Myanmar's coup risks a flood of vaccine-preventable disease

In line with the Sustainable Development Goals (SDGs), the reduction of the under-5 mortality rate to ≤25 deaths per 1000 live births by 2030 is the primary target of Myanmar’s national strategic plan for newborn and child health [1]. Myanmar made considerable strides in decreasing under-5 mortality with a 61% reduction between 1990 and 2019; however, the rate remained high at 45 per 1000 live births as of 2019 and more progress is needed [2]. In Myanmar, more than 45 000 under-5 children died in 2017 primarily due to newborn causes (46.7%), pneumonia (15.1%), diarrhea (8.7%) and injuries (8.5%) [2]. Because immunization is one of the most cost-effective and efficient ways to improve child health [3], Myanmar’s 1978 Expanded Program on Immunization (EPI) [4] was later broadened between 2016 and 2020 to include pneumococcal conjugate vaccines (PCVs), Japanese encephalitis (JE) and rotavirus vaccines [5]. Since then, EPI has been supplying nine types of vaccines for children in Myanmar