World Health Organization • SEARO/CDS/IVD • 31 August 2021

ExpAnDED pROgRAmmE On ImmunIzAtIOn (EpI)

Table 1: Basic information 2020 Table 2: Immunization schedule, 2020

Table 3: Immunization system highlights

EPI hIsTory

• EPIstartedin1978

• EPIre-structuredinMarch2000

• DTP-HepBvaccineintroducedin2007

• DTP-Hib-HepB)vaccineintroducedin2012

• MRvaccineintroducedinFeb2016

• SeconddoseofMRintroducedinFeb2016

• HepBbirthdoseintroducedinFeb2016

• DPT/DT vaccine (booster dose) introduced inFeb2016

• IPVintroducedinFeb2016

• tOPVtobOPVswitchedon18April2016

• RotavirusvaccineintroducedinDec2019

Source: cMYP 2016-2020 and EPI/MOH

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.

TImor lEsTE

Totalpopulation1 1,299,412

Livebirths1 33,333

Children<1year1 31,905

Children<5years1 478,804

Children<15years1 160,621

Pregnantwomen1 41,196

WCBA1(15-49years) 322,969

Neonatalmortalityrate2 19.6(per1,000LB)

Infantmortalityrate2 38.1(per1,000LB)

Under-fivemortalityrate2 44.2(per1,000LB)

Maternalmortalityratio2 142(per100,000LB)

Division/Province/State/Region 13

Municipality 13

Postos/Sub-district 65

Sucos/Village 452

Populationdensity1(persq.km) 87

Populationlivinginurbanareas2 35.80%

Populationusingatleastbasicdrinking-waterservices2

86%

Populationusingatleastbasicsanitationservices2

57%

Totalexpenditureonhealthas%ofGDP2 1.48%

Birthsattendedbyskilledhealthpersonnel 57%

NeonatesprotectedatbirthagainstNT2 83%

1 SEAR annual EPI reporting form, 20202 WHO, Global Health Observatory (GHO) data http://apps.who.

int/gho/data accessed on 01 August 2021

Figure 1: National immunization coverage, 1980-2020

Source: WHO and UNICEF estimates of immunization coverage

Vaccine Age of administration

BCG Birth

HepB Birth

DTP-Hib-HepB 6weeks,10weeksand14weeks

OPV Birth,6weeks,10weeksand14weeks

IPV 14weeks

MR 9monthsand18months

Td Females15to49years(1stpregnancycontact,+1months,+6months,+1year,+1year)

DT 6years

DTP 18months

Rotavirus 6weeks,10weeksand14weeks

VitaminA 6-36months(with6monthsinterval)

Source: WHO/UNICEF JRF, 2020

cMYPforimmunization 2016-2020

NITAG-TL fullyfunctional

Spendingonvaccinesfinancedbythegovernment

75%

Spendingonroutineimmunizationprogramme financed by thegovernment

75%

Updatedmicro-plansthatincludeactivitiestoimproveimmunizationcoverage

13districts(100%)

National policy for health carewaste management includingwastefromimmunizationactivities

inplace

NationalsystemtomonitorAEFI inplace

MostrecentEPICES EPICoveragesurvey2018

>80%coverageforDTP-Hib-HepB3 13districts(100%)

>90%coverageforMCV1 13districts(100%)

>90%coverageforMCV1 None0%

>10%drop-outrateforDTP-Hib-HepB1toDTP-Hib-HepB3

2districts15%

Source: WHO/UNICEF JRF, 2020

FAcTshEET 2021

Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2020

Table 4: reported cases of vaccine preventable diseases, 2015-2020

Figure 3: TT2+ coverage1 and NT cases2, 1980-2020

1 WHO and UNICEF estimates of immunization coverage2 WHO vaccine-preventable diseases: monitoring system 2020

1 Country official estimates, 1980-20202 WHO vaccine-preventable diseases: monitoring system 2020

Figure 4: 2019

DTP-hib-hepB3 coverage by district

Figure 5: 2020

Source: WHO/UNICEF JRF (multiple years) * Imported/ Import related ND=No data

Source: SEAR annual EPI reporting form, 2019 and 2020 (administrative data)

year Polio Diphtheria Pertussis NT (% of all tetanus)

measles rubella mumps JE crs

2015 0 1 5 0 48 5 ND 0 0

2016 0 0 6 0 2 8 0 1 0

2017 0 0 1 1(100%) 0 3 21 7 0

2018 0 0 0 1(100%) 0 8 26 0 0

2019 0 0 7 0 22* 21 ND 23 0

2020 0 0 5 2(100%) 2 5 0 0 0

<70% 70%-79% 80%-89% >90%

Table 5: AFP surveillance performance indicators, 2015-2020

Table 6: oPV sIAs

Non-polio AFP rate by district Adequate stool specimen collection % by district

Source: WHO/UNICEF JRF (multiple years)

Indicator 2015 2016 2017 2018 2019 2020

AFPcases 3 10 5 0 5 1

Wildpoliovirusconfirmedcases 0 0 0 - 0 0

Compatiblecases 0 0 0 - 0 0

Non-polioAFPrate1 0.59 2.16 1.08 - 0.83 0.21

Adequatestoolspecimencollectionpercentage2 100 50% 60% - 20% 0%

Totalstoolsamplescollected 0 - 8 - 2 1

%NPEVisolation 0 - 13 - 0 0

%Timelinessofprimaryresultreported3 0 - 100 - 100 100

• ThelastlaboratoryconfirmedpoliocaseduetoWPVwasreportedinNovember1993

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.

Figure 6: 2019 Figure 8: 2019

Figure 9: 2020

<1 1–1.99 >2 Nonon-polioAFPcase <60% 60%-79% >80% NoAFP

year Antigen Geographic coverage Target age Target population coverage (%)

round 1 round 2 round 1 round 2

2005 OPV NID <5years 177,713 93 102

2015* OPV NID <5years 522,943 96 -

2018* OPV NID <5years 165,013 111 -

2020 OPV

Figure 7: 2020

World Health Organization • SEARO/CDS/IVD • 31 August 2021

VACCInES PROtECtSUSTAIN. ACCELERATE. INNOVATE.

Figure 10: hepB3 and hepB birth dose immunization coverage1, 2000-2020

Figure 11: mcV1 & mcV2 coverage1 and measles, rubella cases2, 1980-2020

Table 7: mcV/mr sIAs

mr1 coverage by district mr2 coverage by district

Source: SEAR annual EPI reporting form, 2019 and 2020 (administrative data)

Source: WHO/UNICEF JRF (multiple years)

1 WHO and UNICEF estimates of immunization coverage 1 WHO and UNICEF estimates of immunization coverage2 WHO vaccine-preventable diseases: monitoring system 2020

Figure 12: 2019

Figure 15: 2020

<80% 80%-89% 90%-94% >95%

year Antigen Geographic coverage Target group Target coverage %

2003 M nationwide 9to59months 128,318 99%

2006 M nationwide 6monthsto14years 390,687 40%

2009 M nationwide 9to59months 167,136 76%

2011 M nationwide 6monthsto14years 494,427 92%

2015 MR nationwide 6monthsto14years 501,832 97%

2018 MR nationwide 6to59months 142,935 110%

Figure 13: 2020

Figure 14: 2019

Figure 16: Immunity against measles - immunity profile by age in 2020*

Figure 18: confirmed measles cases* by month 2018-2020

Figure 17: Immunity against rubella through vaccination - immunity profile by age in 2020*

Figure 19: confirmed rubella cases* by month 2018-2020

*Modeled 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 casesSource: SEAR measles case-based data

*Includes laboratory confirmed and epidemiologically linked cases Source: SEAR measles case-based data

*Modeled using MSP tool ver 2

Vaccines ProtectSUSTAIN. ACCELERATE. INNOVATE.

Figure 20: Vaccination status of confirmed (laboratory, Epi linked and clinically compatible) measles cases, by age in 2019 and 2020

Figure 21: Vaccination status of confirmed (laboratory and Epi linked) rubella cases, by age in 2019 and 2020

Table 8: summary of measles surveillance indicators, 2018-2020 Figure 22: Network of Who supported surveillance and immunization medical officers and laboratories

Source: SEAR measles case-based data

Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data

Source: SEAR measles case-based data

Indicator Target 2018 2019 2020

Numberofsuspectedmeaslescases 163 460 109Confirmedmeaslescases 0 0 33 4

Labconfirmed 0 0 22 0Epi-Linked 0 0 0 0Clinically-compatible 0 0 11 4

Confirmedrubellacases 0 8 21 5Labconfirmed 0 8 21 5Epi-Linked 0 0 0 0

Discardednon-measlesnon-rubellacases 152 405 100Percentage of suspected cases with adequate investigationinitiatedwithin48hoursofnotification

≥80% 100 100 ND

Reporting rate of non-measles non-rubella cases to nationallevelper100,000population

≥2 11.8 30.5 ND

Percentage of second-level administrative units reporting atleast2non-measlesnon-rubellacasesper100,00population

≥80% ND ND ND

Percentageofsurveillanceunitsreportingmeaslesandrubelladatatothenationallevelontime,evenintheabsenceofcases

≥80% 92 100 ND

Percentageofspecimensreceivedatthe laboratorywithin5daysofcollection

≥80% 92 100 100

Percentage of IgM results reported to the national publichealthauthoritiesby the laboratorywithin4daysof receiptofspecimens

≥80% 44 85 ND

GenotypesdetectedMeasles ND ND NDRubella ND ND ND

Forcontactorfeedback:Expanded Programme on ImmunizationMinistryofHealth,Dilli,TimorLesteTel:+670-77351964,Fax:+670-7250097Email:mmausiry@gmail.com,www.moh.gov.tl

Immunization and Vaccine Development (IVD)WHO-SEARO,IPEstate,MGMarg,NewDelhi110002,IndiaTel:+911123370804,Fax:+911123370251Email:SearEpidata@who.intwww.who.int/southeastasia/health-topics/immunization

National health laboratory, Dili

• Nationalmeaslesandrubellalaboratory

• NationalJapaneseencephalitislaboratory