World Immunization Week 2021, 24th to 30th April
Prevention is better than cure. One of the best buys in healthcare is vaccination. We now have vaccines to prevent more than 20 life-threatening diseases. Immunisation currently prevents 2-3 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles. #VaccinesWork
The World Health organisation has chosen the theme “vaccines bring us closer” for this year’s theme marking world immunisation week. This is the crucial message in the middle of a global pandemic of an infectious disease for which we have amazingly now got very good vaccinations.
Infectious diseases are transmitted person to person, either through droplets or through bodily fluids contaminating the environment and then infecting others. We can do many things to reduce the risk of transmission, but many of these measures go against our instincts and our way of life. The way out is to stop the infectious organism circulating in the community.
What’s the point of vaccinating as many people as possible?
Firstly, vaccination protects the individual so that they are less likely to get sick and die if they are exposed to the infection. Secondly, we know that with most vaccines, those who are vaccinated and immune are also less likely to infect others. e infection and to protect those who cannot become immune for other reasons. this gives us a chance to protect those in the community who cannot become immune for various reasons by reducing, or even eliminating, the amount of infection circulating in the community. Many are aware of the concern that new variants of the Covid virus may be resistant to current vaccinations. New variants develop as the virus replicates and spreads within and between communities locally, nationally and internationally. A rapid, comprehensive, world-wide roll out of the vaccine would reduce circulation of the virus world-wide and, therefore, reduce the potential for widespread development and spread of variants.
Vaccination and Africa
The pandemic has meant all health systems have pivoted to the control and treatment of COVID 19, but this has had huge impacts on other essential healthcare services. In Africa, this means that some fragile health systems will be even further away from being able to provide Universal Health Coverage. Health workers are increasingly stressed and burnt out.
Controlling the pandemic as soon as possible is essential to allow health systems to get back on track to reduce the gross inequities in health outcomes.
WHO AFRO points out: “On the eve of the African Vaccination Week – the annual campaign for universal access to life-saving vaccines on the continent – new, early data shows that an estimated 16.6 million children in Africa missed planned supplemental measles vaccine doses between January 2020 and April 2021 and eight African countries reported major measles outbreaks that affected tens of thousands during the period. The outbreaks were largely due to low routine immunization coverage or delayed vaccination drives. In addition, the quality of measles surveillance in Africa fell to the lowest level in seven years in 2020, with just 11 countries meeting their target” There have also been outbreaks of yellow fever, cholera and meningitis because of worrying gaps in immunization coverage.
COVID 19 vaccination and Africa: “With a fast-moving pandemic, no one is safe, unless everyone is safe”.
Vaccination programs roll out globally has been grossly inequitable, with richer countries buying much greater access than poorer countries. Most sub-Saharan African countries have managed low levels of coverage so far. By 22 Apr 2021 – 946 million doses of vaccine had been given worldwide but these were very unfairly distributed.
The Director-General of WHO told a recent UN gathering: “Vaccine equity is the challenge of our time. And we are failing”. He said that of the 832 million vaccine doses administered, 82 per cent have gone to high or upper-middle-income countries, while only 0.2 per cent have been sent to their low-income peers. In high-income countries alone, one in four people has received a vaccine, a ratio that drops precipitously to 1 in 500 in poorer countries.
Although some countries in sub–Saharan Africa are manufacturing some vaccine, there are major barriers to access. The big hope is through the COVAX program which is forecasting that it could roll out almost 2.3 billion doses worldwide this year. Even if this optimistic forecast becomes a reality, this will still only be 27% of the population of lower-income countries across the world in 2021. And it is not on track, with reports this week that the programme had delivered about 40.2m or 21.5% of the 187.2m doses it planned to distribute during or by the end of May.
The world is on the brink of a catastrophic moral failure -and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries
Dr Tedros Adhanom Ghebreyesus, WHO Director-General
However, if pharmaceutical companies would release their intellectual property rights, vaccines could be manufactured everywhere, especially if richer countries supported the development of manufacturing capacity in poorer countries.
Vaccine equity at grassroots
Even when a country acquires a supply of vaccines, we see challenges to equity similar to those for any health care service. Vaccination should be distributed according to the greatest benefits to the individual and their community. However, this often does not happen unless proactive strategies are put in place and monitored. For example, people may be less likely to be vaccinated if they belong to a socially excluded group, are living with a disability or are socioeconomically disadvantaged. Wales has recognised this early and is seeing results from applying its vaccine equity strategy. We should try to leave no one behind and apply the principles of Gender Equity and Social Inclusion (GESI) to how vaccination programs are rolled out (THET have a useful GESI toolkit).
What can you do?
- Support your partners in their efforts for vaccine equity within country
- Sign the WHO Vaccine Equity pledge here
- Sign the global call from health workers and scientists for vaccine equity here
- Sign Oxfam’s petition for a people’s vaccine, not a profit vaccine here
- Donate to the WHO COVID19 response fund here.