The continuity of vaccination programmes: reflections and a case from Gujarat, India.

In the wake of the successful smallpox eradication programme, immunization has become an international affair. The WHO and UNICEF promote universal immunization against six childhood diseases through the Expanded Programme on Immunization. The paper focuses on the process through which rules and procedures which have been formulated and standardized at the international level are realized at the local level, losing part of their rigidity on the way. It is pointed out that the integration of vaccination programmes in society has positive implications with regard to their continuity. On the basis of results of a field study in Gujarat, India, other approaches to enhance this continuity are also discussed.