The Open Vaccine Journal, 2009, 2, 77-84 77 1875-0354/09 2009 Bentham Open Open Access The Trend of Mandatory Vaccination among Children in Egypt Amal Saad 1, * , Ashwak Safi-El-Dine 2 and Karima AI El-Shamy 3 1 Department of Environmental & Occupational Medicine, National Research Center, 2 Department of Public Health, Faculty of Medicine For Girls, Al-Azhar University for Girls, and 3 Department of Medical Physiology, National Research Center, Egypt Abstract: Increase of immunization coverage rate is the most effective method for decreasing the burden of childhood vaccine-preventable diseases. The objective of this work was to present an up-to-date review of the efficacy and the trend of mandatory vaccination regimens among children in Egypt, and its efficacy in decreasing the burden of vaccine-preventable diseases among children under 5 years in Egypt during the period 1995-2005. The sources of data depend on the bibliographic review on MEDLINE, published studies and reports, and WHO and EMRO databases that covered the period from 1995 to 2005. Statistic analysis of the available data revealed that the coverage rate of the existing vaccination program in Egypt has greatly expanded over years and is significantly associated with a swift reduction in the burden of the vaccine-preventable childhood diseases (measles, mumps, rubella, neonatal tetanus, pertussis, diphtheria, poliomyelitis, and hepatitis B). Varicella vaccine is strongly recommended to be added to the mandatory vaccination of children in Egypt. Key Words: Egypt, Children, Time trend, Mandatory vaccination coverage, and Childhood illness. INTRODUCTION Every year, three million children die world-wide from diseases that can be easily prevented with one to three doses of readily available vaccines. The United Nations Interna- tional Children’s Emergency Fund (UNICEF) advocated that protection against preventable diseases is a right of every child, and immunization is a hallmark of UNICEF's activities for more than two decades. Over the past years, the Egyptian Ministry of Health and Population (MOHP) has implemented a national program for childhood immunization. During this period, national guidelines on infection control have been developed by MOHP staff and Egyptian academic experts in collabora- tion with external partners from American Practitioners for Infections, WHO and NAMRU-3 [1]. A cornerstone strategy is maintenance of high levels of immunization coverage among children through routine immunization and implementation of supplementary immu- nization activities. Health authorities in Egypt have also taken important steps to strengthen the immunization coverage. These steps include: bolstering of the cold chain, introduction of vaccine vial monitors used in both routine immunization and campaigns, preparation of local registers based on frequent community census, strengthening of the system for defaulter tracing, as well as vaccine potency testing and the conduct of serosurveys [1, 2]. Immunization is extremely cost-effective, when a suitable vaccine has been developed. Coverage of existing vaccination aimed to eliminate or decrease the burden of childhood diseases has greatly expanded over years. The *Address correspondence to this author at the Department of Environmental & Occupational Medicine, National Research Center, Egypt; E-mail: amel_h3@yahoo.com present study aims to present an up-to-date review of the efficacy and the trend of mandatory vaccination regimens among children in Egypt, as well as its efficacy in decreasing the burden of vaccine-preventable diseases among children under 5 years in Egypt during the period 1995-2005. METHODOLOGY First Step: Collection of Data 1- Data of morbidity rates, number of cases, and immuniza- tion coverage of the mandatory vaccination for Egyptian children under 5 years in both sexes, were used in the present study. 2- Sources of Data: Bibliographic review on MEDLINE, published studies and reports, and WHO and EMRO databases that covered the period from 1995 to 2005. 3- The data were revised and filtered according to documen- tation; all non-documented data were excluded from the final statistical analysis. Second Step: Statistical Analysis of the Collected Data Statistical models are used to identify the direct statistical correlations between the predictor variables (the time in years as well as the immunization coverage) and the outcome of interest (e.g. morbidity rates of childhood diseases i.e. number of cases, incidence or prevalence of the diseases) through SPSS version 14.0. Pearson correlation coefficient and linear regression models were used in the analysis of the data. The significance level was considered at P-value < 0.05. RESULTS Measles Statistical analysis of the collected data proved that there was significant increase in the immunization coverage rate of