Round 2 Round 1 Round 2 2000 OPV NID <5 years 2,147,929 99.6 99.7 2001 OPV NID <5 years 2,120,380 98.8 99.5 2002 OPV NID <5 years 2,098,940 99.7 99.8 2009 JE SNID 12 to 23 months and 4 to 5 years 1,500,000 99.5 <80% 80% - 89% 90% - 94% > 95% Year Antigen Geographic Coverage Target group Target Coverage (%) 2007 M nationwide 6 months to 45 years 16,123,376 99.9 2019 MR nationwide 9 months to 15 years boy and girls and 16 years to 18 years female 5,873,914 99.7 Figure 4: 2021 DTP-Hib-HepB3 coverage by province Figure 5: 2022 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. 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Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2022* Table 5: Reported cases of vaccine preventable diseases, 2016-2022 Table 6: AFP surveillance performance indicators, 2016-2022 Figure 10: HepB3 and HepB birth dose immunization coverage1, 2000-2022 Figure 11: MCV1 & MCV2 coverage1 and measles, rubella cases2, 1980-2022 Table 7: OPV and JE SIAs Table 8: MCV/MR SIAs Figure 3: TT2+ coverage1 and NT cases2, 1980-2022* 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 1 Country official estimates, 1980-2022 2 WHO vaccine-preventable diseases: monitoring system 2022 * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 Non-polio AFP rate by province Adequate stool specimen collection % by province MR1 coverage by province MR2 coverage by province Source: WHO/UNICEF JRF (multiple years) ND=No data Source: SEAR annual EPI reporting form, 2021 (administrative data) Source: SEAR annual EPI reporting form, 2022 (administrative data) Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: WHO/UNICEF JRF (multiple years) Source: WHO/UNICEF JRF (multiple years) Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 2016 0 0 0 0 0 0 0 0 0 2017 0 0 0 0 0 0 0 0 0 2018 0 0 0 0 0 0 0 0 0 2019 0 0 0 0 0 0 0 0 0 2020 0 ND ND ND 0 0 ND ND 0 2021 0 ND ND ND 0 0 ND ND 0 2022 0 0 0 0 0 0 0 0 0 Indicator 2016 2017 2018 2019 2020 2021 2022 AFP cases 105 104 130 122 128 134 132 Wild poliovirus confirmed cases 0 0 0 0 0 0 0 Compatible cases 0 0 0 0 0 0 0 Non-polio AFP rate1 1.83 1.76 2.21 2.07 2.23 1.9 1.93 Adequate stool specimen collection percentage2 98% 97% 100% 100% 100% 100% 100% Total stool samples tested in laboratory 194 202 257 244 256 267 258 % NPEV isolation 14 14 13 13 13 10 10.3 % Timeliness of primary result reported3 93 95 98 100 98 100 100 • The last laboratory confirmed polio case due to WPV was reported in 1996 1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset. 3 Results reported within 14 days of sample received at laboratory. 1 WHO and UNICEF estimates of immunization coverage 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 6: 2021 Figure 8: 2021Figure 7: 2022 Figure 9: 2022 Figure 12: 2021 Figure 14: 2021 Figure 15: 2022Figure 13: 2022 <1 1 – 1.99 >2 No non-polio AFP case<70% 70% - 79% 80% - 89% >90% <60% 60% - 79% >80% No AFP Year Antigen Geographic coverage Target age Target population Coverage (%) Round 1 Round 2 Round 1 Round 2 2000 OPV NID <5 years 2,147,929 99.6 99.7 2001 OPV NID <5 years 2,120,380 98.8 99.5 2002 OPV NID <5 years 2,098,940 99.7 99.8 2009 JE SNID 12 to 23 months and 4 to 5 years 1,500,000 99.5 <80% 80% - 89% 90% - 94% > 95% Year Antigen Geographic Coverage Target group Target Coverage (%) 2007 M nationwide 6 months to 45 years 16,123,376 99.9 2019 MR nationwide 9 months to 15 years boy and girls and 16 years to 18 years female 5,873,914 99.7 Figure 4: 2021 DTP-Hib-HepB3 coverage by province Figure 5: 2022 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. 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EXPANDED PROGRAMME ON IMMUNIZATION (EPI) FACTSHEET 2023 DPR KOREA Table 1: EPI History Year Milestone 1980 EPI launched 2003 HepB vaccine introduced 2003 AD syringes introduced 2004 HepB birth dose introduced 2006 DTP-HepB vaccine introduced 2008 MCV2 introduced 2012 DTP-Hib-HepB vaccine introduced 2015 IPV vaccine introduced 2016 tOPV to bOPV switched on 18 April 2019 MR2 introduced in November Source: cMYP 2016-2020 and EPI/MOPH Table 2: Basic information 2022 Table 3: Immunization schedule, 2022 Table 4: Immunization system highlights Total population 25,652,687 Live births1 305,571 Children <1 year1 302,701 Children <5 years1 1,569,405 Children <15 years1 4,941,881 Pregnant women1 305,004 WCBA1 (15-49 years) 6,268,080 Neonatal mortality rate2 8.25 (per 1,000 LB) Infant mortality rate2 10.1 (per 1,000 LB) Under-five mortality rate2 15.4 (per 1,000 LB) Maternal mortality ratio2 107 (per 100,000 LB) Division/Province/State/Region 13 District 211 Population density (per sq. km)1 210 Population living in urban areas3 61% Population using at least basic drinking- water services2 94% Population using at least basic sanitation services2 85% Total expenditure on health as % of GDP2 ND Births attended by skilled health personnel2 100% Neonates protected at birth against NT2 98% Children not covered by immunization programme (zero dose children)4 201,811 1 SEAR annual EPI reporting form, 2022 2 WHO, Global Health Observatory (GHO) data http://apps.who. int/gho/data accessed on 03 August 2023 3 Central Bureau Statistics (CBS), DPR Korea 4 DTP1 coverage from WHO and UNICEF estimates of immunization coverage and UN estimated under one population Figure 1: National immunization coverage, 2013-2022* Figure 16: Immunity against measles - immunity profile by age in 2022* Figure 20: Vaccination status of confirmed (laboratory, Epi linked and clinically compatible) measles cases, by age in 2021 and 2022 Figure 21: Vaccination status of confirmed (laboratory and Epi linked) rubella cases, by age in 2021 and 2022 Table 9: Summary of measles surveillance indicators, 2020-2022 Figure 22: Network of WHO supported surveillance and immunization medical officers and laboratories Figure 18: Confirmed measles cases* by month 2020-2022 Figure 17: Immunity against rubella through vaccination - immunity profile by age in 2022* Figure 19: Confirmed rubella cases* by month 2020-2022 *Modelled using WHO and UNICEF estimates and JRF (multiple years) and does not include immunity due to natural infection *Includes laboratory confirmed, epidemiologically linked and clinically compatible cases Source: SEAR measles case-based data *Includes laboratory confirmed and epidemiologically linked cases Source: SEAR measles case-based data *Modelled using MSP tool ver 2 Source: SEAR measles case-based data Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Source: SEAR measles case-based data For contact or feedback: Expanded Programme on Immunization Ministry of Public Health, Pyongyang, DPR Korea Phone: +850-2-3814077, Fax: +850-2-44104416 Email: bogon.moph@star-co.net.kp Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India Tel: +91 11 23370804, Fax: +91 11 23370251 Email: SearEpidata@who.int www.who.int/southeastasia/health-topics/immunization Source: WHO and UNICEF estimates of immunization coverage * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 Indicator Target 2020 2021 2022 Number of suspected measles cases 526 508 492 Confirmed measles cases 0 0 0 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Clinically-compatible 0 0 0 0 Confirmed rubella cases 0 0 0 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Discarded non-measles non-rubella cases 526 508 492 Percentage of suspected cases with adequate investigation initiated within 48 hours of notification ≥ 80% 100 100 99 Reporting rate of non-measles non-rubella cases to national level per 100,000 population ≥ 2 2 2.07 1.99 Percentage of second-level administrative units reporting at least 2 non-measles non-rubella cases per 100,00 population ≥ 80% 100 100 ND Percentage of surveillance units reporting measles and rubella data to the national level on time, even in the absence of cases ≥ 80% 100 100 100 Percentage of specimens received at the laboratory within 5 days of collection ≥ 80% 100 100 100 Percentage of IgM results reported to the national public health authorities by the laboratory within 4 days of receipt of specimens ≥ 80% 100 100 98 Genotypes detected Measles - - - Rubella - - - Vaccine Age of administration BCG Birth HepB Birth DTP-Hib-HepB 6 weeks, 10 weeks and 14 weeks OPV 6 weeks, 10 weeks and 14 weeks IPV 14 weeks Measles (MR) 9 months and 15 months Td 3 months and 4 months of pregnancy Vitamin A 6 - 11 months, 12 - 59 months Source: WHO/UNICEF JRF, 2022 Central Hygiene Anti Epidemic Institution à National polio laboratory à National measles & rubella laboratory Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. cMYP for immunization 2020-2024 NITAG fully functional Spending on vaccines financed by the government ND Spending on routine immunization programme financed by the government ND Updated micro-plans that include activities to improve immunization coverage 211 districts (100%) National policy for health care waste management including waste from immunization activities in place National system to monitor AEFI in place Most recent EPI CES National Immunization Coverage Survey 2017 >80% coverage for DTP-Hib-HepB3 None >90% coverage for MCV1 None >90% coverage for MCV2 None >10% drop-out rate for DTP-Hib- HepB1 to DTP-Hib-HepB3 none Source: WHO/UNICEF JRF, 2022 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. 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EXPANDED PROGRAMME ON IMMUNIZATION (EPI) FACTSHEET 2023 DPR KOREA Table 1: EPI History Year Milestone 1980 EPI launched 2003 HepB vaccine introduced 2003 AD syringes introduced 2004 HepB birth dose introduced 2006 DTP-HepB vaccine introduced 2008 MCV2 introduced 2012 DTP-Hib-HepB vaccine introduced 2015 IPV vaccine introduced 2016 tOPV to bOPV switched on 18 April 2019 MR2 introduced in November Source: cMYP 2016-2020 and EPI/MOPH Table 2: Basic information 2022 Table 3: Immunization schedule, 2022 Table 4: Immunization system highlights Total population 25,652,687 Live births1 305,571 Children <1 year1 302,701 Children <5 years1 1,569,405 Children <15 years1 4,941,881 Pregnant women1 305,004 WCBA1 (15-49 years) 6,268,080 Neonatal mortality rate2 8.25 (per 1,000 LB) Infant mortality rate2 10.1 (per 1,000 LB) Under-five mortality rate2 15.4 (per 1,000 LB) Maternal mortality ratio2 107 (per 100,000 LB) Division/Province/State/Region 13 District 211 Population density (per sq. km)1 210 Population living in urban areas3 61% Population using at least basic drinking- water services2 94% Population using at least basic sanitation services2 85% Total expenditure on health as % of GDP2 ND Births attended by skilled health personnel2 100% Neonates protected at birth against NT2 98% Children not covered by immunization programme (zero dose children)4 201,811 1 SEAR annual EPI reporting form, 2022 2 WHO, Global Health Observatory (GHO) data http://apps.who. int/gho/data accessed on 03 August 2023 3 Central Bureau Statistics (CBS), DPR Korea 4 DTP1 coverage from WHO and UNICEF estimates of immunization coverage and UN estimated under one population Figure 1: National immunization coverage, 2013-2022* Figure 16: Immunity against measles - immunity profile by age in 2022* Figure 20: Vaccination status of confirmed (laboratory, Epi linked and clinically compatible) measles cases, by age in 2021 and 2022 Figure 21: Vaccination status of confirmed (laboratory and Epi linked) rubella cases, by age in 2021 and 2022 Table 9: Summary of measles surveillance indicators, 2020-2022 Figure 22: Network of WHO supported surveillance and immunization medical officers and laboratories Figure 18: Confirmed measles cases* by month 2020-2022 Figure 17: Immunity against rubella through vaccination - immunity profile by age in 2022* Figure 19: Confirmed rubella cases* by month 2020-2022 *Modelled using WHO and UNICEF estimates and JRF (multiple years) and does not include immunity due to natural infection *Includes laboratory confirmed, epidemiologically linked and clinically compatible cases Source: SEAR measles case-based data *Includes laboratory confirmed and epidemiologically linked cases Source: SEAR measles case-based data *Modelled using MSP tool ver 2 Source: SEAR measles case-based data Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Source: SEAR measles case-based data For contact or feedback: Expanded Programme on Immunization Ministry of Public Health, Pyongyang, DPR Korea Phone: +850-2-3814077, Fax: +850-2-44104416 Email: bogon.moph@star-co.net.kp Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India Tel: +91 11 23370804, Fax: +91 11 23370251 Email: SearEpidata@who.int www.who.int/southeastasia/health-topics/immunization Source: WHO and UNICEF estimates of immunization coverage * Does not include catch-up vaccination of 2021 and 2022 birth cohorts conducted in 2023 Indicator Target 2020 2021 2022 Number of suspected measles cases 526 508 492 Confirmed measles cases 0 0 0 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Clinically-compatible 0 0 0 0 Confirmed rubella cases 0 0 0 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Discarded non-measles non-rubella cases 526 508 492 Percentage of suspected cases with adequate investigation initiated within 48 hours of notification ≥ 80% 100 100 99 Reporting rate of non-measles non-rubella cases to national level per 100,000 population ≥ 2 2 2.07 1.99 Percentage of second-level administrative units reporting at least 2 non-measles non-rubella cases per 100,00 population ≥ 80% 100 100 ND Percentage of surveillance units reporting measles and rubella data to the national level on time, even in the absence of cases ≥ 80% 100 100 100 Percentage of specimens received at the laboratory within 5 days of collection ≥ 80% 100 100 100 Percentage of IgM results reported to the national public health authorities by the laboratory within 4 days of receipt of specimens ≥ 80% 100 100 98 Genotypes detected Measles - - - Rubella - - - Vaccine Age of administration BCG Birth HepB Birth DTP-Hib-HepB 6 weeks, 10 weeks and 14 weeks OPV 6 weeks, 10 weeks and 14 weeks IPV 14 weeks Measles (MR) 9 months and 15 months Td 3 months and 4 months of pregnancy Vitamin A 6 - 11 months, 12 - 59 months Source: WHO/UNICEF JRF, 2022 Central Hygiene Anti Epidemic Institution à National polio laboratory à National measles & rubella laboratory Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. cMYP for immunization 2020-2024 NITAG fully functional Spending on vaccines financed by the government ND Spending on routine immunization programme financed by the government ND Updated micro-plans that include activities to improve immunization coverage 211 districts (100%) National policy for health care waste management including waste from immunization activities in place National system to monitor AEFI in place Most recent EPI CES National Immunization Coverage Survey 2017 >80% coverage for DTP-Hib-HepB3 None >90% coverage for MCV1 None >90% coverage for MCV2 None >10% drop-out rate for DTP-Hib- HepB1 to DTP-Hib-HepB3 none Source: WHO/UNICEF JRF, 2022