In 1978 the Ministry of Health and Social Welfare in Liberia embarked on a major initiative to expand immunization activity countrywide. During its early development, the Expanded Program on Immunization (EPI) experienced the realities of establishing an immunization program in a developing country, including the high costs of maintaining mobile operations and a network of kerosene refrigerators. To improve vaccination coverage with diminishing resources, the Program recently began to place greater emphasis on integrating immunization activities into the existing infrastructure of hospitals, clinics, and health posts. Although the EPI goal and objectives, which in retrospect were highly ambitious, have not yet been achieved, it is possible to immunize effectively the children and women of Liberia. Effective vaccination coverage can be achieved by developing local strategies, coordinating resources, and most importantly, involving the community. International organizations must support such efforts by continuing to supplement essential supplies and by promoting research to develop vaccines that are more heat-stable and immunogenic.